The Measures Full Movie Download In Italian
Vida Hubbert
In this work, we discuss the necessity and efficacy of lockdown measures for controlling the outbreak of COVID-19, analyzing data from Italy, the country with the first recorded outbreak of the disease during the first spread of COVID-19 in Europe. We also assess the time it takes to reduce the number of patients hospitalized with severe COVID-19 symptoms after the beginning of the lockdown. Currently (October 28th, 2020), COVID-19 cases are surging worldwide, following the relaxation of containment measures during the last months. The impact of lockdown in the first Italian outbreak represents a fundamental precedent that can help policymakers to define the decision timeline for containment measures in the next weeks or months.
While NHS are prepared to receive ICU patients distributed during the influenza season, which lasts several months, no NHS can manage the exponential growing of the number of COVID-19 patients. To avoid the saturation of the ICUs, governments need to impose strong containment measures, such as lockdown of the population early. Acting early is paramount: after the containments measures are taken, the number of cases still grows exponentially for at least ten days, due to infections contracted before the measures [4]. The later these containment measures are taken, the stronger these measures need to be to contain the diffusion of SARS-CoV-2, and could be anyways insufficient to avoid the catastrophic collapse of the NHS. For example, Japan and Singapore were able to avoid the lockdown of the population, because the governments implemented effective measures at the very early stage of the outbreak (Fig. 1).
From the early stage of the COVID-19 outbreak (February 24th 2020), Italy is providing statistics of the epidemic, through a daily bulletin and an open-access repository [8]. This repository contains daily counts of confirmed cases, hospitalized patients, ICU patients, and deceased patients, at the national and regional level (Fig. 3). This repository represents an important and unique source of information for other countries stroke by the pandemic. The number of ICU patients represents a more robust information compared to the number of infected people, which is subject to under-reporting. The number of infected people strongly depends on the number of performed tests and on the strategy of sampling of the population (e.g. only symptomatic people, randomly chosen people). Testing capability and strategy might vary among different countries largely, while ICU patients count is a routine operation performed by all NHSs. ICU counts are more reliable also compared to deaths counts, since most patients dying with COVID-19 have comorbidities and ascertaining that COVID-19 was the primary cause of death can be complicated. Generally, ICU patients counts offers a far more reliable information of the evolution of COVID-19 epidemic, at least until the ICU capability of the NHS is saturated.
Spatial distribution of COVID-19 epidemic in Italy. The maps on the left represent the number of infection cases detected at the regional level (top panel) and the provincial level (bottom panel), on March 9th, when lockdown was imposed. The maps on the right represent the number of total confirmed cases twenty-one days later, on March 30th. The map has been created with GeoPandas library ( )
The Italian government implemented also a series of measures to slow down the diffusion of the virus. Schools and universities were closed in Lombardy on February 26th, and in rest of Italy on March 5th. On March 8th, Lombardy region ordered the lockdown of the populations (Decreto del Presidente del Consiglio dei Ministri 8 Marzo 2020). On the following day, the lockdown was extended to the entire nation. In Lombardy and in Italy, nurses, doctors and health-care professionals have fought with incredible strength, acting as war heroes in dark times. However, the ICUs rapidly saturated by COVID-19 ICU patients in Lombardy region (Fig. 4) and subsequently in other regions (Fig. 5). On March 21st, the Italian government imposed the full lockdown of the nation, closing off all the non-essential companies and manufacturing plants.
The date of ICUs saturation can be predicted early on. The number of deaths (red crosses) grows exponentially in time in Lombardy region, Italy. The number of ICU patients (orange circles) flattens in time: this indicates the saturation of the ICU beds in the region. The dotted blue line is the linear regression of the first six orange data points. The day of the saturation can be predicted by linear regression, fitting the logarithm of the number of ICU patients at early stages of the epidemic: the timeline highlighted in magenta shows the predicted temporal range for the saturation of 50% of the ICU beds; the beginning and the end of the magenta range are obtained by fitting the first four (blue triangle) and nine orange data points respectively. To avoid ICUs saturation, an earlier lockdown (indicated by the blue triangle) would have been necessary. The green triangle and green diamond represent the lockdown day (March 8th 2020) and full lockdown day (March 21st 2020). The orange solid line and dotted line represent 100 and 50% of the actual total number of ICU beds in Lombardy
Spatial distribution of COVID-19 ICU patients in Italy. The maps represent the ICUs saturation (number of ICU patients divided by number of ICU beds) at the regional level on March 9th (left panel), when the lockdown was imposed, and twenty-one days later, on March 30th (right panel). Here we use the regional number of ICU beds reported before the onset of the epidemic. The number of ICU beds was increased throughout the epidemic. The map has been created with GeoPandas library ( )
Here we show that it is possible to predict the date of saturation of the ICUs in a region early on, by using the temporal information about the number of available ICU beds. We focus on Lombardy region. The number of ICU patients in the region grew exponentially for the first ten days, starting from February 24th, and then slowed down as it reached the number of available ICU beds. We can predict the ICU saturation date by performing a linear regression of the logarithm of the number of ICU patients, starting from the first four data points (Fig. 4). This result shows that monitoring the ICUs statistics at the beginning of the epidemic allows countries to assess the date of possible saturation of the ICU beds early on. Monitoring the ICUs early in the outbreak is paramount: Lombardy, in Italy, has one the best NHS in the World [11, 12], therefore most countries will face the saturation of their ICU beds at earlier stages of the outbreak. It is worth to note that several factors affect the time to saturate the ICU beds. In particular, the saturation time depends on the connectivity of the population: the more people are connected within a region, the faster the infection diffuses [13]. Therefore, the risk of ICUs saturation is higher for the most developed and connected regions, and Lombardy is the most connected region of Italy. Moreover, if a lockdown measure is imposed, the ICUs saturation time depends on the incubation time of the disease and on the degree of adherence of the population to the lockdown.
Here we analyze the effects of the lockdown of the Italian population. Italy imposed two major containment measures: the lockdown on March 9th 2020, and the full lockdown on March 21st 2020, where all non-essential companies and manufacturing plant were closed. These measured helped to avoid the collapse of the whole national health system, yet they could not avoid the saturation of the ICU beds in several Italian regions (Fig. 5).
We strongly encourage any government to accurately share data, including ICU patients; this data will significantly help the understanding of present and future evolution of the COVID-19 pandemic. Italy has been the first country in Europe stroke by the COVID outbreak, and it has adopted a policy of wide dissemination of open data with detailed spatial structure. Unprecedented measures have been taken by the Italian government, including systematic sharing of ICUs information, and the lockdown of the country. Most likely, the decisions taken in Italy between February 24th and March 21st have saved thousands of lives, not only within national borders.
The authors want to thank all the Italian nurses, doctors and health-care professionals that are fighting against an invisible enemy as war heroes in dark times. This manuscript is dedicated to the memory of Doctor Li Wenliang, who first tried to warn the World about COVID-19, and all the health-care professionals who died fighting against this virus.
MS analyzed the data, conceived the manuscript and, together with FL, prepared the Figs. MS, ADC, ADO, FL and GO contributed to the interpretation of the data and the discussion of the results. MS and ADC wrote the manuscript, and all the authors reviewed it. The author(s) read and approved the final manuscript.
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