The Outbreak of COVID-19 in Italy

Indolfi, Ciro; Spaccarotella, Carmen

doi:10.1016/j.jaccas.2020.03.012

Cited by 81 publications

(92 citation statements)

References 3 publications

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“…Nevertheless, the Italian case presents several areas of doubt that are under investigation in order to determine whether or not they have had a causal impact: first, Italy has been reducing health expenditure significantly since the 2010 euro crisis [ 11 ]; second, it is one of the countries with the lowest intensive care units per 10,000 inhabitants [ 12 ]; third, it has one of the oldest populations in Europe [ 13 ]; and fourth, it is a society where the elderly have a high level of interaction with younger generations [ 14 ]. These have been reinforced by a delay in adjusting protocols within hospitals; for example, avoiding the admittance of patients exhibiting mild symptoms of COVID-19 [ 15 ], which has the potential to transform hospitals into clusters of contagion.…”

Section: Introductionmentioning

confidence: 99%

Assessing concerns for the economic consequence of the COVID-19 response and mental health problems associated with economic vulnerability and negative economic shock in Italy, Spain, and the United Kingdom

et al. 2020

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Many different countries have been under lockdown or extreme social distancing measures to control the spread of COVID-19. The potentially far-reaching side effects of these measures have not yet been fully understood. In this study we analyse the results of a multi-country survey conducted in Italy (N = 3,504), Spain (N = 3,524) and the United Kingdom (N = 3,523), with two separate analyses. In the first analysis, we examine the elicitation of citizens’ concerns over the downplaying of the economic consequences of the lockdown during the COVID-19 pandemic. We control for Social Desirability Bias through a list experiment included in the survey. In the second analysis, we examine the data from the same survey to predict the level of stress, anxiety and depression associated with being economically vulnerable and having been affected by a negative economic shock. To accomplish this, we have used a prediction algorithm based on machine learning techniques. To quantify the size of this affected population, we compare its magnitude with the number of people affected by COVID-19 using measures of susceptibility, vulnerability and behavioural change collected in the same questionnaire. We find that the concern for the economy and for “the way out” of the lockdown is diffuse and there is evidence of minor underreporting. Additionally, we estimate that around 42.8% of the populations in the three countries are at high risk of stress, anxiety, and depression, based on their level of economic vulnerability and their exposure to a negative economic shock.

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Section: Introductionmentioning

confidence: 99%

Assessing concerns for the economic consequence of the COVID-19 response and mental health problems associated with economic vulnerability and negative economic shock in Italy, Spain, and the United Kingdom

et al. 2020

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“…This global pandemic has challenged hospitals to significantly alter everyday hospital operations in efforts to mitigate the spread of the virus. [1][2][3] As hospitals re-open and allow elective cases, not only will testing be crucial, but the high false negative rate of nasopharyngeal swabs 4,5 necessitates identification of high-risk events. Understanding which procedures are high-risk will be crucial in limiting the spread of the virus and maintaining the safety of healthcare providers.…”

Section: Introductionmentioning

confidence: 99%

Quantification of Aerosol Particle Concentrations During Endoscopic Sinonasal Surgery in the Operating Room

