Abstract
The epidemic of coronavirus-disease-2019 (COVID-19) started in Italy with the first official diagnosis on 21 February 2020; However, it is not known how many cases were already present in earlier days and weeks, thus limiting the possibilities of conducting any retrospective analysis. We hypothesized that an unbiased representation of COVID-19 diffusion in these early phases could be inferred by the georeferenced calls to the emergency number relevant to respiratory problems and by the following emergency medical services (EMS) interventions. Accordingly, the aim of this study was to identify the beginning of anomalous trends (change in the data morphology) in emergency calls and EMS ambulances dispatches and reconstruct COVID-19 spatiotemporal evolution on the territory of Lombardy region. Accordingly, a signal processing method, previously used to find morphological features on the electrocardiographic signal, was applied on a time series representative of territorial clusters of about 100,000 citizens. Both emergency calls and age- and gender-weighted ambulance dispatches resulted strongly correlated to COVID-19 casualties on a provincial level, and the identified local starting days anticipated the official diagnoses and casualties, thus demonstrating how these parameters could be effectively used as early indicators for the spatiotemporal evolution of the epidemic on a certain territory.
Highlights
The epidemic of COronaVIrus Disease 2019 (COVID-19), generated by the diffusion of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), officially started in Italy on 21 February 2020, when the first case was diagnosed in the hospital of Codogno (Lodi province), a small city in the south of Lombardy region (Figure 1A), the most populated area of Italy with 10.06 million residents (16.67% of the total 60.36 million people living in Italy)
The georeferenced database of calls performed by citizens to the unique emergency number 112 and that of emergency medical services (EMS) ambulance dispatches on the Lombardy territory from 1 January to 23 March 2020 was provided after anonymization by AREU (Azienda Regionale Emergenza/Urgenza), which is the EMS provider in Lombardy and the manager of the calls to the unique emergency number 112
The analysis of georeferenced databases of emergency calls to 112 emergency number and dispatches of ambulances by EMS provider for the Lombardy region, Italy, was performed in an attempt to understand the temporal early evolution of the COVID-19
Summary
The epidemic of COronaVIrus Disease 2019 (COVID-19), generated by the diffusion of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), officially started in Italy on 21 February 2020, when the first case was diagnosed in the hospital of Codogno (Lodi province), a small city in the south of Lombardy region (Figure 1A), the most populated area of Italy with 10.06 million residents (16.67% of the total 60.36 million people living in Italy).ISPRS Int. After, screening protocols were rearranged to understand the contagion line, tracing back aIlml cmoendtaiactteslyfoarfpteero, pslcerereensiunlgtinpgroptoocsoitlisvewteoretersetsa.rraWngheedn, taoftuerndfeewrstadnadys,thtehecorenctaogrdioend lcinasee, s extcraeceidnegdbtarcakcinalgl pcoonstsaibctislitfioers p[1e]o,polnelyrepsuelotpinlge sphooswitiivnegtcootmesptsa.tiWblheesny,mafptteormfeswwditahyCs,OthVeIDre-c1o9rdweedre “tmerem“cwseadrtaeeeessrzdaedAueossA(urntesazeereexocsssescccnets”woeeoceedwnortsehddn”dre(eeieadrndhcettaghwchotdaoeorttodorsoatdposcphtlpwiipoiotnnmoetttoggedtswidptwtphoeooaoodonatslsnsstissl2miioid2ip4dbdc4ieoeiteaFlnetnFinlsedttteticbiieibfiafilifrsodripueeeuce[ddaada1anbrl]rsityi,inycionlfoai2itf2VnepVi0a0edloar2oy2s,b’0’0)iipsE.nEl(o(ieuwcwutoilggeufipiatastadlhh)nreni.,nee22soog22ihn99om((cPPwcclouaaooirdddnnneoifogfinitvvrrhgcmamaoanmpepmedrdr5pooo0carvcv,ate0aiiisn0sbnece0tlcsheeser,aoes,onVfysVfiimedien5nnnefp0efene,tetc0ottoctso0mi)t0o),iio,nsnaanrn)w1ne)d2bsidbytimchdycoieusoCinnosnntOotlaitsaclaVitainiipiItnnmnDiangmle-ig11antei92satnesst (Fmiguunrieci1pBa)l.itiTehse(sFeigmureeas1uBr)e.sTwhehseeremoeanslyureefsfewcthievree wonitlhyineftfhecetiivnetewreisthteind tahreeaisn;tearsesatemd aatrteearso; fasfaact, thme adtitfefruosifofnacotf, tthhee depififduesimonicoofutthseideepitdheemmicwoaustasildreeatdhyemexwpoanseanlrteiaaldaynedxapfofnecetnintigaltahnedwahffoelceticnogutnhtery, thwusholleeacdoinugntrtoy, tthheusgloevaderinngmteontth’se dgoevciesrinomn etnot’ssedcuecriesiaonn teoxsteencudreedanreedxtzeonndeedinrceldudzoinnge,inactlufidrsint go,n 9 aMt afrircsht 2o0n209, Mthaerwchho2l0e20L,otmhebawrdhyolreegLioomn baanrdd1y4roegthioenr parnodvi1n4ceost,hwerhipcrhowviansceqsu, iwckhlyichexwteansdqeduitcokltyhe wehxotleenndaetdiotnoatlhteerwrihtoolreynoanti1o1naMl taerrcrhito2r0y20o.n 11 March 2020
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