Abstract
The effects of different COVID-19 swab testing policies in Italy need investigation. We examined the relationship between the number of COVID-19 swab tests (per 10,000 population) performed from February 24 through March 27 and 7-day lagged COVID-19 mortality (per 10,000 population) in four regions of northern Italy. Lombardy, Piedmont, and initially, also Emilia-Romagna, which followed recommendations for limiting swab testing to symptomatic subjects requiring hospitalization, had a much steeper increase in mortality with increasing number of tests performed than Veneto, which applied a policy of broader testing. The relationship between tests performed and mortality declined in Emilia-Romagna in coincidence with a substantial increase in the number of tests performed on March 18. When the cumulative number of tests performed was regressed linearly toward lagged mortality in Lombardy and Veneto, the slope of the regression was 133 in Veneto and 10.4 tests per one death in Lombardy. These findings suggest that the strategy adopted in Veneto, similar to that in South Korea, was effective in containing COVID-19 epidemics and should be applied in other regions of Italy and countries in Europe.
Highlights
On February 20, 2020, a first autochthonous case of COVID-19 respiratory disease was observed in Lombardy, Italy [1], soon followed by a second patient in Veneto
We observed that extensive swab testing, applied since the beginning of the epidemics, may contribute to reducing the spread of COVID-19 by identification of a high number of positive cases that can eventually be isolated [3, 7]
In Veneto, where a policy for extensive testing followed by strict isolation of positive cases was applied [3], the increase in COVID-19 mortality was milder than in the other regions, which initially clustered in a steeper relation between the number of tests and mortality
Summary
On February 20, 2020, a first autochthonous case of COVID-19 respiratory disease was observed in Lombardy, Italy [1], soon followed by a second patient in Veneto. Has been the Western country with the highest incidence of, and grimly with the greatest death toll from, COVID-19. Epidemiological surveillance and strategies for swab testing, followed by COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR), were under the control of regional healthcare authorities. On February 25, the Italian Ministry of Health issued more stringent policies for swab testing, prioritizing symptomatic patients with possible COVID-19 contacts requiring hospitalization. We aimed at assessing, using data from the first month of the Italian experience, how different policies for swab testing may impact on the initial progression of COVID19 epidemics
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