The severity of clinical manifestations is primarily related to the age of the subject and, secondly, with its conhorbidity.
We're seeing an increase in cases. How many of these cases will need hospitalization?
Easy question but whose exact answer is extremely difficult.
- Francia: https://www.data.gouv.fr/fr/datasets/donnees-hospitalieres-relatives-a-lepidemie-de-covid-19/
- United Kingdom: https://coronavirus.data.gov.uk/healthcare
- Belgium: https://epistat.wiv-isp.be/covid/
- Denmark: https://www.ssi.dk/sygdomme-beredskab-og-forskning/sygdomsovervaagning/c/covid19-overvaagning
Thankfully Australia offers the solution to both problems: publishes a lot of data on the health surveillance of infectious diseases (http://www9.health.gov.au/cda/source/cda-index.cfm) and now there it's full winter.
We're learning about this infection and the way it spreads, now we have so many experiences from other countries in the world to think about.
In some states it's all pretty quiet for months despite the virus entering their borders (South Korea, Taiwan, Greece, New Zealand).
Others do not appear to be able to contain the first wave (Mexico, for example).
Other countries are facing a second wave (Iran, Serbia, Israel).
In the US in some states it's all under control, others are in trouble.
Sweden applied soft measures early on, avoiding a lockdown, had far more deaths than “Neighbors” but less than other European countries.
There are very different scenarios in the world.
What we can learn from these situations:
-should not underestimate an increase in cases. An increase in cases is followed by, late, necessarily the increase #8217 in admissions and deaths. The ratio of curves depends on the testing capabilities, average age #8217 of infected individuals and the capacity of health systems (see USA).
-test, "It's not just about the #8217, it's about the same way," he said. (Korea).
-lockdown is the most extreme measure, very effective in bringing down the contagio>e-contaminas but harmful to the #8217;economy (Italy).
-lifestyle has a lot of influence on infections. The pre-epidemic Italian lifestyle led to R0 3-3,5. The lockdown at 0,3-0,5.
Between these two extremes there are so many nuances and the current lifestyle allows an R0 close to ’1.
-Spain, climatically and culturally close to us, is facing a new increase in cases these days and some areas have been put in lockdown.
We can say that a second wave will not necessarily wait for the cold weather.
September will be an extremely critical moment, in my opinion: we will see at the same time the repopulation of cities, the reopening of many businesses/activities and the reopening of schools.
There will be a gradual reduction in activities and life to the ’open.
What can we do?
We must work today to make people understand that it is essential to continue to keep all the attention, social distance, masks indoors or when you can't keep your distance, hygiene standards.
We need to install and incentivize the #8217 use of immune to facilitate tracking.
We must always pay close attention to hospitals and RSA (almost the 40-50% of the infections come from here).
We need to train citizens to understand what is going on and to self-exate at the first symptoms.
We need to encourage flu vaccination both to reduce flu mortality and to reduce cases that could be confused with COVID.
Insist that smart working continue.
Public Health will need to work hard to ensure testing, contact tracking and isolation and to filter cases from ’foreign.
The Italians have been better than many others in both the lockdown and the later stages, we must continue on this path and avoid new waves.
Clinical course of COVID-19 patients: share of asymptomatic patients, mild shapes, severe, incubation time, duration of the contagious phase.
SARS-COV-2 is a virus that we've been getting to know these months, extremely contagious that can occur with very different forms from subject to subject, going from completely asymptomatic forms to fatal forms in a few days.
The duration of the incubation period, the contagious phase and symptomatic phase are extremely variable.
I did a Literature review to try to do some’ and summarized the MEDI data in the attached chart.
This graph is useful for having an epidemiological’epidemiological idea of the behavior of the virus but of course it should not be interpreted as a means of predicting the #8217;performance of the individual patient.
We often see patients with extremely prolonged hospitalizations and positive swab even after 3 weeks from the resolution of the symptoms.
And’ clear to everyone that the real number of infected is significantly higher than stated by the official numbers that refer to positive tampons.
Admitting as real the declared number of deaths, if we increase the denominator it lowers the real lethality of the virus.
I'll point out a’interesting analysis to try to calculate this value