Covid-19: Italy’s accurate count of Covid-19 patients has damaged its international position.

Italy has had a bad week. As reported in a New York Times article on February 27, 2020 [1], Italy leapt to the top ranks of the world’s coronavirus “centers of global concern”—joining China and South Korea with alarming alacrity—as it reported 650 infections and 17 deaths related to the virus. The newly reported infections have been concentrated in the Lombardy region (northern Italy), which claimed 403 of the newly reported cases. (According to the Times article, Lombardy has strong trading ties with China.) These reported cases included asymptomatic infections and counting those infections helped to rapidly increase Italy’s numbers [2]. Political issues, as well as national 2 and international health policy concerns, are swirling over the number of Italian cases identified so quickly. Lombardy immediately faced strong criticism both internally and internationally for its comprehensive testing effort.

Lombardy, as distinct from even the rest of Italy and certainly the balance of the world, is trying to identify asymptomatic carriers of the virus in addition to cases where the patient is already exhibiting signs of infection. To that end, Lombardy’s health officials have been swabbing and testing individuals who are not coughing, wheezing or feverish. As a result of this more comprehensive approach, Lombardy is obtaining a more accurate understanding of both the scope of infection and  human response (or nonresponse) to the virus. That effort to better understand has left wealthy Lombardy in a world of hurt.

Following on its reports of a significant number of infections outside of China, Italy has been internationally branded as a “hotspot,” and travel to and relationships with the country have been immediately and materially impacted. Around the world, people are speculating on how and why Italy developed so many and so many infections so quickly. The speculation is all negative for Italy. Interestingly, though its protocols in this regard are under review, the World Health Organization does not recommend testing asymptomatic carriers of the virus because it does not see asymptomatic carriers as a source of virus spread [1]. The U.S. Centers for Disease Control have taken a similar approach; in the U.S. testing is limited to symptomatic patients.

Lombardy has bowed to national and international pressure and has suspended asymptomatic testing. While recognizing the impact that their “accurate” reporting of actual infections has had on Italy’s international reputation, Lombardy health officials continue to insist that comprehensive testing—identifying both asymptomatic and symptomatic carriers of the virus—is essential to understanding the virus and its spread.

~~ David M. Walsh

[1] - Horowitz, Jason. “Italy, Mired in Politics Over Virus, Asks How Much Testing Is Too Much”. New York Times. New York, New York. February 27, 2020. https://www.nytimes.com/2020/02/27/world/europe/italy-coronavirus.html.

[2] - In addition, infections which may have originated in Lombardy have been reported in Austria, Switzerland and the Canary Islands.