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Review
. 2020 Apr 11;395(10231):1225-1228.
doi: 10.1016/S0140-6736(20)30627-9. Epub 2020 Mar 13.

COVID-19 and Italy: what next?

Andrea Remuzzi  1 , Giuseppe Remuzzi  2
Affiliations
Review

COVID-19 and Italy: what next?

Andrea Remuzzi et al. Lancet. .

Abstract

The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has already taken on pandemic proportions, affecting over 100 countries in a matter of weeks. A global response to prepare health systems worldwide is imperative. Although containment measures in China have reduced new cases by more than 90%, this reduction is not the case elsewhere, and Italy has been particularly affected. There is now grave concern regarding the Italian national health system's capacity to effectively respond to the needs of patients who are infected and require intensive care for SARS-CoV-2 pneumonia. The percentage of patients in intensive care reported daily in Italy between March 1 and March 11, 2020, has consistently been between 9% and 11% of patients who are actively infected. The number of patients infected since Feb 21 in Italy closely follows an exponential trend. If this trend continues for 1 more week, there will be 30 000 infected patients. Intensive care units will then be at maximum capacity; up to 4000 hospital beds will be needed by mid-April, 2020. Our analysis might help political leaders and health authorities to allocate enough resources, including personnel, beds, and intensive care facilities, to manage the situation in the next few days and weeks. If the Italian outbreak follows a similar trend as in Hubei province, China, the number of newly infected patients could start to decrease within 3-4 days, departing from the exponential trend. However, this cannot currently be predicted because of differences between social distancing measures and the capacity to quickly build dedicated facilities in China.

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Figures

Figure 1
Figure 1
Measured and predicted number of patients reported to be infected in Italy using an exponential curve Panel A shows number of infections in previous days and B shows projections for the coming days.
Figure 2
Figure 2
Measured and predicted number of patients in intensive care units in Italy using an exponential curve Panel A shows number of patients in intensive care units in previous days and B shows projections for the coming days. The dotted line represents the estimated capacity of intensive care beds in Italy.
Figure 3
Figure 3
Fitting of cumulative curve of measured infected patients in Hubei, China, with an exponential curve The dotted line represents the timepoint of the infection outbreak in Italy. It is expected that the number of cumulative patients who are infected will start to deviate from the exponential low in 3–4 days. The plateau of the cumulative curve will be reached just over 30 days from March 11, 2020.
See this image and copyright information in PMC

Comment in

  • COVID-19 in Europe: the Italian lesson.
    Saglietto A, D'Ascenzo F, Zoccai GB, De Ferrari GM. Saglietto A, et al. Lancet. 2020 Apr 4;395(10230):1110-1111. doi: 10.1016/S0140-6736(20)30690-5. Epub 2020 Mar 24. Lancet. 2020. PMID: 32220279 Free PMC article. No abstract available.
  • Handling the COVID-19 pandemic in the oncological setting.
    Mussetti A, Maluquer C, Albasanz-Puig A, Gudiol C, Moreno-Gonzalez G, Corradini P, Sureda A. Mussetti A, et al. Lancet Haematol. 2020 May;7(5):e365-e366. doi: 10.1016/S2352-3026(20)30108-3. Epub 2020 Apr 1. Lancet Haematol. 2020. PMID: 32246913 Free PMC article. No abstract available.

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