On February 20th, 2020 an Italian citizen in his 30s tested positive for a new type of coronavirus. “Patient 1” had to go into the intensive care unit (ICU) in Codogno Hospital. Furthermore, within 24 hours the number of positive cases came to 36. The patients were not in contact with “patient 1” or other patients with the COVID-19 infection.
In response to the infection outbreak, the Government of Lombardy and the local health authorities form an emergency task force. This task force aims to combat the existing epidemiological situation in the country. Their procedures and the measures they took were effective. However, the Italian outbreak was far larger than the Chinese one.
One of the main features of the Lombardian outbreak is the percentage of patients that have to be in ICU units. Within the first 14 days, admission to the ICU was at a constant rise. The publicly available data shows that 16% of all patients with COVID-19 are occupying an ICU bed. That is, out of the 3420 people that are positive for COVID-19, 556 are in ICU beds.
To combat the situation the government and medical task force had to increase the ICU capacity. Not only that, but the patients with COVID-19 require beds that are separate from other patients in the hospital. Within a few days, they were able to form 15 hub hospitals with 482 cohort COVID-19 ICU beds.
Currently, there are two different estimates as to how many new admissions will occur until March 20, 2020. The linear model estimates that approximately 869 patients will need ICU beds. On the other hand, the exponential model growth projects a figure of 14542 ICU admissions. The projections are hypothetical and involve various assumptions but they point to the same fact. A new increase in the number of patients will rapidly exceed the ICU capacity.
Aside from the hospitals, there is also a need to increase laboratory capacities. However, since this change needs to occur rapidly it may cause an additional strain on the system. Such problems may influence the accuracy of testing results.
This news article is based on the report Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy. The authors claim that this is the first report that looks at the consequences of the COVID-19 outside of China. As such, the report shows us that the current epidemiological image is stark. Even though the authorities reacted promptly to the spread of the infection it may not be enough to contain it.
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