Struck by a human catastrophe unseen in Europe outside of war, with military trucks taking away corpses from the city of Bergamo, Lombardy has a death rate of 17.6 per cent.
Nearby Veneto’s stands at 5.6 per cent. While virologists caution that the percentage death rate is closely tied to the level of testing, they also attribute the gap to other factors, such as Veneto’s reluctance to hospitalise compared with its neighbour.
“Veneto has a very low mortality compared to the rest of Italy,” said Professor Andrea Crisanti, a leading virologist from the University of Padua, in charge of a mass testing programme across Veneto. “This shows that our approach has worked well so far.”
As of Saturday Lombardy, which has a population of 10m people, accounts for 8,656, or 56.3 per cent, of Italy’s total declared deaths from the virus of 15,362. Meanwhile Veneto, which has a population of 4.9m, has suffered 607 official deaths out of 10,824 diagnosed cases.
Higher levels of testing and tracing in Veneto is the most widely cited explanation for why the region has managed to control its outbreak more effectively than its neighbours. . . . Yet experts say testing is not the only reason for the lower death rate.
Venetian doctors also cite the region’s expertise in infectious disease, something they trace back to its pioneering history dealing with viruses arriving in its port from the east. The word quarantine derives from quarantena, the Venetian word for “40 days”, or the amount of time ships arriving from plague-ridden destinations were isolated.
For Giorgio Palù, one of Europe’s leading virologists, and scientific adviser to the governor of Veneto, a critical factor has been the number of diagnosed patients taken into hospital.
The number of diagnosed patients who were taken in hospitals for clinical treatment at the start of the outbreak was about 65 per cent in Lombardy, Prof Palù said.
This compares with 20 per cent in Veneto, where the majority were told to stay at home unless urgent care was required.
“There were different instructions given to the sick by the different regional health authorities,” he said. “Yes, there has been more testing in Veneto but people were kept at home and not taken into hospitals. The more patients you admit to the hospital, the more cases you get. You create the outbreak as at the start nobody was taking care of sampling the doctors or nurses, [so] you were taking home the infection.”
His observation comes as more than 60 Italian doctors and health workers have died, the majority of these in Lombardy. A group of doctors from the Papa Giovanni XXIII hospital in Bergamo warned last month that hospitals had become the main source of transmission of Covid-19 infections, and urged more patients to be treated at home.
“We are learning that hospitals might be the main Covid-19 carriers,” they wrote in the New England Journal of Medicine. “They are rapidly populated by infected patients, facilitating transmission to uninfected patients.”
Monday, April 6, 2020
In Veneto, Keeping People out of the Hospital
From the Financial Times, a comparison of coronavirus treatment in two of Italy's most populous regions, Lombardy and the Veneto: