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Abstract

Background

Veneto was one of the Italian regions hit hardest by the early phase of the coronavirus disease (COVID-19) pandemic.

Aim

This paper describes the public health response and epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the Veneto Region from 21 February to 2 April 2020.

Methods

Information on the public health response was collected from regional health authorities’ official sources. Epidemiological data were extracted from a web-based regional surveillance system. The epidemic curve was represented by date of testing. Characteristics of hospitalised COVID-19 cases were described and compared to those never admitted to hospital. Age- and sex-stratified case-fatality ratios (CFRs) were calculated.

Results

Key elements of the regional public health response were thorough case-finding and contact tracing, home care for non-severe cases, creation of dedicated COVID-19 healthcare facilities and activation of sub-intensive care units for non-invasive ventilation. As at 2 April 2020, 91,345 individuals were tested for SARS-CoV-2 and 10,457 (11.4%) were positive. Testing and attack rates were 18.6 per 1,000 and 213.2 per 100,000 population, respectively. The epidemic peaked around 20 to 24 March, with case numbers declining thereafter. Hospitalised cases (n = 3,623; 34.6%) were older and more frequently male compared with never-hospitalised cases. The CFR was 5.6% overall, and was higher among males and people > 60 years of age.

Conclusion

In the Veneto Region, the strict social distancing measures imposed by the Italian government were supported by thorough case finding and contact tracing, as well as well-defined roles for different levels of care.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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/content/10.2807/1560-7917.ES.2020.25.47.2000548
2020-11-26
2024-11-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2020.25.47.2000548
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References

