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Weekly monitoring Covid-19, report July 27- August 02

Key points

  • An analysis of the data for the period  July 27-  August 2nd, 2020, following the third phase of reopening on  June 3rd, 2020, is provided below. Due to the time lag between exposure to the pathogen and the development of symptoms, and the time lag between these and the diagnosis and subsequent notification, it is likely that many of the cases notified this week developed the infection 2-3 weeks earlier, i.e. mainly in the first half of July. Some of the cases identified through screening, however, may have developed the infection in earlier periods.
  • Overall, the general picture of the transmission and impact of the SARS-CoV-2 infection in Italy, although not in a critical situation, is increasingly showing signs that require special attention: the cumulative incidence (ISS flow data) over the last 14 days (period 20/7-2/8) was 5.8 per 100 000 inhabitants, up from 6/7-19/7.
  • On a national level, there is an overall increase in the number of new cases diagnosed and notified to the integrated surveillance system coordinated by the Higher Institute of Health, compared to the previous monitoring week. The increase is mainly in asymptomatic people. The national transmission index (Rt) calculated on symptomatic cases, is 1.01. This indicates that, net of cases identified through screening activities and imported cases, the number of symptomatic cases diagnosed in our country has been substantially stable 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 ever decreasing involvement of elderly people, partly to an increase among imported cases and partly to the identification of asymptomatic cases through screening and contact tracing in lower age groups. This leads to a lower risk of possible overloading of health services in the short term.
  • In all Regions/PPAA new cases of infection were diagnosed in the current monitoring week. This finding is largely due to intensive case screening and investigation with identification and monitoring of close contacts. In addition to the outbreaks attributable to the reimport of the infection, some small transmission chains of unknown origin have been reported on the national territory. 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 foreign states is reported in many Regions/PAs. An extremely fluid epidemiological situation is therefore confirmed.
  • Eleven Regions/PAA showed an increase in the number of diagnosed cases, compared to the previous week. These cannot be attributed solely to an increase in imported cases. However, it should be noted that in some of these Regions/PAA, although increasing, the total number of newly diagnosed cases is low (less than 10 cases diagnosed per week or with a weekly incidence of less than 1/100,000). None of the Regions/PAA have experienced any signs of overburdening of health services, and the present outbreaks are 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 have been observed in twelve Regions, where recent outbreaks have occurred in the last 3 weeks, but without overburdening health care services. In some regions, although cases have decreased, high numbers of new cases continue to be reported. This should call for caution as it shows that in some parts of the country the circulation of SARS-CoV-2 is still relevant.

Conclusions

  • Although the lockdown measures in Italy have allowed effective control of SARS-CoV-2 infection, at the moment we are in a situation that shows an increasing trend: in fact, widespread transmission of the virus persists, which, when favourable conditions occur, causes outbreaks even on a large scale, often associated with the imports of cases arriving from foreign countries.
  • The number of new cases of infection, although remaining low still shows an increasing trend. This is also due to contact tracing and management, including quarantine of close contacts and immediate isolation of secondary cases. The reduction in the time between the onset of symptoms and diagnosis/isolation is one of the reasons for earlier identification and clinical care of people contracting the infection.
  • It is necessary to maintain a high level of resilience within territorial services, continue to strengthen awareness and compliance throughout the population, carry out active research and diagnostic investigation of potential cases, isolation of confirmed cases, as well as 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 contact tracing activities, in order to identify all potential transmission outbreaks early and continue to control the epidemic. For this reason, it is still essential to maintain a high awareness of the uncertainty of the epidemiological situation among the general population, as well as the importance of continuing to strictly adhere to all measures necessary to reduce the risk of transmission such as individual hygiene, use of masks and physical distancing.
  • The need to comply with the quarantine measures is reiterated, including by identifying dedicated facilities. This concerns all those people returning from quarantine countries and following a request from the health authority having been identified as close contacts in a case. Otherwise, we may see a significant increase in the number of cases at national level in the coming weeks.
  • The situation described in this report, which mainly relates to infections that occurred in the second decade of July 2020, shows signs of alert. At the moment, the data confirm that the prevention and control measures already adopted by the Regions/PAA should be maintained, and that attention should be paid to the preparation of interventions in case of further deterioration.



Data di pubblicazione: 10 agosto 2020 , ultimo aggiornamento 10 agosto 2020


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