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I, a doctor, have doubts about the colored areas and the 21 Covid indicators. Here because

I, a doctor, have doubts about the colored areas and the 21 Covid indicators. Here because

Colored zones, Covid indicators and communication to citizens: what is going and what is not. The speech by Gianluigi Magri, doctor, former undersecretary and acting director for Research and Innovation of the University Hospital of Bologna

The pits are full of hindsight so I think we need to think quietly but in a short time to understand any errors to be corrected and the possibility of improvement.

My immediate perplexity regarding the division into colored zones arose from considering the 21 Covid indicators useful, but substantially too partial.

The monitoring of 9 parameters in two evaluation algorithms produces a risk matrix which, however, must be considered at the same time.

The assessment of the impact, albeit dynamic, of the indicators risks underestimating a gap whose consequences could be grasped too late.

Numerous phone calls from friends from Campania and Lazio described dramatic realities that are difficult to interpret with the characteristics of a yellow zone (theoretically in a less difficult situation).

Of course, the monitoring of the 21 indicators shows trends that end up describing the effectiveness of the intervention in the various territories, but perhaps too late and too partially.

Surely the evaluation of the data collection and evaluation capacity, the ability to deal with suspicious cases and the capabilities in resources and structures make a very important framework that is however too weak if it is not corrected by assessments on the level of compliance with the rules, on logistics of the territory (mainly transport and concentration of presences) and above all on the capacity of the territorial health structures to support the overall effort.

The ability to treat symptomatic paucis at home and the ability to quickly screen health workers, which necessarily represent a formidable potential for contagion, are unavoidable characteristics.

If the mutations of the virus and the improvement of the therapeutic capacity have certainly influenced the decrease in lethality, the progressive increase of the infection risks reaching shortly the saturation of the response capacity.

The number of operators then represents a very uncertain parameter where the means available are too different in the different situations.

The famous USCAs in some territories have given important results, in others they are non-existent and the ability to communicate with the citizen passes from rare examples of efficiency to the most frequent cases of lack of answers, of perpetually busy switchboards, of difficulty in reaching diagnostic devices. .

Home care for the dependent, the sick and the elderly shows the usual patchy Italy with situations of real abandonment of citizens.

Another fundamental fact is the ability to transmit clear indications to the territory, to transfer means and resources and above all the capacity and reaction times of the territory to the new organizational and structural needs.

In other words, the evaluation of 21 indicators, if not accompanied by an accurate analysis of the territory, risks not grasping the effective response capacities. A brilliant epidemiological study is essential, but it must be useful for a contextualized analysis.

Last but not least, I put the communication to the citizens which should be summarized in a few clear rules of behavior which, instead, submerged by an exhibitionistic chatter, end up giving information that is often wrong and contradictory.


This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/io-medico-ho-dubbi-sulle-zone-colorate-e-i-21-indicatori-covid/ on Wed, 11 Nov 2020 15:30:21 +0000.