Why are cases in Italy still rising when they have been on lockdown for 3 weeks?

[AnxiousOverCovid]

Italy has been on lockdown for 23 days, from the 9th March. The number of new cases are starting to gradually reduce (thank goodness) but they are still rising. Yesterday there were 4053 new cases whilst their highest number of daily cases was 6557 cases on 21st March.

Surely during lockdown the only transmission that should occur for the majority of the cases is transmission within a family and occasionally transmission during rare trips to the supermarket or out for exercise? As well as hospital-acquired cases for both non-covid patients and medical staff.

Does that kind of transmission explain why there are still thousands of new cases each day or am I missing something?

I think fuckwitjohnson was criticising earlier posters who were saying that it was airborne, one of whom said that some scientists disagreed with WHO about it being airborne (there was a study today that found virus particles in the air in hospital rooms after patients left, although it didn't say if they were viable particles. Someone asked the poster to link to the paper and you immediately posted your links so I think fuckwit thought you were saying it is airborne...

That was meant for @Weedsnseeds1

And apogies for the rubbish typing!
It's just very hard for people to be constantly aware, especially if they don't work in a hospital, a laboratory or similar where it's drummed into ypu.
Even then, people make mistakes

Thank you goingoverground.

But why is Sweden not showing the same increase yet not on lockdown?

I heard that something like 50% of Swedish households were single person ( radio 4, medical advisor, but can't remember from which country) so expected transmission was different in Sweden. Not sure how true that is and it seems a very brave strategy if it all goes, horribly wrong.

If you had 10,000 infectious people showing symptoms on the day of lockdown, they will have already infected 30,000 people

That is incorrect. 1 person having it infects 3, they each infect three so by the second level 1 person infects ten people. If you keep making this exponential calculation, to ten layers, 1 person is responsible for infecting 59,000 people.

So there would be a whole lot more than 30,000 coming from 10,000 cases.

But why is Sweden not showing the same increase yet not on lockdown?

Lots of reasons, but one is because they are not being told to behave by politicians, they are being advised by medical professionals to protect the health of the nation. Largely people are staying in and behaving themselves. It’s a cultural thing.

I hear what you are saying @MintyMabel but you've misunderstood me. It is correct that those 10,000 people only directly infect 30,000 people. The effect of lockdown/social distancing/self isolation is that those 30,000 don't then directly infect 90,000 people, instead of infecting 3 people each, if they have reduced their contact with people by 33%, they will only infect 2 people.

Except what I didn't explain clearly is that you are most likely to infect the people you live with. So in households where no one is working outside the home, after lockdown the people infected within that household won't infect anyone in the next level. But if 10k of the next level are still working outside home, you will still have similar numbers of new infections as the previous "level", so the numbers stay the same even thought the rate has changed.

If we tested 100,000 per day, it would take nearly two years to test the entire nation. Its not going to happen is it?

A decent sample size of tests for the general population rather than just the very sick will give epidemiologists a far better idea of what is actually happening to allow us to make better decisions about what needs to be done.

Also, I understand some the serological tests being developed are tests that can be done at home by the general public, like a pregnancy test, so the only limit on numbers are how many can be produced.

@TheCanterbuyWhales I didn’t mean extended families living together, I mean families living together like we do.

In relation to airborne transmission the link by @Weedsnseeds1 states that The WHO said that this kind of airborne transmission of the new coronavirus might be possible "in specific circumstances and settings in which procedures that generate aerosols are performed," such as when a patient is intubated in a hospital or being disconnected from a ventilator

Prof Kim Woo Joo is interviewed here and at 11.35 describes how airborne transmission might happen in other circumstances, and why and how

The point is made also that the virus has only been known about for 3 months, and so much is still being investigated, and also that WHO advice can vary/be simplified depending on the circumstances and the recipient.

@aprilstory thanks, I was thinking about their policy re quarantining in terms of being strict, I had just been listening to Prof Kim Woo Joo! I didn't realise that their lockdown generally was less strict - are you there?

An infection control nurse at work told us that the problem with Italy is their huge extended family set ups. Something not so common here.

And I repeat.
The "huge extended family set ups" in Italy is virtually non existent.
I'll give the figures again.
Just over 1% of Italians live in multi-generational households.
Compared to 1.3 million British people.

Multi-generational - families of more than one generation
Extended- aunts uncles cousins etc.

Neither set up is any more common in Italy than it is in the UK.

The reason the infection spread so rapidly in the north west of Italy was simply that it was a perfect storm:

Patient zero took time to locate (because he was German and had returned to Germany)
Patient One was a superspreader
The north of Italy in February is a tourist hotspot for skiing
The area around Milan is very industrialised, imports, exports, trade with China
The north of Italy has 5 international borders

But mainly?

Because they didn't take it seriously enough, lockdown quickly enough.

Kind of like everywhere else.

Canterbury, excuse my maths

So roughly 600k inter gen households in Italy?

I don't do numbers at all sorry!
But a few weeks ago, when all of us in Italy were a bit bemused at this idea that we all live with granny, I looked at the census and saw 1.2 % of Italians- that's individuals. The only corresponding UK figures I found were in a Guardian article (iirc) which said 1.3 million (people) in the UK.

The difference would be though that yes, of those families in Italy it would definitely be an elderly grandparent who has gone to live with son or daughter probably after being widowed whereas in the UK I'd imagine probably a single parent and their child/ren living with middle aged parents.

Obviously, anybody not living in a single person household is more likely to spread it/catch it from another family member but much more probable that someone working outside of the house brought it home. Milan, Bergamo, Brescia all with hundreds of commuter towns serving them.

Canterbury, you wave the figures around and then say you don’t do figures?

“ The difference would be though that yes, of those families in Italy it would definitely be an elderly grandparent who has gone to live with son or daughter probably after being widowed”

If you’re saying there’s a lot of elderly living with super spreading children, that’s pretty fundamental.

I'm not saying that at all. Superspreader Covid carriers are thankfully rare.
Nor do I wave figures around. I looked at the Istat Italian census from 2016 and the Guardian article.
What is being waved around on almost all of the conjecture threads is that Italians live in multi-generational families and that's why the virus spread so easily.
And just over 1% isn't a lot. Whether you do numbers or not.

Italy is getting better. There is a clear pattern.

After lockdown, the worst day for actual new infections will probably be 5-6 days after. Most present at hospital on day 7 of the disease, so the peak should be 12-13 days after lockdown, with peak deaths about a week later.

Italy locked down on March 9th and has the most new cases on March 21st (t+12) and peak deaths on March 27th (6 days later). So, it fits with the above very well.

Then you get intra family transmission and transmission between those still working.

The Imperial team, I believe, calculated the transmission rate at 0.63, far better than hoped and, if true, as long as the Italians (and everyone else) keep abiding by the rules , cases and deaths should start to fall dramatically.

March 11th was national lockdown but yes, everyone is cautiously optimistic now. You can sense a renewed "we can do this".

I live in the West Midlands, in Birmingham, the second highest region the UK.

Here it is quute common for large, multi-generational Asian families to live together, so in that respect this is not uncommon with Italy.

second highest infected

larry by that reckoning, if we locked down on March 24th, I guess we can expect to see most new cases around April 5th and peak deaths April 12th? Fingers crossed it resolves so soon. I just hope that people don't start getting antsy around April 11th saying lockdown isn't working because deaths are still going up.