The early phase of the COVID-19 epidemic in Lombardy, Italy

Background: In the night of February 20, 2020, the first epidemic of the novel coronavirus disease (COVID-19) outside Asia was uncovered by the identification of its first patient in Lombardy region, Italy. In the following weeks, Lombardy experienced a sudden increase in the number of ascertained i...

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Autores principales:	Danilo Cereda, Mattia Manica, Marcello Tirani, Francesca Rovida, Vittorio Demicheli, Marco Ajelli, Piero Poletti, Filippo Trentini, Giorgio Guzzetta, Valentina Marziano, Raffaella Piccarreta, Antonio Barone, Michele Magoni, Silvia Deandrea, Giulio Diurno, Massimo Lombardo, Marino Faccini, Angelo Pan, Raffaele Bruno, Elena Pariani, Giacomo Grasselli, Alessandra Piatti, Maria Gramegna, Fausto Baldanti, Alessia Melegaro, Stefano Merler
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	COVID-19 SARS-CoV-2 Epidemiology Transmission dynamics Reproduction number Coronavirus Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/346cfc8d2e4a41cfa372778df672c65f
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spelling	oai:doaj.org-article:346cfc8d2e4a41cfa372778df672c65f2021-11-22T04:19:58ZThe early phase of the COVID-19 epidemic in Lombardy, Italy1755-436510.1016/j.epidem.2021.100528https://doaj.org/article/346cfc8d2e4a41cfa372778df672c65f2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1755436521000724https://doaj.org/toc/1755-4365Background: In the night of February 20, 2020, the first epidemic of the novel coronavirus disease (COVID-19) outside Asia was uncovered by the identification of its first patient in Lombardy region, Italy. In the following weeks, Lombardy experienced a sudden increase in the number of ascertained infections and strict measures were imposed to contain the epidemic spread. Methods: We analyzed official records of cases occurred in Lombardy to characterize the epidemiology of SARS-CoV-2 during the early phase of the outbreak. A line list of laboratory-confirmed cases was set up and later retrospectively consolidated, using standardized interviews to ascertained cases and their close contacts. We provide estimates of the serial interval, of the basic reproduction number, and of the temporal variation of the net reproduction number of SARS-CoV-2. Results: Epidemiological investigations detected over 500 cases (median age: 69, IQR: 57–78) before the first COVID-19 diagnosed patient (February 20, 2020), and suggested that SARS-CoV-2 was already circulating in at least 222 out of 1506 (14.7%) municipalities with sustained transmission across all the Lombardy provinces. We estimated the mean serial interval to be 6.6 days (95% CrI, 0.7–19). Our estimates of the basic reproduction number range from 2.6 in Pavia (95% CI, 2.1–3.2) to 3.3 in Milan (95% CI, 2.9–3.8). A decreasing trend in the net reproduction number was observed following the detection of the first case. Conclusions: At the time of first case notification, COVID-19 was already widespread in the entire Lombardy region. This may explain the large number of critical cases experienced by this region in a very short timeframe. The slight decrease of the reproduction number observed in the early days after February 20, 2020 might be due to increased population awareness and early interventions implemented before the regional lockdown imposed on March 8, 2020.Danilo CeredaMattia ManicaMarcello TiraniFrancesca RovidaVittorio DemicheliMarco AjelliPiero PolettiFilippo TrentiniGiorgio GuzzettaValentina MarzianoRaffaella PiccarretaAntonio BaroneMichele MagoniSilvia DeandreaGiulio DiurnoMassimo LombardoMarino FacciniAngelo PanRaffaele BrunoElena ParianiGiacomo GrasselliAlessandra PiattiMaria GramegnaFausto BaldantiAlessia MelegaroStefano MerlerElsevierarticleCOVID-19SARS-CoV-2EpidemiologyTransmission dynamicsReproduction numberCoronavirusInfectious and parasitic diseasesRC109-216ENEpidemics, Vol 37, Iss , Pp 100528- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 SARS-CoV-2 Epidemiology Transmission dynamics Reproduction number Coronavirus Infectious and parasitic diseases RC109-216
