Friday 29 January 2021 18:01
Italy Covid alarm: cases may be 50% higher than thought
The Covid-19 situation in Italy could be much worse than has been thought. The number of new daily cases may be 40-50% higher than official figures, according to an article in La Repubblica on Friday.
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The Covid-19 situation in Italy could be much worse than has been thought. The number of new daily cases may be 40-50% higher than official figures, according to an article in
La Repubblicaon Friday. In the midst of a political crisis and with the country on autopilot pending the outcome of consultations to cobble together a new government, a dossier has arrived on the desk of outgoing Prime Minister Giuseppe Conte that dramatically calls into question the perceived trend of the pandemic over the last two months.
"The total number of cases has been underestimated due to a decrease in the number of swab tests in mid-November 2020," the analysts write. They raise two concerns: the curve of the infection is not falling as rapidly as the bulletins issued by the Ministry of Health indicate; and the data are currently unreliable and therefore difficult to use deciding how to contain the virus.
The dire health and social impact of Covid-19 is considered a matter of national security and thus a priority for the Italian intelligence agencies. With the help of statisticians and mathematicians, they developed a predictive model that appears to work. On December 25th, the model estimated that Italy would reach a total of 86,500 deaths in the next thirty days: on January 26, the count of Covid victims reached 86,422, only 0.09 percent out. Based on the proportion of new cases in intensive care and the daily number of positives reported, the authors calculate that the Italian health system is vastly underestimating the number of infections.
"Looking at intensive care at the end of the year, it can be inferred that the epidemic improved mid-December. This recovery was not detected by the national numbers due to the small number of tests carried out at the time," the dossier states. Just before Christmas, the curve began to rise, demonstrated by the fact that the number of patients in intensive care did not decrease as expected: in fact, the figure remained stable at around 2,580. However, health ministry bulletins at the time were reporting that from the peak of 13 November (40,902 new cases) the number of new cases had gradually decreased, except for a brief jump around 25 December.
The statistics of the pandemic are frequently misunderstood, misrepresented and misleading, usually unintentionally. Here the error seems to lie in which tests have been included in the count. In the week of 11-18 November, 1.5m tests were carried out, the highest number ever. From then on, the number of tests began to fall, to 868,000 in the week of 23-30 December, only to then leap again to 1.4 million from 13 January. However, this increase was due to the inclusion of rapid antigen tests. Previously, only molecular tests were calculated.
"The inclusion of rapid testing has made it impossible to make comparisons with the past. Moreover, some regions don't distinguish between the molecular test and the rapid tests, with obvious repercussions for the calculation of all values, including the ratio of positives to swabs." The reporting method must be reviewed, the report argues, excluding rapid tests, and particularly those taken to see if patients have recovered, which then need to be confirmed by a molecular test. "Only first diagnosis swabs give a picture of the real epidemiological situation, and since mid-November we have seen a sharp drop in this type." To date, 65% of tests have been to ascertain whether patients have recovered, with obvious implications for the curve.
Repubblica asked Professor Pierluigi Lopalco, internationally renowned epidemiologist, for his reaction. "It’s true that new cases are underestimated, even more than the dossier claims. And it’s true that at the moment it’s impossible to assess the trend. The data we have come from monitoring systems, which by their very nature underestimate the phenomenon.”
It has puzzled me for some time why Italy seems to be doing so well compared to many other countries, despite the fact that the "
English variant" may have been circulating for months. As I write, the government is thought to be on the verge of announcing the easing of restrictions in many regions, despite the intelligence report calling for extreme caution. The report argues that if the country lowers its guard now, when the benefits of the stricter lockdown over Christmas are ending and the English and Brazilian variants of Covid-19 are circulating, "it could lead to a new uncontrolled upsurge of the epidemic, overloading a health system that is already reaching saturation point.”