Background
The first outbreak of COVID-19 in Italy occurred during the second half of February 2020 in some areas in the North of the country. Due to the high contagiousness of the infection, further spread by asymptomatic people, Italy has become in a few weeks the country with the greatest number of infected people in the world. The large number of severe cases among infected people in Italy led to the hospitalization of thousands of patients, with a heavy burden on the National Health Service.
Methods
We analyzed data provided daily by Italian Authorities for the period from 24 February 2020 to 30 March 2020. Considering such information, we developed a forecast model in real-time, based on the cumulative log-logistic distribution.
Results
A total of 101,739 infected individuals were confirmed until 30 March 2020, of which 14,620 recovered or discharged, and 11,591 deaths. Until the same date patients quarantined at home were 43,752, whereas hospitalized patients were 31,776, of which 3981 in intensive care. The active cases (i.e. the number of patients not yet recovered until that date) were 75,528. The forecast model estimated a number of infected persons for Italy of 234,000 about, and a duration of the epidemic of approximately 4 months.
Conclusions
One month after the first outbreaks there seemed to be the first signs of a decrease in the number of infections, showing that we could be now facing the descending phase of the epidemic. The forecast obtained thanks to our model could be used by decision-makers to implement coordinative and collaborative efforts in order to control the epidemic. The pandemic due to novel Coronavirus must be a warning for all countries worldwide, regarding a rapid and complete dissemination of information, surveillance, health organization, and cooperation among the states.
The initial detected outbreaks of COVID-19 in Italy occurred during the second half of February 2020 in some areas in the North of the country. First cases were diagnosed in southern Lombardy on February 21, on the border of the Veneto and Emilia Romagna regions [5,6,7]. On February 23, 11 municipalities were quarantined: nobody could enter and leave those territories (DL n. 6, 23 February 2020) [8]. Quickly other outbreaks occurred in the North of the country, requiring a wider extension of the area of limited human activities to various northern regions including Lombardy, Emilia Romagna, and Veneto (DPCM of 4 March 2020) [9]. Despite the drastic restrictions imposed by the Italian Government in those areas, several other outbreaks began in other areas of northern Italy, forcing the Authorities to extend the previously adopted restrictions to the entire national territory (DL of 9 March 2020, and DPCM of 22 March 2020) [10, 11]. Due to the high contagiousness of the infection, further spread by asymptomatic people [4, 12], in few weeks Italy became the country with the greatest number of infected people after China (confirmed cases greater than 80,000 from 26 March 2020). As a matter of fact, the virus spread globally so fast that currently the country with the highest number of cases is the US [13]. The large number of severe cases among infected people in Italy led to the hospitalization of thousands of patients [14, 15], with a heavy burden on the National Health Service [7]. In particular, the most affected regions were Lombardy and Emilia Romagna, with more than half of the total cases. It is reasonable to assume that the large spread of the novel Coronavirus in these regions was due to the development of the first outbreaks which caused a high number of people infected before the social distancing imposed by Government. Starting from 1 month after the initial outbreak in Italy, we reported the current status and proposed a forecast model in real-time to estimate its evolution in terms of epidemic duration and potential number of infected persons. This information could be applied in surveillance to inform clinicians and decision-makers to take coordinative and collaborative efforts to control the pandemic.
There are all kinds of mixed reviews as to why it spread to and through Northern Italy so fast.