spellingShingle	COVID-19 SARS-CoV-2 Epidemiology Transmission dynamics Reproduction number Coronavirus Infectious and parasitic diseases RC109-216 Danilo Cereda Mattia Manica Marcello Tirani Francesca Rovida Vittorio Demicheli Marco Ajelli Piero Poletti Filippo Trentini Giorgio Guzzetta Valentina Marziano Raffaella Piccarreta Antonio Barone Michele Magoni Silvia Deandrea Giulio Diurno Massimo Lombardo Marino Faccini Angelo Pan Raffaele Bruno Elena Pariani Giacomo Grasselli Alessandra Piatti Maria Gramegna Fausto Baldanti Alessia Melegaro Stefano Merler The early phase of the COVID-19 epidemic in Lombardy, Italy
description	Background: In the night of February 20, 2020, the first epidemic of the novel coronavirus disease (COVID-19) outside Asia was uncovered by the identification of its first patient in Lombardy region, Italy. In the following weeks, Lombardy experienced a sudden increase in the number of ascertained infections and strict measures were imposed to contain the epidemic spread. Methods: We analyzed official records of cases occurred in Lombardy to characterize the epidemiology of SARS-CoV-2 during the early phase of the outbreak. A line list of laboratory-confirmed cases was set up and later retrospectively consolidated, using standardized interviews to ascertained cases and their close contacts. We provide estimates of the serial interval, of the basic reproduction number, and of the temporal variation of the net reproduction number of SARS-CoV-2. Results: Epidemiological investigations detected over 500 cases (median age: 69, IQR: 57–78) before the first COVID-19 diagnosed patient (February 20, 2020), and suggested that SARS-CoV-2 was already circulating in at least 222 out of 1506 (14.7%) municipalities with sustained transmission across all the Lombardy provinces. We estimated the mean serial interval to be 6.6 days (95% CrI, 0.7–19). Our estimates of the basic reproduction number range from 2.6 in Pavia (95% CI, 2.1–3.2) to 3.3 in Milan (95% CI, 2.9–3.8). A decreasing trend in the net reproduction number was observed following the detection of the first case. Conclusions: At the time of first case notification, COVID-19 was already widespread in the entire Lombardy region. This may explain the large number of critical cases experienced by this region in a very short timeframe. The slight decrease of the reproduction number observed in the early days after February 20, 2020 might be due to increased population awareness and early interventions implemented before the regional lockdown imposed on March 8, 2020.
format	article
author	Danilo Cereda Mattia Manica Marcello Tirani Francesca Rovida Vittorio Demicheli Marco Ajelli Piero Poletti Filippo Trentini Giorgio Guzzetta Valentina Marziano Raffaella Piccarreta Antonio Barone Michele Magoni Silvia Deandrea Giulio Diurno Massimo Lombardo Marino Faccini Angelo Pan Raffaele Bruno Elena Pariani Giacomo Grasselli Alessandra Piatti Maria Gramegna Fausto Baldanti Alessia Melegaro Stefano Merler
author_facet	Danilo Cereda Mattia Manica Marcello Tirani Francesca Rovida Vittorio Demicheli Marco Ajelli Piero Poletti Filippo Trentini Giorgio Guzzetta Valentina Marziano Raffaella Piccarreta Antonio Barone Michele Magoni Silvia Deandrea Giulio Diurno Massimo Lombardo Marino Faccini Angelo Pan Raffaele Bruno Elena Pariani Giacomo Grasselli Alessandra Piatti Maria Gramegna Fausto Baldanti Alessia Melegaro Stefano Merler
author_sort	Danilo Cereda
title	The early phase of the COVID-19 epidemic in Lombardy, Italy
title_short	The early phase of the COVID-19 epidemic in Lombardy, Italy
title_full	The early phase of the COVID-19 epidemic in Lombardy, Italy
title_fullStr	The early phase of the COVID-19 epidemic in Lombardy, Italy
title_full_unstemmed	The early phase of the COVID-19 epidemic in Lombardy, Italy
title_sort	early phase of the covid-19 epidemic in lombardy, italy
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/346cfc8d2e4a41cfa372778df672c65f
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The early phase of the COVID-19 epidemic in Lombardy, Italy

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