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"Leaving the number of SWABS in the hands of the regions creates chaos. The Korean model must be followed"
Coronavirus. The decision by the British authorities to "let the epidemic out" is causing a sensation by placing almost no restriction on crowding (in the hope that this will lead to rapid immunization in the infected) and, at the same time, placing high-risk people in quarantine, such as example, the elderly. On the strategies that oversee (or should oversee) the tackling of epidemic emergencies we reinterviewed (see here and here) prof. Giulio Tarro of whom we report his, just published, scientific article on Coronavirus.
Interview supplemented by some explanatory tables taken from this source
by Francesco Santoianni
In the meantime, what are the possible strategies for dealing with an epidemic
"In epidemics such as influenza, generally, there is a tendency to reduce the size of the epidemic peak by" spreading "it in the longest period possible; this is to avoid the collapse of the health system following the high number of hospitalizations."
To achieve this, there are various strategies
It goes without saying that each of these strategies must be chosen by analyzing precise data; among these, the reliable estimate of the non-infected, of the infected and of the people they could infect is fundamental. In this regard, for example, in South Korea, we are proceeding not only to swab people who do not show particular clinical pictures but, even, by tracking their movement through their mobile phone, thus determining (once we know the their possible positivity) the danger represented by them.
In Italy, however, the number of swabs and the procedures for carrying them out is essentially left to the arbitration of the Regions; a chaos that prevents any reference model from being determined. With this situation, it is not clear why among the various strategies that could have been adopted, after the home isolation of the population not engaged in certain work activities, there is even a quarantine for all people. Measure that it is not clear how long it can last. "
You stated that you believe the real number of people infected in Italy at least 4 or five times higher than that declared by the government
"I specify that mine is an estimate that is based on the interpolation of the data referring to those infected in respiratory viral epidemics that have occurred in Italy in recent decades. From this it can be deduced that the lethality rate of COVID 19 is considerably lower than 1%: a This finding was also incorporated into a study by colleague Anthony Fauci of the US National Institute of Allergy and Infectious Diseases, based on a report focusing on 1099 laboratory-confirmed COVID-19 patients from 552 Chinese hospitals.
This suggests that the overall clinical consequences of COVD-19 could ultimately be similar to that of severe seasonal flu, which has a lethality rate of around 0.1%, or pandemic influenza such as that of 1957 or of 1968, rather than those of SARS or MERS, characterized respectively by a lethality of 10% and 36% and which, incredible to say, did not produce any alarmist campaign in our country. "
And the current clogging of the intensive care units, especially in Lombardia, which show us every day on TV how do you explain it?
"In the meantime, I remember that according to the World Health Organization, our country has halved the number of beds for acute cases and intensive care, from 575 per 100,000 inhabitants to 275 today. A scandalous cut of 51%, operated progressively from 1997 to 2015, which brings us to the bottom of the European rankings. Among other things, it should be said that, despite the images of what was happening in China were there for all to see, it would be said that - unlike other countries such as France - very little has been done in Italy to prepare for the epidemic, plus it should be noted that, following the emphasis of the threat posed by COVID 19, patients who could have been treated in other facilities were brought to the intensive care units As regards, then, the peak of deaths recorded in Lombardia it is to be noted that this region is in first place for the making of tampons; this, combined with the casual praxis to present, even in institutional settings, as "coronavirus deaths" patients who, on the other hand, could have "coronavirus deaths" (ie suffering from previous pathologies that caused death) could explain the "mortality peak for COVID19" of Lombardia. For this reason, it would be appropriate before identifying the primary cause of death in COVID19, carrying out the necessary pathological investigations and, above all, defining a standard to be applied throughout the national territory. A question that - in my opinion - still does not have the space it deserves. "
