Coronavirus statistics: is Italy the new China?

After several weeks of fighting the epidemic, the situation in China finally seems to come back under control. But can we say that even in our country we will see similar results? How are they similar and how do their situations differ? We therefore report the statistics on coronavirus in Italy and some interesting considerations published in the Lancet magazine by Andrea and Giuseppe Remuzzi of the University of Bergamo.

In China, thanks to very restrictive measures, coronavirus infections have decreased by over 90%. In Italy, it was initially decided to try to contain the epidemic with gradual measures, to avoid impacting too much on the economy, but the situation quickly got out of hand following a trend of exponential contagion. The main risk is the default of the national health system: in fact about 9-11% of coronavirus positive patients need intensive care, statistics say. As long as the number of sufferers remains below a certain threshold, the NHS has enough resources to provide adequate care for all. But what if the threshold is crossed? Someone must remain without assistance. If the infections continue to grow at the current rate, about 30,000 infected could be reached within a week, corresponding to about 3300 intensive care units only for coronavirus compared to about 5200 available. The question is: is the Chinese model replicable in Italy? Not exactly. In fact, the availability of resources in our country is more limited than the Chinese giant and society is very different.

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.

An in-depth look at the Italian situation

According to the latest estimates, there are 15,113 infected and 1,258 dead, which corresponds to a mortality of around 6.6%, much higher than the estimated 3-4% in China. A first big difference could be due to the society of the two countries, in particular the average age which is 45 years in Italy and 38 in China. We better identify the statistics on coronavirus patients in Italy. The average age of those who died in Italy is 81 years and more than two thirds of these patients had diabetes, cardiovascular disease, or cancer, or were ex-smokers. In most cases, patients had already compromised health conditions, but it is also true that if they did not contract acute respiratory distress syndrome (ARDS) caused by acute acute respiratory syndrome coronavirus 2 pneumonia (SARS-CoV-2), they would not they would die. Of the deceased patients, 42.2% were aged between 80-89 years, 32.4% were aged between 70 and 79 years, 8.4% were aged between 60 and 69 years and 2.8% were aged between 50 and 59 (those over the age of 90 made up 14.1%). The ratio between men and women is 80-20% with a median age more advanced for women (83.4 years for women versus 79.9 years for men).

: 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

Coronavirus statistics in Italy: a comparison with the epidemic in China

Let us now try to compare the coronavirus epidemic in China with the Italian model developed by researchers from the University of Bergamo. From a mathematical point of view, the trend of the contagions can be modeled with an exponential function with a base between 2.76 and 3.25 and the coefficient of the dependent variable (which represents the days) equal to 0.225. From this point of view, the trend seems to be similar to what we saw in the early stages of the Wuhan epidemic. If this were to continue, the full saturation of all intensive care places will be completed by 14 March. The only way to save yourself is to stop the exponential growth of the infections.

 In China, as of January 7, coronavirus statistics indicate a cumulative number of infected patients that began to diverge 20 days later. If the Italian epidemic follows a trend similar to the Chinese one, the number of new infected patients could start to decrease within 3-4 days from 11 March. Similarly, we can predict that the cumulative curve of infected patients will peak 30 days later, with the maximum load for clinical facilities for the treatment of these patients expected for that period. This is because although the drop in infections is positive, the onset of the disease can be long and the NHS will continue to be stressed. Of course, the social and geographical situation in Italy is very different: Wuhan is a metropolis with about 19 million inhabitants (including the whole suburban area). Since the infections in the areas of the province are much slower, the general trend may develop differently. But in densely urbanized areas such as Lombardy this is not necessarily the case.

: 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.

Coronavirus statistics in Italy: are the measures sufficient?
The capacity of the health system has been under enormous pressure, especially in Lombardy. Experts who, if the exponential trend of the model continues in the coming days, in a single week more than 2500 beds will be needed for ICU patients to treat the ARDS caused by SARS-CoV-2-pneumonia in Italy. In the meantime, the government is preparing to launch a move that will allow the health service to hire another 20,000 doctors and nurses and to supply another 5,000 fans to Italian hospitals. These are all correct measures, but the model says that they must be implemented urgently, within a few days. This is the real problem. It is hoped that the new restrictive measures will at least be able to give a few more days to the people who are working to strengthen our health system. You can do it, with everyone’s help.

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