Coronavirus: Fall in new cases in Italy raises hope of ‘first sign of relief’ for nation on brink

Number of hospitalised patients in worst-hit region also shrinks for the first time in the month-long epidemic

Federica Marsi
Tuesday 24 March 2020 17:30 GMT
Coronavirus: Harrowing footage from Italy hospital showing A+E overrun with coronavirus patients

The relentless hike in coronavirus cases sweeping across Italy appeared to be slowing its course as contagions rose by the smallest increase for the second consecutive day, raising cautious hopes for a turnaround.

Confirmed cases totalled 63,927 on Monday, an increase of 4,789 from a day earlier, marking the smallest rise in five days. The number of patients admitted to hospital in Lombardy – the region around Milan that is by far the worst-hit by the virus – also shrunk from 9,439 to 9,266 for the first time in the epidemic.

“It is not the time to sing victory, but we are beginning to see the light at the end of the tunnel,” Giulio Gallera, the top health official in the northern region of Lombardy, said.

Italy has been anxiously looking at day-to-day figures to confirm the effectiveness of a nationwide lockdown that entered its third week amid tightening measures that shut the doors of all non-essential businesses and banned outdoors exercise.

Premier Giuseppe Conte yesterday announced much stiffer fines for violators of the national lockdown restrictions. At a Cabinet meeting the government set fines for violators from €400 (£343) to €3,000 (£2,576)euros. Initially, fines topped out at €206.

While it was too soon to say if the recent decline would continue, Andrea Gori, director of the Infective Disease department at Policlinico hospital in Milan, was cautiously optimistic. “What is encouraging is not only that we are seeing a reduction in numbers, but also that we are seeing it within the expected timeframe,” he told The Independent.

“This shows that there is a correspondence between the measures put in place and the desired outcome.”

Milan, the capital of Lombardy, showed signs of improvement with an increase of 137 cases compared to 210 on Sunday and 279 on Saturday. While the increment also slowed down in the town of Bergamo – where the burgeoning amount of piled-up coffins had to be removed by the army last week – cases jumped significantly in Brescia, another hard-hit Lombardy city.

The Civil Protection Agency has warned that real numbers in Italy may be 10 times the official tally, given that people with symptoms compatible to coronavirus who do not require hospitalisation are never tested.

Mr Gori confirmed the “ratio of one certified case out of every 10 is credible” – meaning around 640,000 people may have been infected.

It remains to be seen if this could impact the country’s death toll. In Italy it rose by 602 on Monday, the smallest increase for four days – but still a significantly higher toll than a week ago, when the number of new deaths was 345. On Tuesday, however, it rose by 743 to 6,820 deaths.

Tests are being conducted on patients who are in hospital, while those experiencing non life-threatening symptoms compatible with Covid-19 are under self-quarantine at home.

This also makes it hard to make comparisons among countries, Mr Gori said, as testing strategies and the total number of hospital beds available weight on the results. According to the last available Eurostat data in 2017, Italy aligned with Europe’s average with a ratio of 3.1 beds for every 1,000 inhabitants, while the UK ranked at the bottom with 2.5.

Lombardy’s regional authority announced it would work with general practitioners to map out the health of their patients, estimated to be around 1,000 to 1,500 people per doctor.

As Italy battles to devise a strategy that can effectively roll back the course of the outbreak, an infection control experiment that stopped all new cases in the small town of Vo’, near Venice, opened up a new debate on the effectiveness of mass testing.

By taking multiple swabs of all 3,300 inhabitants, regardless of whether they were exhibiting symptoms, and rigorous quarantining of their contacts once infection was confirmed, health authorities have been able to completely stop the spread of the illness.

However, experts expressed concerns that the same methodology would not work in Milan, a city of 1.3 million.

“We must remember that testing is not like taking a picture, it is more like a movie,” Maria Rita Gismondo, virologist at Sacco hospital in Milan, said. “A person who tests negative can contract the virus and start showing symptoms in just a few days, so a negative result is no guarantee.”

At present, Lombardy has 22 centres processing 5,000 swabs per day and it is planning to increase this capacity.

At Milan’s Sacco hospital, Ms Gismondo said the marginal decrease in numbers had begun to take off some of the pressure from the overburdened facility but that the way forward was still full of hurdles.

“We are still full to the brink,” she said, “but we welcome the first sign of relief and, one month on, we can say we are also more organised and prepared to manage the situation.”

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