Coronavirus, Update April 25th, Day 65

Coronavirus, Update April 25th, Day 65

Encouraging numbers.   In Lombardy, 713 positive out of 6.400 people tested and over 12.000 tests (80 and 219 respectively in Milano and the surrounding province).   Positive data for the healthcare system as well with 302 people discharged and 32 discharged from the ICU.

Total deaths reached 163, a seemingly fixed number. Conspiracy theorists are saying they are “spreading out” this number….even if it was the case, what does it change?  Total deaths in Italy were 415.

In the 4th slide, in a kind of perspective, I have aligned the regions for positive tests, people tested and total tests over the last three days.

Key concepts to know

Leggi l’articolo in Italiano

I hope you can read these numbers as they may need to be enlarged.   I can’t find a better system to show all of this data together, without running the risk of creating a confusing table.  The data covering the number of people is still inconsistent but it’s overdue that they are included. From tomorrow, we may have enough to change some of the graphs on the summary charts on page 4.

On the “traffic light” page, the 5th slide, you’ll find that green prevails with several regions closing to 0.  Today the average yellow value is 3 while the red scale is 6.   When we started these were at 8 and 16 respectively. This is enough to understand how much progress we’ve made and that the epidemic is finishing.

I would like to call your attention to the projection curves and in particular to the situation of the “home isolations”, which has been a concern for us since we underlined how these cases were being handled by Lombardy and the strong impact on the data for the entire country.  We have yet see real progress being made here. We are not talking about abstract  or complex statistical analysis. This is a large number of people who are still considered infected which are not being re-contacted or given new tests which will allow them to leave isolation without putting family and others at risk.    These people, are only small part of the people actually quarantined after contracting the virus. We would love to shed light on all the others who have not been traced although we appreciate the difficulty in reaching hundreds of thousands of people.  We would be happy to see the official numbers track the actual course of the epidemic and reflect reality more faithfully.

Outside of Lombardy, the green curves for the regions are showing us that Piemont, Liguria, Lazio and Puglia remain at the peak of the home isolations while other regions have surpassed or are moving towards a resolution.  The example of Veneto and Emilia-Romaga, both hit quite hard by the virus, show that things can be done well, even in an emergency  or at least once the critical phase has passed. Among the regions less exposed, an honorable mention goes to Umbria, Valle d’Aosta, Friuli VG, Trentino AA, Molise, Basilicata and Sardegna

I would also like to touch upon the report of the Istituto Superiore di Sanita, to which I referred to yesterday regarding the locations of the exposure of the infection (in synthesis: RSA/retirement, communities for the disabled 44%, hospitals/clinics: 11%, workplace 4%). This is partial data and the period refers to the last weeks of the lockdown but it reminds us of how long we’ve asked for this information,  how important it is especially to determine the strategy to combat the virus. A country without data is blind. Information, even partial, is a candle which helps us move forward in the dark.

It makes one think, for example, the lack of cases resulting from possible exposure in supermarkets which, over the last weeks, has been one of the few potential places of exposure. This bodes well for the next phase and the possibility to create safe conditions by using elementary distancing measures as well as wearing masks.  

We also don’t find evidence of significant open air infections which is a major focus of the media and the authorities.  I am personally convinced, and not just from today, that allowing walks, runs or even a moderate concentration of people on beaches, in parks or squares, in open restaurants, will not result in a significant increase in new infections.

I may be an incurable optimist but I strongly believe that a population, which has remained home for such a long time, can face the next phase with the necessary level of responsibility, especially in order to gain back our freedom, our lives.  It is an important step, which is within our reach and deserves to be faced, not with angst but with pride and civil commitment alongside our neighbors, our communitie, for everyone’s survival and happiness. 

Once it a while, we are called to do it, as other generations have done in the past.. 

Now is our time.  

 

Dr. Paolo Spada
Link to my Facebook page

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He is a vascular surgeon at the Humanitas Institute in Milan: this article, also published on his Facebook profile, is a daily update regarding the trend of COVID-19 in Italy based on official data published after 6 pm by the Ministry of Health.

The reports I publish here are based on official information. I am a doctor, and I report the numbers that the Ministry of Health issues every evening after 6pm. My job was to automate a system of graphs that show the same data over time, and divided by areas, a few minutes later the dissemination of raw data. It is a useful job, first for me, to understand the progress of the epidemic, but that many websites, and newspapers, do better than me, with interactive and much more complete graphics (as well as all over the world, not Italy only). What I add, taking advantage of some years of experience in the development of algorithms applied to medicine, is a series of projections, that is, attempts to predict the epidemic in the following weeks. It is not a question of wanting to see in the crystal ball, but only of getting an idea of ​​the possible scenario, which day by day you can glimpse on the basis of the real data available. The algorithms were initially designed on the basis of the data of the experience of the epidemic in China, the only available benchmark, against which our numbers, which can be almost superimposed in the first few weeks, vary significantly over the course of days. The projections therefore change, as data is acquired, and are also subject to “assumptions” which presuppose a certain degree of arbitrariness. Among the various hypotheses, I try to represent the “minimum” scenario, that is, the one that will probably happen even in the best of cases, or for good that the contagion goes from here on. Compared to this “little but safe” (which however is never safe) I prefer to contemplate more severe scenarios only if supported by further evidence. Finally, it should be added that the same official data are often incomplete, discontinuous, and discordant in the method of collection between one area and another in the country. An example is that of the number of infections, widely and variously underestimated, but it is not the only one, unfortunately. Although with many limitations, and lacking in the representation of the spread spread in the asymptomatic or paucisymptomatic population, these reports still provide a reading of the health burden, the effort required of hospitals, intensive care, and the number of deaths. The emergency is here, and this remains my focus, with the sole purpose of being somehow useful, and in absolute good faith. I therefore distrust anyone from the improper use, or in any case not previously authorized, of the images and comments. The content of these posts is the result of an initiative carried out in a personal capacity, in no way related to my professional activities and the institutions to which I belong. On the other hand, I have an obligation to mention, with pride, the commitment and the high social and human profile shown by doctors, nurses, and by all the staff and management of Humanitas Research Hospital in coping, at the forefront of this dramatic emergency.