  1. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382(13):1199-207.  https://doi.org/10.1056/NEJMoa2001316  PMID: 31995857 
  2. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. , China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33.  https://doi.org/10.1056/NEJMoa2001017  PMID: 31978945 
  3. World Health Organization (WHO). WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. Geneva: WHO; 2020. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
  4. Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. JAMA. 2020;323(18):1775-6.  https://doi.org/10.1001/jama.2020.4683  PMID: 32203977 
  5. Lavezzo E, Franchin E, Ciavarella C, Cuomo-Dannenburg G, Barzon L, Del Vecchio C, et al. , Imperial College COVID-19 Response Team. Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo’. Nature. 2020;584(7821):425-9.  https://doi.org/10.1038/s41586-020-2488-1  PMID: 32604404 
  6. Paterlini M. On the front lines of coronavirus: the Italian response to covid-19. BMJ. 2020;368:m1065.  https://doi.org/10.1136/bmj.m1065  PMID: 32179517 
  7. Dipartimento Della Protezione Civile. [Civil Protection Department]. Homepage. [Accessed: 3 Apr 2020]. Italian. Available from: http://www.protezionecivile.gov.it/home
  8. National Statistic Institute (ISTAT). Conti economici territoriali. 2016-2018. [Territorial economic accounts. 2016-2018]. Rome: ISTAT; 2020. Italian. Available from: https://www.istat.it/it/files/2020/01/Conti-economici-territoriali.pdf
  9. Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DK, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill. 2020;25(3):25.  https://doi.org/10.2807/1560-7917.ES.2020.25.3.2000045  PMID: 31992387 
  10. World Health Organization (WHO). Country & Technical Guidance - Coronavirus disease (COVID-19). Geneva: WHO; 2020. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/laboratory-guidance
  11. Veneto Regional Government. Regional Government Deliberation number 344 of 17 March 2020 - Approval of the Plan “COVID-19 epidemic: urgent public health interventions”. Venice: Veneto Regional Government; 2020. Italian. Available from: https://bur.regione.veneto.it/BurvServices/pubblica/DettaglioDgr.aspx?id=417291
  12. European Centre for Disease Prevention and Control (ECDC). Discharge criteria for confirmed COVID-19 cases – When is it safe to discharge COVID-19 cases from the hospital or end home isolation? Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-Discharge-criteria.pdf
  13. European Centre for Disease Prevention and Control (ECDC). Contact tracing: Public health management of persons, including healthcare workers, having had contact with COVID-19 cases in the European Union – second update 2020. Stockholm: ECDC; 2020. Available from: https://www.ecdc.europa.eu/en/covid-19-contact-tracing-public-health-management
  14. Pasin L, Sella N, Correale C, Boscolo A, Rosi P, Saia M, et al. Regional COVID-19 Network for Coordination of SARS-CoV-2 outbreak in Veneto, Italy. J Cardiothorac Vasc Anesth. 2020;34(9):2341-5.  https://doi.org/10.1053/j.jvca.2020.05.005  PMID: 32425461 
  15. EpiCentro. Coronavirus. Rome: Istituto Superiore di Sanità. [Accessed: 4 Apr 2020]. Italian. Available from: https://www.epicentro.iss.it/coronavirus/
  16. Bai Y, Yao L, Wei T, Tian F, Jin D-Y, Chen L, et al. Presumed Asymptomatic Carrier Transmission of COVID-19. JAMA. 2020;323(14):1406-7.  https://doi.org/10.1001/jama.2020.2565  PMID: 32083643 
  17. Han Y, Yang H. The transmission and diagnosis of 2019 novel coronavirus infection disease (COVID-19): A Chinese perspective. J Med Virol. 2020;92(6):639-44.  https://doi.org/10.1002/jmv.25749  PMID: 32141619 
  18. Hoehl S, Rabenau H, Berger A, Kortenbusch M, Cinatl J, Bojkova D, et al. Evidence of SARS-CoV-2 Infection in Returning Travelers from Wuhan, China. N Engl J Med. 2020;382(13):1278-80.  https://doi.org/10.1056/NEJMc2001899  PMID: 32069388 
  19. Lai C-C, Liu YH, Wang C-Y, Wang Y-H, Hsueh S-C, Yen M-Y, et al. Asymptomatic carrier state, acute respiratory disease, and pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): Facts and myths. J Microbiol Immunol Infect. 2020;53(3):404-12.  https://doi.org/10.1016/j.jmii.2020.02.012  PMID: 32173241 
  20. Mizumoto K, Kagaya K, Zarebski A, Chowell G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill. 2020;25(10):25.  https://doi.org/10.2807/1560-7917.ES.2020.25.10.2000180  PMID: 32183930 
  21. Nishiura H, Kobayashi T, Miyama T, Suzuki A, Jung SM, Hayashi K, et al. Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19). Int J Infect Dis. 2020;94:154-5.  https://doi.org/10.1016/j.ijid.2020.03.020  PMID: 32179137 
  22. Pan X, Chen D, Xia Y, Wu X, Li T, Ou X, et al. Asymptomatic cases in a family cluster with SARS-CoV-2 infection. Lancet Infect Dis. 2020;20(4):410-1.  https://doi.org/10.1016/S1473-3099(20)30114-6  PMID: 32087116 
  23. Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C, et al. Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. N Engl J Med. 2020;382(10):970-1.  https://doi.org/10.1056/NEJMc2001468  PMID: 32003551 
  24. Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020;382(12):1177-9.  https://doi.org/10.1056/NEJMc2001737  PMID: 32074444 
  25. Li R, Pei S, Chen B, Song Y, Zhang T, Yang W, et al. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2). Science. 2020;368(6490):489-93.  https://doi.org/10.1126/science.abb3221  PMID: 32179701 
  26. Hellewell J, Abbott S, Gimma A, Bosse NI, Jarvis CI, Russell TW, et al. , Centre for the Mathematical Modelling of Infectious Diseases COVID-19 Working Group. Feasibility of controlling COVID-19 outbreaks by isolation of cases and contacts. Lancet Glob Health. 2020;8(4):e488-96.  https://doi.org/10.1016/S2214-109X(20)30074-7  PMID: 32119825 
  27. Wang Y, Wang Y, Chen Y, Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol. 2020;92(6):568-76.  https://doi.org/10.1002/jmv.25748  PMID: 32134116 
  28. Azman AS, Luquero FJ. From China: hope and lessons for COVID-19 control. Lancet Infect Dis. 2020;20(7):756-7.  https://doi.org/10.1016/S1473-3099(20)30264-4  PMID: 32251637 
  29. Ferretti L, Wymant C, Kendall M, Zhao L, Nurtay A, Abeler-Dörner L, et al. Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing. Science. 2020;368(6491):eabb6936.  https://doi.org/10.1126/science.abb6936  PMID: 32234805 
  30. Sjödin H, Wilder-Smith A, Osman S, Farooq Z, Rocklöv J. Only strict quarantine measures can curb the coronavirus disease (COVID-19) outbreak in Italy, 2020. Euro Surveill. 2020;25(13):25.  https://doi.org/10.2807/1560-7917.ES.2020.25.13.2000280  PMID: 32265005 
  31. Cereda D, Tirani M, Rovida F, Demicheli V, Ajelli M, Poletti P, et al. The early phase of the COVID-19 outbreak in Lombardy, Italy; ArXiv:200309320 [q-Bio] 2020. Available from: https://arxiv.org/abs/2003.09320
  32. World Health Organization (WHO). Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) 2020. Geneva: WHO; 2020. Available from: https://www.who.int/publications/i/item/report-of-the-who-china-joint-mission-on-coronavirus-disease-2019-(covid-19)
  33. Verity R, Okell LC, Dorigatti I, Winskill P, Whittaker C, Imai N, et al. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect Dis. 2020;20(6):669-77.  https://doi.org/10.1016/S1473-3099(20)30243-7  PMID: 32240634 
Epidemiology and public health response in early phase of COVID-19 pandemic, Veneto Region, Italy, 21 February to 2 April 2020
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Francesca+Russo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Russo Francesca</a>, <a href="/search?value1=Gisella+Pitter&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pitter Gisella</a>, <a href="/search?value1=Filippo+Da+Re&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Da Re Filippo</a>, <a href="/search?value1=Michele+Tonon&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tonon Michele</a>, <a href="/search?value1=Francesco+Avossa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Avossa Francesco</a>, <a href="/search?value1=Stefania+Bellio&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bellio Stefania</a>, <a href="/search?value1=Ugo+Fedeli&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fedeli Ugo</a>, <a href="/search?value1=Lorenzo+Gubian&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gubian Lorenzo</a>, <a href="/search?value1=Daniele+Monetti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Monetti Daniele</a>, <a href="/search?value1=Mario+Saia&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Saia Mario</a>, <a href="/search?value1=Francesca+Zanella&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zanella Francesca</a>, <a href="/search?value1=Manuel+Zorzi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zorzi Manuel</a>, <a href="/search?value1=Elena+Narne&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Narne Elena</a>, <a href="/search?value1=Domenico+Mantoan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mantoan Domenico</a></span>. Epidemiology and public health response in early phase of COVID-19 pandemic, Veneto Region, Italy, 21 February to 2 April 2020. <a href="/content/ecdc">Euro Surveill.</a> 2020;25(47):pii=2000548. <a href="https://doi.org/10.2807/1560-7917.ES.2020.25.47.2000548" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2020.25.47.2000548</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 08 Apr 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 14 Aug 2020 </span> </p>
/content/10.2807/1560-7917.ES.2020.25.47.2000548
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