Despite myriad challenges, clinicians see room for progress.
Image credit: Shutterstock/David Tadevosian.
New Research In
Physical Sciences
Featured Portals
Articles by Topic
Biological Sciences
Featured Portals
Articles by Topic
Edited by Andrea Rinaldo, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland, and approved December 14, 2020 (received for review September 18, 2020)
Article Figures & SI
Figures
- Fig. 1.
(A) Mean number (bars) and 95% CI (lines) of daily contacts by type of contact aggregated over three age groups (0 to 19, 20 to 59, and 60+ y old) as estimated from the analysis of the contact diaries collected in 2007 for the Italian population by the POLYMOD study (17). (B) Heat map of the overall contact matrix representing the mean daily number of contacts that an individual of a given age group has with other individuals, stratified by age group, used in the model to represent contact rates in the predetection epidemic phase. The color of each cell represents the mean total number of daily contacts (scale on the right). The contact matrix shown here is the mean of 300 bootstrapped contact matrices as obtained by the analysis of the contact diaries collected in 2007 for the Italian population by the POLYMOD study (17) (SI Appendix). (C) Workforce involved in different employment sectors who were physically present at work throughout the lockdown, worked from home since the lockdown, or were suspended and then reopened at different times (data from ref. 31); red diamonds represent the integrated occupational risk of exposure to SARS-CoV-2 in each sector (data from ref. 31; scale on the right y axis). (D) Proportion of contacts over time with respect to the preepidemic period in transportation means, leisure venues, and other generic settings, derived from refs. 32, 33 (SI Appendix). Main events and national government decisions for control of the COVID-19 epidemic are indicated. (E) Schematic representation of the timeline of different phases considered in the actual interventions (scenario 1) and in 18 counterfactual scenarios.
- Fig. 2.
(A) Daily hospitalizations with COVID-19 over time in Italy, according to surveillance data (10) (gray bars) and as estimated by the baseline model, scenario 1 (solid line, median; shaded area, 95% CI). (B) Comparison of estimates of the net reproduction number Rt, averaged over a weekly moving window, obtained from the daily number of symptomatic cases by date of symptom onset from surveillance data (10) (black solid line, median; shaded areas, 95% CI) and from estimates of the baseline model, scenario 1 (blue solid line, median; shaded areas, 95% CI). (C) Peak hospital and ICU bed occupancy by patients with COVID-19 according to official data (11) (dots) and corresponding baseline model estimates (boxplots: median, interquartile ranges, and 95% CI). (D) Hospital and ICU bed occupancy by patients with COVID-19 on September 30, according to official data (11) (dots) and corresponding baseline model estimates (boxplots: median, interquartile ranges, and 95% CI).
- Fig. 3.
Daily hospitalizations with COVID-19 over time in Italy, according to surveillance data (10) (gray bars) and as estimated in (A) scenario 2 (end of lockdown anticipated to May 4), (B) scenario 6 (end of lockdown anticipated to May 4 + reopening of all educational levels), and (C) scenario 14 (end of lockdown anticipated to April 20). Solid line, median; shaded area, 95% CI.
- Fig. 4.
Daily hospitalizations with COVID-19 (thousands) over time in Italy, according to surveillance data (10) (gray bars, used for calibration; green bars, additional data points) and as projected under the assumption that the reopening of all educational levels and community contacts are maintained unchanged until December 23, without further control interventions. Red indicates projections from 10,000 model realizations; blue indicates the subset of 1,000 simulations with highest Poisson likelihood over hospital admissions occurring between September 15 and October 31. Solid line, median; shaded area, 95% CI.
- Fig. 5.
Subnational analysis for Campania, Lazio, and Lombardy. (A–C). Model estimated daily hospital admissions per 100,000 individuals under scenario 1 (actual interventions) after the lifting of lockdown in the three regions (solid lines, median; shaded area, 95% CI). (D) Model estimated incidence of infection per 10,000 individuals at the date of lifting of lockdown for selected scenarios (mean and 95% CI). (E) Estimated proportion of immune individuals on May 18 (mean and 95% CI). (F) Model estimated cumulative hospital admissions per 100,000 individuals under selected scenarios (mean and 95% CI).
Tables
For all scenarios, all educational levels are closed on March 5 and reopened on September 14, and national lockdown initiates on March 11. For scenarios reopening schools after lockdown, the natural summer break is assumed between June 10 and September 14 for all educational levels except kindergartens, which are assumed to be closed between August 1 and September 14. Median and 95% CI are reported for the cumulative number of patients admitted to a hospital or ICU before September 30, and the hospital and ICU bed occupancy on September 30. Purple represents observed values, pink is the scenario representing actual interventions, and different shades of blue differ by the date of lifting of lockdown.
* K, kindergartens; P, primary; S, secondary; H, high schools. Reopening is assumed on the same day the lockdown is lifted.
Data supplements
Supporting Information
Retrospective analysis of the Italian exit strategy from COVID-19 lockdown
Sign up for Article Alerts
Article Classifications
- Biological Sciences
- Medical Sciences
Jump to section
You May Also be Interested in
Better explicating the strengths and shortcomings of these models will help refine projections and improve transparency in the years ahead.
Image credit: Witsawat.S.
Using CRISPR, researchers showed that a region some used to label “junk DNA” has a major role in a rare genetic disorder.
Image credit: Nathan Devery.
Mara Reed and Michael Manga explore why Yellowstone's Steamboat Geyser resumed erupting in 2018.
A study demonstrates how two enzymes—MHETase and PETase—work synergistically to depolymerize the plastic pollutant PET.
Image credit: Aaron McGeehan (artist).