Coronavirus, in Campania the scenario could worsen: there are two measures to be implemented immediately

As of March 22, 2020, the most serious data in Italy is represented by the high average lethality of the viral infection from Covid19 compared to the data coming from the rest of the world (about 10%, compared to a world average of about 2-3%).

This high lethality shows itself parallel, and in a non-causal way, to the very high percentage of infected that is recorded among the health workers and the staff engaged in the operations of assistance to the infected, with a percentage that reaches about 10% of the total.

There is also an unexpected and very serious one shortage of beds dedicated and adequately equipped hospitals, both in the ordinary and especially in the wards Intensive care, and this both in the northern regions, at this time the peak of the national epidemic, and in the central and southern regions.

The plan devised by the Campania regional government is being structured on a scenario of approximately 3 thousand infected, with the possibility of transforming the Loreto Mare hospital and the Cotugno di Naples in Covid hospital. About 30 million euros have been allocated to go from 320 to almost 500 places in a few days. To date, however, the saturation Intensive Care wards, whose needs – keeping the forecast of infected people unchanged – should be increased conveniently.

It is estimated that in Italy, and therefore also in Campania, the infected are many more: a study published on Science calculate that for each positive there are at least 5-10 uncensored. A mathematical model signed by Livio Fenga Istat in turn shows that on March 12, compared to the 12,839 cases reported in Italy, people infected with the SARS-CoV-2 it may have been 105,789.

If indeed the infected subjects were up to ten times as much, the percentage of lethality calculated with respect to the entire nation would drop to values ​​very close to those of the China continental. Consequently, for a more realistic and optimistic scenario of around 30 thousand infected in Campania as a peak, the minimum requirement needed in a few days of bed in intensive care units could be far greater than that currently expected.

This largely justifies the behavior inflexible and the draconian provisions of the regional government regarding social distancing and blocking individual free movement, but this meritorious prophylaxis action cannot cover what appears to be the main source of infection in Italy, and therefore also in Campania, and therefore virus spreading: the hospitals and all healthcare activities.

And Campania, which is not only the youngest region of Italy but unfortunately (also due to the lack of primary prevention actions not implemented for decades, see the “Terra dei Fuochi” case)) also the one with the highest incidence of all chronic-degenerative pathologies in Italy also in young subjects, it risks more also for this reason.

The constant and continuous use of healthcare facilities of any level remains a necessity that cannot be avoided by Campania citizens and therefore represents, in my opinion, the main potential source of spread of the infection in the population, far greater than any lack of respect for the draconian provisions in force.

Analyzing the data produced so far, more than for the virus itself, I believe that the main cause of this anomalous incidence of high lethality and infections in health and emergency structures can be identified in the very serious underestimation of the epidemic impact on our healthcare facilities, and in particular on our First Aid and Intensive Care, not adequately equipped with suitable Personal Protective Equipment (DPI) nor the possibility of carrying out screening operations for potential infected.

In conclusion, therefore, I believe it is essential to bring to the attention of the responsible authorities the absolute and urgent need in Campania, as the citizens who are affected by the greatest number of chronic pathologies in Italy cannot be eliminated, to immediately proceed to:

1. Recovery and immediate diffusion, at all health facilities, of the DPs, for the staff engaged in the activities – both directly (doctors and nurses) and support (OS and various workers) – and for the whole population until the end of the epidemic;

2. Make it immediately possible, at all our hospitals with parking (and there are many: Ospedale del Mare, Cardarelli, Policlinici, etc.) of workstations in task force fixed where it is possible to perform screening swabs on the Korean model, with the obligation of priority for health personnel, in order to make citizens aware of the real situation on the infection from Covid19 and thus putting them in the best conditions to adopt social distancing behaviors, even within their families.

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