key: cord-0980531-xtug3kto
authors: Molinari, Andrea; Pistoia, Federico; Antonelli, Giuditta
title: SARS-CoV-2: The Lombardy scenario in numbers
date: 2020-04-07
journal: Infection control and hospital epidemiology
DOI: 10.1017/ice.2020.115
sha: 82ec0b804584a48e019b22a531d233dd3ccb5206
doc_id: 980531
cord_uid: xtug3kto

nan

To the Editor-On March 11, 2020, the World Health Organization (WHO) declared the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to constitute a pandemic of COVID-19 infectious disease. 1 On February 20, 2020, the first national cluster in Italy was identified in the Lombardy region after the diagnosis of SARS-CoV-2 in a 38-year-old man with a severe pneumonia and no relevant exposure history. 2 To date, 74,386 SARS-CoV-2 laboratory-confirmed cases have been reported in Italy, with 32,346 cases in Lombardy alone, by far the most affected region. 3 Given the extent of the phenomenon, we must urgently consider how the rapid spread of the infection can overload the National Health Service (SSN) and affect the mortality rate. The SSN is regarded as a high-level healthcare service, and it is regionally based. 4 Specifically, Lombardy's healthcare service is considered a benchmark in terms of quality and efficiency. 5 In Lombardy, region of~10 million people, the pre-crisis total intensive care unit (ICU) bed capacity was of~720 beds, with a mean occupancy rate in the winter months of 85%-90%. 2 To deal with SARS-CoV-2 outbreak, the number of ICU beds has significantly increased, and several departments have been reorganized and dedicated exclusively to COVID-19 patients. Nonetheless, hospitals in Lombardy are dramatically overcrowded with lack of medications, mechanical ventilators, oxygen, and personal protective equipment (PPE). 6 Clearly, the increased number of cases is posing a serious threat to the entire SSN. 7 We believe that the following numbers regarding the Lombardy region help to fully measure and elucidate the medical and social impact of SARS-CoV-2 outbreak.

The Italian National Institute of Health (ISS) reported that 4,451 people died in Lombardy due to SARS-CoV-2 complications between January 3 and March 25, 2020. 3 In March 2019, there were 9,062 deaths, with 292 deaths per day 8 ; in March 2020, the number of deaths per day was exceeded for 8 days by the number of deaths of confirmed COVID-19 patients alone. The most deadly day was March 21, with 546 daily fatalities due to COVID-19.

To date, 11,262 COVID-19 patients have been hospitalized-1,236 in an ICU. More than 5,000 healthcare workers have been infected across Italy, accounting for 9% of total cases. This number particularly reflects the lack of PPE and the unexpected pressure on the SSN. 3 This report highlights how the impact and the consequences of the COVID-19 pandemic have been largely underestimated in Western countries, and it raises concerns about the potential responsiveness of healthcare systems in less-developed countries.

World Health Organization website

Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy

Measuring overall health system performance for 191 countries. World Health Organization website

Quality and efficiency of the health service in the Italian region of Lombardy

At the epicenter of the COVID-19 pandemic and humanitarian crises in Italy: changing perspectives on preparation and mitigation

COVID-19 in Europe: the Italian lesson

Statistiche demografiche website

Acknowledgments.Financial support. No financial support was provided relevant to this article.

All authors report no conflicts of interest relevant to this article.