Gimbe: the virus advances but weak measures, we go towards the lockdown

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October 20, 2020 Faced with a contagion curve that rises more and more every day and hospitals fill inexorably, "as in a de'ja'-vu within a few days, the Government introduces further restrictive measures in an attempt to curb the epidemic".

This was stated by Nino cartabellotta, president of the Gimbe Foundation, according to which "the need to issue two Dpcm in a week confirms that the containment of the second wave is entrusted to the evaluation of the numbers of the day with the progressive introduction of too weak measures to bend a curve of contagions in a dizzying rise ".

"Failure to prevent the epidemic curve from rising when we had a great advantage over the virus - explains Cartabellotta - now imposes the need for containment measures capable of anticipating the virus. These measures must be planned on predictive models at least 2-3 weeks, because the "non-strategy" of chasing the numbers of the day with a dripping of Dpcm which, week after week, impose the continuous need to reorganize itself on various fronts, will inevitably push the country towards that new lockdown that nobody wants and that does not we can afford ".

The numbers reported daily by the Civil Protection bulletin, remembers the Gimbe Foundation, do not at all reflect the cases of the day because from the infection to the notification there is an average delay of 15 days, as the average time between contagion and the appearance of symptoms is 5 days (range 2-14 days).

According to the Istituto Superiore di Sanità, the median time between the onset of symptoms and sampling / diagnosis is 3 days (week 7-13 October), but it could lengthen considering the laboratory analysis and reporting times.

Moreover, for asymptomatic cases it is not known because the timeliness in requesting the tampon depends on the effectiveness of the testing & tracing activity.Moreover, the communication of new cases from the Regions to the Civil Protection does not take place in real time: for example, in the week 5-11 October less than one third of cases were notified within 2 days of diagnosis, 54% between 3 and 5 days and 14% after more than 6 days;

however, this delay gradually increases due to the growing number of cases.

It should also be considered that the difficulty of the testing & tracing system "increases the probability of underestimating cases, because the expansion of the pool of non-isolated asymptomatic patients further accelerates the spread of the infection".

Therefore, "the effects of the restrictive measures, which cannot be assessed before 2-3 weeks, will probably be neutralized by the growth trend of the epidemic curve".

The second component that risks making the situation explosive is "the lack of alignment between the measures of the two DPCM and the provisions of the circular of 12 October of the Ministry of Health".

In the document "Prevention and response to COVID-19" four scenarios of evolution of the epidemic are outlined in relation to different levels of risk accompanied by relative measures to be implemented in the various sectors.

"Considering that several Regions - explains Cartabellotta - are now in the high / very high risk phase, it is inexplicable that the recommended measures were not introduced by the new DPCM, which followed the indications of the Technical Scientific Committee, nor implemented by the Regions, which they participated in the drafting of the document ".

The third component of the "non-strategy" is the lack of a system approach based on responsibility and alliance between politics and citizens, as well as on the efficiency of health services.

"Numbers aside - specifies Cartabellotta - the containment of the second wave inevitably had to rest, already at the end of the lockdown, on three integrated pillars: maximum adherence of the population to recommended behaviors, strengthening of local and hospital health services and collaboration in full harmony between the Government , Regions and Local Authorities ".