21 April 2020. To open or not to open? This is the question currently tormenting Italian policy-makers, and consequently millions of people deprived of their basic liberty and rights.
Daily deaths have plunged from 800-1000 to 400-600 in the last couple of weeks. Is this the result of the reduction of the infection rate due to the lock-down? Indeed, 3-4 weeks are needed from incubation to death (or recovery), and the current lag from the beginning of the lockdown – and the likely reduction in R0 - is likely why we only now see the decline in the number of deaths. This is also confirmed by the decline in acute hospitalization. Or, as some people think, the peak would have passed anyway, and we are on the declining side of the curve? While I do not believe this second explanation is true, I must admit that we will never know for sure until we get able to test representative samples of the population. Such tests should be carried out in all regions and all provinces, and in all big cities.
Unfortunately, the regional and central governments have waited far too long to do random representative sample swab testing, which could easily and cheaply have started two months ago. By now, this would have tracked the evolution of contagion through the population in a reliable way to correctly inform decision-makers. Instead we have the official numbers, which are no good substitute, because they are not representative of the whole population. They in fact suffer from "selection bias" and are statistically almost meaningless.
Even if we now start proper swab testing, it would be too late, as we would not be able to have any idea of how many people have already recovered from Covid-19, because they would appear anyway negative to Covid-19. Our only fortune is that serological testing will soon become available, so we have a chance to finally starting to collect decent data, worthy of an advanced country.
Before proper sampling is done, reopening is just a hazard: the (in-)famous R0 will certainly go up and we will probably have a second peak. True, now our doctors - especially in the several general practice clinics - have learned to better use medicines and have started teleworking, and can avoid that too many people are left alone at home, just taking paracetamol against fever. Moreover, our intensive care units are now better. In general, we can capitalize on all the mistakes done in the first months at the local level, especially in Lombardy. Therefore, maybe the second peak will be less extreme. However, one thing remains certain: no reliable data have been competently collected and whatever decision we make now is little more than a shoot in the dark.
Photo: photocase.com / rarrarorro