Abstract
Background: a second wave (W2) of COVID-19 is affecting Italy.
 Objective: to analyze the ratio between deaths and positive cases in two different 36-day periods of W2.
 Methods: data were retrieved by the Official Bulletin of the Italian Protezione Civile. The analysis was based on mobile averages.
 Results: The ratios deaths/positive cases in the first 35-day period form October 9th and November 13th were of 2.45 ± 0.482 and in the second 36-day period from November 14th and December 19th was 2.37 ± 0.416. There is no statistical difference between the periods (p> 0.05). The differences are significant (p<0.01) in terms of trends, since in the first period the curve is flat, while in the second is growing.
 Conclusions: the reason of the different trends are several, such as the starting of the colder season, the delay in providing with the common flu vaccination. the confusion about the initiative of lockdown, and the poor care for the older people.
Highlights
The data of positive cases and deaths were taken from the Official Bulletins of the Protezione civile [1.]
The curve was arbitrarily divided into two period of 36 days: the Ratio deaths/positive cases and the relative regression analysis of the first period are reported respectively in Fig. 2 and 3
The present study has some limitations due to the median time calculated between the viral infection and death which has been settled at 15 days
Summary
During the first wave (W1) of COVID-19 in Italy, approximately between end of February and of June 2020, the official records [1] were reporting 240578 positive cases and 34788 deaths, corresponding to about 14.46 % of mortality.Starting from approximately September 25th, a second wave (W2) was appearing and updating the values to December 19th the number of positive cases increased to about 1.63 million (1.634150) and deaths were 32708 accounting for 2.00 % of mortality.The deaths ratio during W2 was improving consistently compared to W1 when it was 14.9 %, thanks to the efficiency of the medical personnel (doctors, nurses, assistants) and for the high number of asymptomatic swabs.According to the official data [2], from the moment of positivity to the moment of deaths the median value was calculated in 12 days. During the first wave (W1) of COVID-19 in Italy, approximately between end of February and of June 2020, the official records [1] were reporting 240578 positive cases and 34788 deaths, corresponding to about 14.46 % of mortality. Starting from approximately September 25th, a second wave (W2) was appearing and updating the values to December 19th the number of positive cases increased to about 1.63 million (1.634150) and deaths were 32708 accounting for 2.00 % of mortality. According to the official data [2], from the moment of positivity to the moment of deaths the median value was calculated in 12 days. The symptoms start as average 3 days after the infection which means that the ratio between positivity and deaths should be calculated with a shift of 15 days. We are observing two different trends during the 72 days; in the first part of W2 between October 9th and November 13th (36 days) the ratio was flat, while in the following period between November 14th and December 19th (36 days) the ratio was increasing
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