tetano
Editor, Senior Moderator
Bull World Health Organ
. 2022 Feb 1;100(2):161-167.
doi: 10.2471/BLT.21.286317. Epub 2021 Nov 25.
COVID-19 response: effectiveness of weekly rapid risk assessments, Italy
Flavia Riccardo[SUP] 1 [/SUP], Giorgio Guzzetta[SUP] 2 [/SUP], Alberto Mateo Urdiales[SUP] 1 [/SUP], Martina Del Manso[SUP] 1 [/SUP], Xanthi D Andrianou[SUP] 1 [/SUP], Antonino Bella[SUP] 1 [/SUP], Patrizio Pezzotti[SUP] 1 [/SUP], Simona Carbone[SUP] 3 [/SUP], Tiziana De Vito[SUP] 3 [/SUP], Francesco Maraglino[SUP] 3 [/SUP], Vittorio Demicheli[SUP] 4 [/SUP], Claudio Dario[SUP] 5 [/SUP], Enrico Coscioni[SUP] 6 [/SUP], Giovanni Rezza[SUP] 3 [/SUP], Andrea Urbani[SUP] 3 [/SUP], Stefano Merler[SUP] 2 [/SUP], Silvio Brusaferro[SUP] 1 [/SUP], Italian COVID-19 monitoring group
Affiliations
Abstract
in English, French, Spanish, Arabic, Chinese, Russian
Problem: After Italy's first national restriction measures in 2020, a robust approach was needed to monitor the emerging epidemic of coronavirus disease 2019 (COVID-19) at subnational level and provide data to inform the strengthening or easing of epidemic control measures.
Approach: We adapted the European Centre for Disease Prevention and Control rapid risk assessment tool by including quantitative and qualitative indicators from existing national surveillance systems. We defined COVID-19 risk as a combination of the probability of uncontrolled transmission of severe acute respiratory syndrome coronavirus 2 and of an unsustainable impact of COVID-19 cases on hospital services, adjusted in relation to the health system's resilience. The monitoring system was implemented with no additional cost in May 2020.
Local setting: The infectious diseases surveillance system in Italy uses consistent data collection methods across the country's decentralized regions and autonomous provinces.
Relevant changes: Weekly risk assessments using this approach were sustainable in monitoring the epidemic at regional level from 4 May 2020 to 24 September 2021. The tool provided reliable assessments of when and where a rapid increase in demand for health-care services would occur if control or mitigation measures were not increased in the following 3 weeks.
Lessons learnt: Although the system worked well, framing the risk assessment tool in a legal decree hampered its flexibility, as indicators could not be changed without changing the law. The relative complexity of the tool, the impossibility of real-time validation and its use for the definition of restrictions posed communication challenges.
. 2022 Feb 1;100(2):161-167.
doi: 10.2471/BLT.21.286317. Epub 2021 Nov 25.
COVID-19 response: effectiveness of weekly rapid risk assessments, Italy
Flavia Riccardo[SUP] 1 [/SUP], Giorgio Guzzetta[SUP] 2 [/SUP], Alberto Mateo Urdiales[SUP] 1 [/SUP], Martina Del Manso[SUP] 1 [/SUP], Xanthi D Andrianou[SUP] 1 [/SUP], Antonino Bella[SUP] 1 [/SUP], Patrizio Pezzotti[SUP] 1 [/SUP], Simona Carbone[SUP] 3 [/SUP], Tiziana De Vito[SUP] 3 [/SUP], Francesco Maraglino[SUP] 3 [/SUP], Vittorio Demicheli[SUP] 4 [/SUP], Claudio Dario[SUP] 5 [/SUP], Enrico Coscioni[SUP] 6 [/SUP], Giovanni Rezza[SUP] 3 [/SUP], Andrea Urbani[SUP] 3 [/SUP], Stefano Merler[SUP] 2 [/SUP], Silvio Brusaferro[SUP] 1 [/SUP], Italian COVID-19 monitoring group
Affiliations
- PMID: 35125541
- PMCID: PMC8795855
- DOI: 10.2471/BLT.21.286317
Abstract
in English, French, Spanish, Arabic, Chinese, Russian
Problem: After Italy's first national restriction measures in 2020, a robust approach was needed to monitor the emerging epidemic of coronavirus disease 2019 (COVID-19) at subnational level and provide data to inform the strengthening or easing of epidemic control measures.
Approach: We adapted the European Centre for Disease Prevention and Control rapid risk assessment tool by including quantitative and qualitative indicators from existing national surveillance systems. We defined COVID-19 risk as a combination of the probability of uncontrolled transmission of severe acute respiratory syndrome coronavirus 2 and of an unsustainable impact of COVID-19 cases on hospital services, adjusted in relation to the health system's resilience. The monitoring system was implemented with no additional cost in May 2020.
Local setting: The infectious diseases surveillance system in Italy uses consistent data collection methods across the country's decentralized regions and autonomous provinces.
Relevant changes: Weekly risk assessments using this approach were sustainable in monitoring the epidemic at regional level from 4 May 2020 to 24 September 2021. The tool provided reliable assessments of when and where a rapid increase in demand for health-care services would occur if control or mitigation measures were not increased in the following 3 weeks.
Lessons learnt: Although the system worked well, framing the risk assessment tool in a legal decree hampered its flexibility, as indicators could not be changed without changing the law. The relative complexity of the tool, the impossibility of real-time validation and its use for the definition of restrictions posed communication challenges.