Working Paper Article Version 1 This version is not peer-reviewed

The Evolution of COVID-19 in Italy after the Spring of 2020: An Unpredicted Summer Respite Followed by a Second Wave

Version 1 : Received: 31 October 2020 / Approved: 3 November 2020 / Online: 3 November 2020 (11:57:06 CET)

A peer-reviewed article of this Preprint also exists.

De Natale, G.; De Natale, L.; Troise, C.; Marchitelli, V.; Coviello, A.; Holmberg, K.G.; Somma, R. The Evolution of Covid-19 in Italy after the Spring of 2020: An Unpredicted Summer Respite Followed by a Second Wave. Int. J. Environ. Res. Public Health 2020, 17, 8708. De Natale, G.; De Natale, L.; Troise, C.; Marchitelli, V.; Coviello, A.; Holmberg, K.G.; Somma, R. The Evolution of Covid-19 in Italy after the Spring of 2020: An Unpredicted Summer Respite Followed by a Second Wave. Int. J. Environ. Res. Public Health 2020, 17, 8708.

Journal reference: Int. J. Environ. Res. Public Health 2020, 17, 8708
DOI: 10.3390/ijerph17238708

Abstract

The coronavirus (COVID-19) pandemic was particularly invasive in Italy during the period between March and late April 2020 then decreased in both in the number of infections and in the seriousness of the illness throughout the summer of 2020. In this discussion, we measure the severity of the disease by the ratio of Intensive Care Units (ICU) spaces occupied by COVID-19 patients and the number of Active Cases (AC) each month from April to October 2020. We also use the ratio of the number of Deaths (D) to the number of Active Cases. What clearly emerges, from rigorous statistical analysis, is a progressive decrease in both ratios until August, indicating progressive mitigation of the disease. This is particularly evident when comparing March-April with July-August; during the summer period the two ratios became roughly 18 times lower. We test such sharp decreases against possible bias in counting active cases and we confirm their statistical significance. We then interpret such evidence in terms of the well-known seasonality of the human immune system and the virus-inactivating effect of stronger UV rays in the summer. Both ratios, however, increased again in October as ICU/AC began to increase in September 2020. These ratios and the exponential growth of infections in October indicate that the virus - if not contained by strict measures - will lead to unsustainable challenges for the Italian health system in the winter of 2020-2021 .

Subject Areas

Covid-19 in Italy; summer mitigation; autumn sharp worsening of epidemics

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