key: cord-0933118-7hqn997j
authors: Tradigo, Giuseppe; Guzzi, Pietro Hiram; Veltri, Pierangelo
title: On the assessment of more reliable COVID-19 infected number: the italian case.
date: 2020-03-27
journal: nan
DOI: 10.1101/2020.03.25.20043562
sha: 769d953d28605c51f20b2fd049ffabc4d73583a7
doc_id: 933118
cord_uid: 7hqn997j

COVID-19 (SARS-CoV-2) is the most recent pandemic disease the world is currently managing. It started in China at the end of 2019, and it is diffusing throughout Italy, one of the most affected countries, and it is currently spreading through European countries and USA. Patients affected by COVID-19 are identified employing medical swabs applied mainly to (i) citizens with COVID-19 symptoms such as flu or high temperature, or (ii) citizens that had contacts with COVID-19 patients. A percentage of COVID-19 affected patients needs hospitalisation, whereas a portion needs to be treated in Intensive Care Units (ICUs). Nevertheless, it is a matter of current intuition that COVID-19 infected citizens are more than those detected, and sometime the infection is detected too late. Thus there are many efforts in both tracking people activities as well as diffusing low cost reliable COVID-19 tests for early detection. Starting from mortality rates of diseases caused by viruses in the same family (e.g. MERS, SARS, H1N1), we study the relations between the number of COVID-19 infections and the number of deaths, through Italian regions. We thus assess several infections being higher than the ones currently measured. We thus focus on the characterisation of the pandemic diffusion by estimating the infected number of patients versus the number of death. We use such an estimated number of infections, to foresee the effects of restriction actions adopted by governments to constrain virus diffusion. We finally think that our model can support the healthcare system to react when COVID-19 is increasing.

patients versus the number of death. We use such an estimated number of infections, to foresee the effects of restriction actions adopted by governments to constrain virus diffusion. We finally think that our model can support the healthcare system to react when COVID-19 is increasing.

fection of about 4.3%. Starting from the analysis of number of death with 23 respect to number of identified infected in Italy, we map the percentage in The Coronaviridae family contains many viruses, seven of which are known 27 to be responsible for human diseases (229E, NL63, OC43, HKU1, MERS-28 CoV, SARS-CoV, and SARS-CoV-2) [7] . One of the main differences be-29 tween the novel virus and the previous ones is its high spreading rate. Table   30 2 . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted March 27, 2020. . 1 reports the percentage of death known from Coronaviridae family viruses 31 exploited recently. We started observing that death percentage has an av-32 erage value with respect to infected cases for all viruses. We report about 33 hypotheses on a death percentage and we extract the number of infections. 34 We compare such a number with respect to officially diffused infected ones. 35 We finally use estimated numbers to evaluate containment measures with 36 respect to infection diffusion. 3 . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)

The copyright holder for this preprint this version posted March 27, 2020. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted March 27, 2020. which suffers the same problems we have just described. We claim that the 72 total number of detected infections is much lower than the real ones due to 73 the bias described above. We observe that we can derive the real cases of Such information can be useful for governments to plan actions for a 83 better swab testing protocol and for ICU beds and resources strengthening 84 at both a national and regional levels. CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted March 27, 2020. . Figure 2 : In blue the total infections currently detected in Italy via swab tests. The other bars report three scenarios with different Case Fatality Rates: CFR = 1% with 547, 600 infections (1174.1% more than currently detected), CFR = 2% with 273, 800 infections (587.1% more than currently detected) and CFR = 3% with 182, 533 infections (391.4% more than currently detected). measures need several days for their effect to be seen. The most exposed 98 people are the so-called hubs (or people having many social contacts), which 99 have the highest probability of spreading the infection due to their jobs (e.g. We here report the effects of Italian containment measurements, by con-104 sidering the main three events related to the red zones definitions, as reported 105 in Table 2 . 106 We plot the number of infections considering the first three above reported CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted March 27, 2020. . ments. This allows a scalability in terms of rules and allows quarantine for 124 large set of citizens. We here show that the above reported intuition and 125 measurements are scalable also at regional and sub-regional scale. The emergency of COVID-19 is related to an aggressive virus that diffuses 138 rapidly and strongly stresses the resistance of health structures. We started 139 from observation of death percentage from previous coronavirus family viruses 140 and we inferred the number of infections starting from CFR rates. The cal-141 culated infection levels should be considered to be more reliable than the 142 9 . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted March 27, 2020. . 

. CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)

The copyright holder for this preprint this version posted March 27, 2020. 

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