Lombard Chronicles - Day 55th (last day of isolation)

Italian version

"With the bleeding treasure, the state raises taxes. Goods and resources vanish, and the country is starving. The peasants lose seven tenths of their income, and the government six tenths of its income." Sun Tzu - The Art of War

Today, 4th of May, "Phase 2" officially begins and with it a relative loosening of the isolation to which we have been subjected in the last 55 days.

How much has the scenario changed since we locked ourselves in?

On March 9, 2020, we had entered quarantine with 4,490 positive "active" cases, today we leave the house with 36,926 cases still active (the total number of cases to date was 77,528, the difference is explained by discharges and deaths).

Of the 77,528 "official" positive cases recorded so far, those who can say they "got away with it" are just over a third, equal to 26,371 individuals declared cured.

The price paid to the epidemic was at least 14,231 deaths, equal to 18.4% of the total number of cases. Yesterday we still had to undergo the "adjustment" of the 280 new cases of deaths referred to the entire month of April, relating to deaths at home and until yesterday, never calculated so far in the statistics. Practically 258 deaths on average per day, while at the beginning we had recorded since February 24, "only" 333 (and without considering the numerous deaths that sooner or later will be attributed to covid-19). 

For almost half (48%) of the 77,528 the match is still not closed, and there are those who are still fighting at home (29,785), those in hospital (7,141) and those in intensive care (532), while on 9 March we had 3,242 patients admitted, 440 of whom were in intensive care (the peak had been reached on 6 April with 1,343 admissions to intensive care).

While the hospitalization curve is slowly decreasing, the rate of growth of new positive cases in home isolation continues to grow.

These numbers must make us understand that we have not won any war, but that we have, inevitably, decided the sortie from the stronghold, because the siege began to undermine the morale of the troops and, above all, the capacity for resistance began to waver, especially in economic terms.

So now we face the enemy virus in "open field" and the question is whether we are adequately geared up.

In terms of hospital capacity, and especially intensive care, there is clearly a reserve of around 900 posts, which we do not hope to use but which we have learned, at our own expense, to be "the last line of defence".

It should necessarily be noted that "Phase 2" is not a real reopening, but a "probation" and probation to a series of important constraints, which will lead many companies to prefer the continuation of "smart working" (at least those whose activity is transferable "online") rather than imposing unnecessary risks on their staff.

The conditions that have been established to continue to benefit from this relaxation are, however, very strict and described in the now famous DPCM of 24 April 2020:

In particular, it is explained to us that the conditions to be met to avoid a return to lockdown are that :

1. Epidemiological monitoring capacity.
2. Transmission stability.
3. Health services not overloaded.
4. Readiness activities.
5. Ability to promptly test all suspicious cases.
6. Ability to ensure adequate resources for contact tracing, isolation and quarantine.

More specifically, it is explained to us that at least 60% of the following "kpi's" will need to show a trend of improvement, otherwise ... you will go back to "home base".

• Number of reported symptomatic cases per month.
• Number of reported cases per month with a history of hospitalisation (in wards other than intensive care -TI) 
• Number of cases notified per month with a history of transfer/intensive care (ICU) 
• Number of cases notified per month in which the municipality of domicile and residence is reported

From what little we are given to understand is that therefore it is the municipality of residence that is the monitoring unit and, within it, the usual known parameters, that is, total cases, hospitalized cases and intensive therapies.

When we went into isolation the official "active" cases were less than 5,000, while tomorrow we will "go out" with 35,000 cases still potentially infectious and we know nothing about the famous "asymptomatic" whose number (estimate) will be revealed to us by the next survey on the 150,000 Italians, but we will not count them for a month.

What have we learned in these two months?

We have learned that never before, as in this case, are the things we do not know more than we know.

We do not know the date of when a vaccine will be available, as we do not know so far, any really effective therapy.

Equally we do not know the real number of those infected and even the apparent crude certainties, such as deaths, we hold bitter surprises.

In short, science, can not give us "irrefutable certainties" (dear our minister Boccia) but only probability and hypothesis. We live in a world of probability.

There are some certainties, in truth. One of these is represented by the collapse of the gross domestic product which will soon be accompanied by the collapse of employment.

We also know, however, that without work and remuneration there is no future for many and therefore if we exclude the 16 million pensioners, who in some way, in the various constraints do not see a change in their economic position, (and the same could be said for the 3 million civil servants) for the other 40 million Italians the scenario that risks opening up reserves risks no less than those of the epidemic.

"Primum vivere, deinde philosophari" (First, to live, then philosophy) . It is therefore necessary to face the enemy face to face (perhaps with a mask) and begin to elaborate new strategies of confrontation.

There is a risk in every human activity.

If the soldier who goes to war were to be guaranteed 100% security (like the policeman who protects us, or the fireman) we would have neither soldiers, nor policemen, nor firemen.

We are starting a navigation in unknown waters, and we have to accept that the 90% of the world we have been told by the Economist is really a challenge that cannot be faced with the same tools and certainties as two months ago. 

In this new world of uncertainty that awaits us, we will have to acquire the progressive awareness that we will have to live with a higher level of risk.

This is a message that may seem complex or even unacceptable to many politicians, but it would be necessary to convey it clearly and firmly.

We need a different and more proactive approach to virus tracking and isolation, to enable us to live "dynamically" with the virus. 

We, in our small project #tamponailvirus, have (and still are) trying to give our contribution in this direction and we remain convinced that the direction of qualitative immunological rapid tests is, to date and in the expectation of new rapid tests such as molecular tests based on saliva, the only way that allows, on large volumes, in an economic and distributed also at the level of citizenship, to reactivate economic processes but also the simple relationships between people in every community. 

At the beginning of this project, we had taken the scepticism of many people for granted.

Time instead gave us reason and rapid tests are instead becoming the only possible tool for an effective and efficient analysis on the territory, as for example this morning in Naples at the arrival of the train from Milan that was transporting "the children of the south" back from the north, after two months of involuntary captivity. 

The #tamponailvirus project will continue, at least until its second objective will be realized (while the first has already been realized, through the financing of the experimentation of a health protocol in two big hospitals in our country and we will tell you about it soon). 

The second objective will be the diffusion of a "standard" medical-legal medical protocol to be made available free of charge to companies to restart production safely, and we will tell you about this too soon. 

With this Chronicle, instead, we stop the "statistical" part of the project, in the hope that the numbers of the virus will become less and less important in the future. 

We still have a long way to go and among so much uncertainty, at least one thing is sure: from today we start running again (in every sense). 

And if you want to help us, support the #tamponailvirus project!

We thank all those who will support our initiative!