New red areas: what are the 21 indicators that decree the report cards of the regions?

14 November 20203 years ago babelfish

The government has decided to redefine the color map of Italy by changing the color of five Regions. The in-depth study on the 21 indicators of discord

The government has decided to redefine the color map of Italy by changing the color of five Regions.

Emilia-Romagna , Friuli and Marche become orange areas, joining Abruzzo, Basilicata, Liguria, Puglia, Sicily and Umbria. Veneto, poised until the last moment, remains for the moment in the yellow zone. Tuscany and Campania, on the other hand, turn red and enter the maximum risk area together with Calabria, Lombardy, Piedmont, the Autonomous Province of Bolzano and Valle d'Aosta. These provisions will come into force on Sunday 15 November 2020 .

Campania with a single step has jumped two steps moving from all the yellow regions to the red zone, unleashing the ire of the Governor Vincenzo De Luca who thundered against the national government. This decision was made by the Minister of Health in the latest report with the data of the 21 indicators updated to 11 November 2020.

What are the 21 indicators

On 30 April 2020, when Italy was emerging from the most acute phase of the first wave of the pandemic, the Ministry of Health passed the decree establishing the 21 indicators , 16 mandatory and 5 optional, to establish the trend of the epidemic. From the following week, 4-10 May 2020, the Ministry of Health , together with the Higher Institute of Health, the Regions and the Autonomous Provinces, on the basis of the 21 indicators , produces national and regional reports with which the evolution of the epidemic in the country and in the regions, noting every step change in the spread of the virus.

The three variables for the regions

The indicators of the Ministry of Health make it possible to verify three aspects of interest for risk assessment: the monitoring capacity , the capacity for diagnostic assessment , investigation and management of contacts, the stability of transmission and the stability of health services .

The collected data, each of which has an alert threshold, are analyzed through two algorithms, one for probability and one for impact, from these analyzes the level of risk is calculated for each Region and for the national territory as a whole. .

What moves a region from one risk level to another

To define the three fundamental variables for the study of the pandemic, multiple indicators are needed, each of which, as mentioned, has its own level of alert. If for more indicators a Region exceeds the alert level it must be moved to the risk level immediately and, therefore, change color.

What are the 21 indicators

The 21 indicators, identified by the decree of the Ministry of Health and included in annex 10 of the dpcm of 26 April 2020 , are divided by type of variable analyzed.

Monitoring capabilities

Number of symptomatic cases reported per month in which symptomatic start date is indicated / total of symptomatic cases reported to the surveillance system in the same period.
Number of cases reported per month with a history of hospital admission (in wards other than IT) indicating the date of admission / total of cases with a history of hospital admission (in wards other than IT) notified to the surveillance system in the same period.
Number of cases notified per month with history of transfer / ICU admission indicating the date of transfer or admission in Tl / total of cases with history of transfer / ICU admission reported to the surveillance system during the same period.
Number of cases notified per month in which the municipality of domicile or residence is reported / total of cases notified to the surveillance system in the same period.
Number of checklists administered weekly to residential and health care facilities (optional).
Number of social and health residential structures that respond to the checklist weekly with at least one criticality found (optional).

Ability to diagnose, investigate and manage contacts

Percentage of positive swabs excluding as far as possible all screening and "re-testing" activities of the same subjects, overall and by macro-setting (territorial, PS / hospital, other) per month.
Time between symptom onset date and diagnosis date.
Time between symptom onset date and isolation date (optional).
Number, type of professional figures and time / person dedicated in each territorial service to contact-tracking.
Number, type of professional figures and time / person dedicated in each territorial service to the activities of sampling / sending to the reference laboratories and monitoring of close contacts and cases placed respectively in quarantine and isolation.
Number of confirmed cases of infection in the region for which a regular epidemiological survey has been carried out with search of close contacts / total of new confirmed cases of infection.

Stability of transmission and resilience of health services

Number of cases reported to the Civil Protection in the last 14 days.
Rt calculated on the basis of integrated ISS surveillance (two indicators will be used, based on symptom start date and hospitalization date).
Number of cases reported to sentinel COVID-net surveillance per week (optional).
Number of cases by diagnosis date and symptom onset date reported to integrated COVID-19 surveillance per day.
Number of new transmission outbreaks (2 or more epidemiologically linked cases or an unexpected increase in the number of cases in a defined time and place).
Number of new cases of confirmed SARS-CoV-2 infection per region not associated with known transmission chains.
Number of accesses to the PS with ICD-9 classification compatible with syndromic frameworks attributable to COVID-19 (optional).
Occupancy rate of total ICU beds for COVID-19 patients.
Occupancy rate of total medical area beds for COVID-19 patients.

This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/nuove-zone-rosse-quali-sono-i-21-indicatori-che-decretano-le-pagelle-delle-regioni/ on Sat, 14 Nov 2020 17:21:34 +0000.