The COVID-19 infection: lessons from the Italian experience

Abstract

The first case of the new coronavirus, COVID-19, was reported in China on 17 November 2019. By the end of March 2020, the rapid global spread of infection affected over 1 million people. Italy is one of the countries most impacted, with over 100,000 positive cases identified. The first detected cases were reported on 21 February 2020 in two Italian towns: Vo' Euganeo in the Province of Padua, Veneto region, and Codogno, in the Province of Lodi, Lombardy. In the next weeks the epidemic spread quickly across the country but mainly in the north of Italy. The two regions: Veneto and Lombardy, implemented different strategies to control the viral spread. In Veneto, health personnel tested both symptomatic and asymptomatic subjects, while in Lombardy only symptomatic cases were investigated. We analyzed the evolution of the epidemic in these regions and showed that testing both symptomatic and asymptomatic cases is a more effective strategy to mitigate the epidemic impact. We strongly recommend that decision-makers: ensure early isolation of symptomatic patients and rapid identification of their contacts; maximize testing rapidly, especially among people with multiple daily contacts with infected populations, high exposure to the public in essential services; rapidly increase diagnostic capacity by mobilizing trained personnel capable of performing rRT-PCR on respiratory samples; equip the population with protective masks.

Keywords: COVID-19; Pandemic; Virus spread.

Fig. 1

The relationship between COVID-19 testing success (a ratio of positive tests and total tested) and case fatality rate (CRF) (a ratio of deaths and positive tests) in 14 Italian regions with at least 10 cases of deaths due to COVID-19 as of 22 March 2020 (Spearman rank correlation coefficient ρ = 0.657; p < 0.01). Data source: www.protezionecivile.gov.it/

Fig. 2

The relationship between COVID-19 testing success (a ratio of positive tests and total tested) and case fatality rate (CRF) (a ratio of deaths and positive tests) in 21 countries with more than 10 deaths as of 3 March 2020 (Spearman rank correlation coefficient ρ = 0.739; p <  < 0.01). Data sources: for total tests performed—https://ourworldindata.org/ and for positive tests and deaths—www.who.int/