Ferrante Pierpaolo
Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian National Workers' Compensation Authority (INAIL).
J Public Health Res. 2021 Oct 6;11(1):2201. doi: 10.4081/jphr.2021.2201.
The novel coronavirus disease is an ongoing pandemic that started in China in December 2019. This paper is aimed at estimating the first two infections waves in Italy in relation to adopted health policies.
We moved deaths of the Italian COVID-19 registry from recorded to infection date by the weighted moving average. We considered two infection fatality ratios related to the effective or saturated health system, we estimated the likely incidence curve from the resulting deaths and evaluated the curve shape before and after the national health policies.
From the 24th of February 2020 to the 7th of February 2021, we estimated 6,664,655 (4,639,221-9,325,138) cases distributed on two waves. Suitable daily infection fatality rates were 2.53% within the first wave and 1.15% within the second one. The first wave (February-July 2020) had its peak on the 14th of March 2020 (26,575). The second wave (August 2020-February 2021) was fatter with the peak on the 12th of November (60,425) and a hump in December before decreasing to 26,288 at the end. Adopted health policies were followed by changes in the curve rate.
Tracing infection contacts and quarantining asymptomatic people reduced virus lethality in the second wave. Restriction on population mobility is effective within a suppression strategy, distance learning reduces contacts among families. Removal of restrictions should be implemented by sequential steps for avoiding a quick rising of incident cases. A reasonable public health daily goal to control both virus spread and lethality could be to find at least 87 cases for each death.
新型冠状病毒病是一场于2019年12月在中国爆发的持续大流行。本文旨在评估意大利前两波感染与所采取的卫生政策之间的关系。
我们通过加权移动平均法将意大利新冠病毒病登记中的死亡时间从记录时间转换为感染时间。我们考虑了与有效或饱和卫生系统相关的两种感染致死率，从由此产生的死亡人数估计了可能的发病率曲线，并评估了国家卫生政策前后的曲线形状。
从2020年2月24日至2021年2月7日，我们估计两波疫情中共发生了6,664,655例（4,639,221 - 9,325,138例）感染。第一波疫情期间合适的每日感染致死率为2.53%，第二波为1.15%。第一波疫情（2020年2月至7月）于2020年3月14日达到高峰（26,575例）。第二波疫情（2020年8月至2021年2月）规模更大，于11月12日达到高峰（60,425例），12月出现一个小高峰，随后在月底降至26,288例。所采取的卫生政策之后，曲线速率发生了变化。
追踪感染接触者并对无症状者进行隔离降低了第二波疫情中的病毒致死率。在抑制策略中，限制人员流动是有效的，远程学习减少了家庭之间的接触。应分阶段取消限制措施，以避免病例数迅速上升。控制病毒传播和致死率的一个合理的公共卫生每日目标可能是每发现一例死亡病例至少追踪87例病例。
