Institute of Clinical Physiology of the National Research Council (CNR), Grande Ospedale Metropolitano (GOM) Bianchi-Melacrino-Morelli of Reggio Calabria, Italy.
Department of Laboratory Medicine, University-Hospital of Padova, Padova, Italy.
Eur J Public Health. 2021 Feb 1;31(1):7-12. doi: 10.1093/eurpub/ckaa221.
Italy was the second country in the world, after China, to be hit by SARS-CoV-2 pandemic. Italy's experience teaches that steps to limit people's movement by imposing 'red zones' need to be put in place early by carefully identifying the cities to be included within these areas of quarantine. The assessment of the relationship between the distance from an established outbreak of SARS-CoV-2 infection with transmission-linked cases and mortality observed in other sites could provide useful information to identify the optimal radius of red zones.
We investigated the relationship between SARS-CoV-2 cases and the distance of each Italian province from the first outbreak of SARS-CoV-2 epidemic in Italy (the city of Lodi placed in the Lombardia region). In 38 provinces of Lombardia and neighboring regions, we performed a breakpoint analysis to identify the radius of the red zone around Lodi minimizing epidemic spread and mortality in neighboring cities.
In all Italian provinces, a non-linear relationship was found between SARS-CoV-2 cases and distance from Lodi. In an analysis including the provinces of Lombardia and neighboring regions, SARS-CoV-2 cases and mortality increased when the distance from Lodi reduced below 92 and 140 km, respectively, and such relationships were amplified by ozone (O3) pollution.
The breakpoint analysis identifies the radius around the outbreak of Lodi minimizing the public health consequences of SARS-CoV-2 in neighboring cities. Such an approach can be useful to identify the red zones in future epidemics due to highly infective pathogens similar to SARS-CoV-2.
意大利是继中国之后全球第二个遭受 SARS-CoV-2 大流行冲击的国家。意大利的经验表明，需要通过仔细确定纳入隔离区的城市，尽早采取限制人员流动的措施，实施“红区”。评估 SARS-CoV-2 感染爆发与在其他地点观察到的与传播相关的病例之间的距离的关系，可以为确定红区的最佳半径提供有用的信息。
我们研究了 SARS-CoV-2 病例与意大利每个省份与意大利 SARS-CoV-2 疫情首例（位于伦巴第地区的洛迪市）的距离之间的关系。在伦巴第和邻近地区的 38 个省份中，我们进行了断点分析，以确定围绕洛迪的红区半径，从而最大限度地减少邻近城市的疫情传播和死亡率。
在意大利所有省份，SARS-CoV-2 病例与距离洛迪的距离之间都存在非线性关系。在包括伦巴第和邻近地区的省份进行的分析中，当距离洛迪减少到 92 公里和 140 公里以下时，SARS-CoV-2 病例和死亡率分别增加，而臭氧（O3）污染加剧了这种关系。
断点分析确定了围绕洛迪爆发的半径，最大限度地减少了邻近城市 SARS-CoV-2 的公共卫生后果。这种方法可以用于确定未来因类似于 SARS-CoV-2 的高传染性病原体而引发的疫情的红区。