Murr

Lenze

Brown

et al. 2020

Am J Rhinol�Allergy

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Background Recent indirect evidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) transmission during endoscopic endonasal procedures has highlighted the dearth of knowledge surrounding aerosol generation with these procedures. As we adapt to function in the era of Coronavirus Disease 2019 (COVID-19) a better understanding of how surgical techniques generate potentially infectious aerosolized particles will enhance the safety of operating room (OR) staff and learners. Objective To provide greater understanding of possible SARS-CoV-2 exposure risk during endonasal surgeries by quantifying increases in airborne particle concentrations during endoscopic sinonasal surgery. Methods Aerosol concentrations were measured during live-patient endoscopic endonasal surgeries in ORs with an optical particle sizer. Measurements were taken throughout the procedure at six time points: 1) before patient entered the OR, 2) before pre-incision timeout during OR setup, 3) during cold instrumentation with suction, 4) during microdebrider use, 5) during drill use and, 6) at the end of the case prior to extubation. Measurements were taken at three different OR position: surgeon, circulating nurse, and anesthesia provider. Results Significant increases in airborne particle concentration were measured at the surgeon position with both the microdebrider (p = 0.001) and drill (p = 0.001), but not for cold instrumentation with suction (p = 0.340). Particle concentration did not significantly increase at the anesthesia position or the circulator position with any form of instrumentation. Overall, the surgeon position had a mean increase in particle concentration of 2445 particles/ft3 (95% CI 881 to 3955; p = 0.001) during drill use and 1825 particles/ft3 (95% CI 641 to 3009; p = 0.001) during microdebrider use. Conclusion Drilling and microdebrider use during endonasal surgery in a standard operating room is associated with a significant increase in airborne particle concentrations. Fortunately, this increase in aerosol concentration is localized to the area of the operating surgeon, with no detectable increase in aerosol particles at other OR positions.

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“…Our hospital is a neonatal tertiary referral center, covering around 6000 pregnancies per year. It is located in Lombardy, Northern Italy, one of the Italian regions most early and severely affected by the current pandemic [7].…”

Section: Methodsmentioning

confidence: 99%

Newly Mothers' Mental Health and Breastfeeding Rates During 2019 Coronavirus Disease Outbreak

Morniroli¹,

Consales²,

Colombo³

et al. 2020

Preprint

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BackgroundNewly mothers are at higher risk of experiencing higher levels of anxiety and stress, especially during a pandemic event. Mothers’ mental health can negatively impact breastfeeding rates and the dyad’s overall health. Aim of the study was to determine the prevalence of anxiety symptoms in newly mothers throughout hospital stay during the COVID-19 pandemic and its association with perceived postpartum support and breastfeeding outcomes at discharge.MethodsA cross-sectional survey study was conducted in a neonatal tertiary referral center, in northern Italy between April and May 2020 during Italy’s lockdown, including a sample of 117 mothers with a negative naso-pharyngeal swab for SARS-CoV-2.Maternal anxiety levels were assessed through State-Trait Anxiety Inventory-Form Y, with TRAIT-A and STATE-A scores indicating personality trait and current emotional state, respectively. Maternal perception of staff’s support was evaluated by the Nurse Parent Support Tool (NPST). Breastfeeding rates at discharge and sociodemographic information were also collected. A STATE-A score >=40 was considered indicative of clinically significant symptoms of anxiety. Binary logistic regression models were used to examine correlations between anxiety levels and variables of interest.ResultsA total of 109 mothers completed the study. Mean STATE-A score was >=40 in 42% of mothers and median NPST score was 4.23. A TRAIT-A score>=40, a NPST score <=4.23, father’s absence during hospital stay and primiparity were independently associated with a STATE-A score >=40 (OR 3.45 (95%CI 1.27; 9.35), 4.72 (1.91; 11.64), 2.73 (1.06; 7.07), 3.74 (1.35; 10.37), respectively). Exclusive breastfeeding rates at discharge were 80% and were not affected by neither mothers’ anxiety level nor changes in hospital policies.Conclusions Our study describes the short-term effects on newly-mothers of hospital policies and preventive measures implemented during the COVID-19 pandemic, highlighting the positive impact of fathers’ presence and high perceived support during hospital stay on maternal mental health, particularly primiparas’. Breastfeeding rates at discharge were not affected by the pandemic.

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The Outbreak of COVID-19 in Italy

Cited by 81 publications

References 3 publications

Assessing concerns for the economic consequence of the COVID-19 response and mental health problems associated with economic vulnerability and negative economic shock in Italy, Spain, and the United Kingdom

Assessing concerns for the economic consequence of the COVID-19 response and mental health problems associated with economic vulnerability and negative economic shock in Italy, Spain, and the United Kingdom

Quantification of Aerosol Particle Concentrations During Endoscopic Sinonasal Surgery in the Operating Room

Newly Mothers' Mental Health and Breastfeeding Rates During 2019 Coronavirus Disease Outbreak

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