Thread by @DellAnnaLuca

Crucial piece of information in evaluating the number of cases in Italy (from 7h ago): many doctors in Codogno – the epicenter – are in quarantine waiting to be tested, test kits are few. They're not testing doctors in the epicenter even with fever/cough unless also dyspnea.

1/N

2/ The regional welfare administrator: doctors in Codogno followed the protocols from WHO & MoH prescribing testing only those who came back from China […]we're lucky patient 1 met someone who came back from China (who later tested negative) otherwise we'd have a later diagnosis

3/ … if he didn't have a friend who came back from China, he would have been treated for days as if he had a pneumonia, we would have diagnosed him much later, perhaps the number of contagions would have been 2x or 3x.

(from his interview, paraphrased for Twitter char limit)

4/ This isn't a critique of the hospital – if test kits are limited, tradeoffs have to be made, and kits supply limits buying availability.

This is rather a note saying that the diagnostic net being cast is still very small, and more cases might surface as more people are tested

5/ I understand setting rules for the use of diagnostic kits if these are in limited supply (sigh).

I don't understand not limiting public gatherings or initiating other preventive measures before it's too late, because that's what you do when you cannot test during a pandemic.

6/ The most important question is: what are we learning out of it?

What are other countries learning from China?
What are other countries learning from Italy?
What systems are they putting in place *now* to avoid finding themselves in the same situation later?

7/ The Lombardy president: "we followed the protocols from the government, we proposed to make more controls, the PM told us to trust him."

Of course it's too late now, the right time to over-react is before there is a need to.

Posting this not as a critique, but as a learning.