Key points

  • An analysis of the data for the period between July 20 and - 26, 2020, following the third phase of reopening on June 3, 2020, is provided below. Due to the time lag between exposure to the pathogen and the development of symptoms, between these and a diagnosis and the subsequent notification of the diagnosis itself, many of the cases notified this week are likely to have developed the infection 2-3 weeks earlier, i.e. mainly in the first ten days of July. Some of the cases identified by screening, however, may have developed the infection in earlier periods.
  • In general, the overall picture of the transmission and impact of SARS-CoV-2 infection in Italy, although not at a critical juncture, shows some signs that require special attention: the cumulative incidence in the last 14 days (period 13/7-26/7) has been of 5.1 per 100 000 inhabitants, therefore increasing in the period between 29/6-12/7. On a national level, there is an increase in the number of new cases diagnosed and notified to the integrated surveillance system coordinated by the Italian Higher Institute of Health, compared to the previous week monitored, with a national Rt = 0.98, although greater than 1 in its highest confidence interval. This suggests that transmission in our country has been largely stationary over the past few weeks.
  • The average age of the cases diagnosed in the last week is now around 40 years; this is partly due to the characteristics of the outbreaks that see an increasing involvement of older people, an increase among imported cases and partly due to the identification of asymptomatic cases through screening in lower age groups. This leads to a lower risk of possible overloading of health services in the short term.
  • In almost all Regions/PPAA, new infections were diagnosed in the current monitored week. This finding is largely due to intensive screening and case investigation with identification and monitoring of close contacts. In addition to the outbreaks associated with newly imported infection cases, some small transmission chains of unknown origin are reported throughout the country. This shows that the COVID-19 epidemic in Italy is not over yet. The presence of new cases of infection imported from other regions and/or from foreign countries has been reported in some Regions/PAs. An extremely fluid epidemiological situation is therefore confirmed.
  • A total of 736 active outbreaks were reported during last week monitoring, 123 of which were new. This implies a strong commitment of the territorial services in "testing-tracking-tracing" activities.
  • Fifteen Regions/PAA had an increase in the number of cases diagnosed compared to the previous week. These cannot be attributed solely to an increase in imported cases. However, it should be pointed out that in some of these Regions/PAA, although increasing, the total number of new cases diagnosed is extremely low (less than 10 cases diagnosed per week or with a weekly incidence of less than 1/100,000). There are no signs of health services overload in any of these Regions/PAA and the existing outbreaks have been promptly identified and investigated.
  • Rt estimates tend to fluctuate in some Regions/PPAA in relation to the occurrence of transmission outbreaks that are subsequently contained. Therefore, over the last 14 days estimates of more than 1 are observed in eight Regions where recent outbreaks have occurred. However, there are still no signs of welfare services overload. Although decreasing, high numbers of new cases continue to be reported in some regions. This should call for caution as it shows that in some parts of the country the circulation of SARS-CoV-2 is still significant.

Conclusion

  • Although lock-down measures in Italy have allowed effective control of SARS-CoV-2 infection, now we are in a situation of stationary transmission at national level, where widespread transmission of the virus persists. Therefore, when favourable conditions occur, this leads to outbreaks even on a large scale. These outbreaks are sometimes associated with the imports of cases from foreign countries.
  • Although the overall number of new cases of infection remains low, it shows an increasing trend. This is due to testing-tracking activities that allow potential chains of transmission to be broken in the bud. The reduction of the time between the onset of symptoms and diagnosis/isolation allows earlier identification and clinical care of people contracting the infection.
  • It is therefore not surprising to observe a small number of cases requiring hospitalization because, due to the characteristics of COVID-19 disease, only a small proportion of the total number of people contracting SARS-CoV-2 develop more severe clinical situations. This result, expected according to the strategy adopted in the transition phase, makes it possible to manage the presence of the virus on the territory, in conditions of reopening, without overloading welfare services.
  • The situation described in this report, mainly regarding infections that occurred at the beginning of July 2020, is maintained to be positive in general, with small warning signs of transmission. At present, data confirm that the prevention and control measures already adopted by the Regions/PAA should be maintained.
  • It is necessary to preserve a high resilience level within the territorial services, continue to strengthen the awareness and compliance of the population, carry out active research and diagnostic assessment of potential cases, isolation of confirmed cases, quarantine of their close contacts. These actions are essential to control transmission and possibly rapidly identify and cope with epidemic upsurges.
  • It is essential to maintain a high level of attention and continue to strengthen testing-tracking activities, to identify all potential transmission outbreaks early and continue to control the epidemic. Therefore, it remains essential to maintain a high level of awareness among the general population, especially regarding the fluidity of the epidemiological situation and the importance of continuing to strictly adhere to all measures necessary to reduce the risk of transmission, such as individual hygiene, the use of masks and physical distancing.
  • It is confirmed that the quarantine measures are to be respected, including the identification of dedicated facilities, both for people returning from quarantined countries, and following the request of the health authority, once they have been identified as close contacts in a case. Otherwise, in the coming weeks, we may experience a significant increase in the number of cases nationwide.

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Data di pubblicazione: 5 agosto 2020, ultimo aggiornamento 5 agosto 2020

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