Report. In Italy, deaths are still on the rise and admissions have peaked. Compared to before, the epidemic is distributed throughout the entire country.

The second wave is increasingly similar to the first (or worse)

With almost 38,000 cases and 636 deaths, the reasons for calling for a new lockdown appear more and more solid. The number of patients hospitalized has exceeded the peak of the first wave: now there are more than 33,000. In the intensive care units, 89 more beds were occupied in 24 hours, for a total of 3,170. The number of swabs performed, almost 235,000, is showing a ratio between positive cases and tests at a steady 16%. However, excluding repeated swabs and those made for screening, the percentage rises to 28%. One test out of four gives a positive result.

The new high reached by the number of deaths—identical to that of April 6—makes the second wave look more and more similar to the first. The lethality of the virus is clearly visible at the population level. According to the latest report of the Daily Mortality Surveillance System, which samples about 20% of Italians, both in central-northern and central-southern regions, at the end of October there was already an increase in mortality of about 50% compared to previous years. Given that during the last week the deaths due to COVID have been more than three times higher than those recorded at the end of October, the impact will presumably be worse in the next reports.

In the first wave, the lockdown was decided with less than two hundred deaths per day and seven hundred patients in intensive care. If we look at today’s figures, the same restrictive measures would seem to be mandatory. But there are important differences from back then. At that time, about two thirds of the hospitalized patients and victims were located in Lombardy alone.

Today, the epidemic is distributed throughout the country, and this reduces the pressure on individual regions. But on the other hand, it also exposes the most fragile regions to the virus. The GIMBE weekly report summarizes the current situation: “A slight slowdown in the percentage of increase in cases, that could depend both on the effect of the containment measures introduced at the end of October and on the saturation of testing capacity.”

The focal point of the crisis is in hospitals: “in 11 regions, the saturation threshold of 40% of beds in the general area has been exceeded, and in 11 other regions the 30% threshold for ICUs has been reached.”

The report criticizes the system of 21 indicators and color-coded areas according to risk: “It is technically complex,” the President of GIMBE, Nino Cartabellotta, explains, “subject to numerous institutional ‘steps,’ affected by various regulatory stratifications, attributes a predominant role to the Rt index which has many limitations, and, most crucially, offers a snapshot of the situation 2-3 weeks earlier.” Commissioner Domenico Arcuri spoke of a way out of the crisis with the future arrival of a vaccine. For now, there is only a statement from the pharmaceutical company Pfizer. But Arcuri, who was entrusted with the management of the project, made bold promises: “We’re planning to vaccinate the first Italians in January.”

The distribution of the vaccine will not rely on the regional health organization, as “the government has decided that there should be a centralization of the mechanism.” “We must very quickly identify the first categories to which to administer the vaccine,” Arcuri added, “and we will do it according to their exposure to the virus and according to the frailty of their condition. Since yesterday, we have been organizing the first round, but also the following ones.” A commission of 15 experts is developing a distribution plan—not an easy task for a vaccine that must be kept at a temperature of 80 degrees Celsius below zero and administered in two doses to tens of millions of people.

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