Covid tests and real numbers
Italy and Covid: the “Real” situation
One year of tracking overwhelming numbers in my own chart
Last year has been a challenging one. I remember returning to Italy from China on 22nd January, exactly while all this terrible mess was starting. The plan for the year was to complete the construction of the house, go back to China and start preparation to move to Italy with my fiancé by the end of 2020.
Unluckily, I found I have escaped from initial lockdown in China, only to be locked inside my parents’ house in Italy for almost 2 months.
I found myself adjusting the way I live, as all of us have experienced: working on Zoom, consuming Netflix’ catalogue, doing Yoga over WeChat with my girlfriend, talking with her for a few hours every day, discussing the situation and going crazy because all our plans was being postponed, our life was on hold and we didn’t have a clue to when we could even encounter each other again, let alone move to our own brand-new house.
I had to find a way to grasp what was going on: my mind needs analyzing numbers all the time, as an engineer this is what I do and if I cannot comprehend things in my own mathematical way, my subconscious do not rest.
While the news kept reporting awful increasing numbers every day, I started to place them into my own chart, and I realized almost instantly the situation could indeed be substantially worst.
The numbers of Covid Tests analyzed every day, specially at the initial stage of the pandemic, were extremely small, and basically not tracking the factual situation. After one full year, we have achieved an average for the number of tests analyzed daily in Italy just over 100.000.
But while now we can see something like 250.000 or more every day, at the beginning the average was around 10.000. It took from the end of February up to September to arrive to 100.000. Is like eating soup with a fork!
I had to adjust the numbers relative to the moving average of tests performed, to have at least some idea of what was indeed going on. And what was going on was not pretty, still it isn’t after one year, unfortunately.
Today is exactly 365 days since I started to collect this numbers and analyze them. In this article I would like attempting to explain what I did, what results I get, how I understand the situation and where I think we are going, now that the Vaccine campaign is ultimately on track.
Daily Numbers and “Real Positives” numbers
The first thing I did, was adjusting the number of Tests performed, taking care of the total average, which is changing every day, and the moving average, which I considered on a period of 21 days. I decided for 21 because this seems to be the maximum incubation time.While incubation is normally around 7–14 days, a few cases were discovered after 21 or even more. In this way I am trying filtering the results taking into consideration the incubation of the virus, because the cases found positive today, could be originated up to 3 weeks earlier. We are running on the back of this damn virus, and if we are to stop it, we have to catch it and be in front of it.
Once I have calculated the total average and the moving average, I had a way to determine what I call the number of “Real Positives."
Every day we receive the numbers for Covid Test performed, and percentage of positives found. I decided to calculate the “Real Positives” in this way:
- If the number of tests was below the total average, I would calculate the “Real” figure as the average multiplied by the percentage of positives found for that specific day;
- After the first 3 weeks, I introduced the running moving average of 21 days. If the moving average in the day were to be lower than the total average of tests performed than I would still use the total average as in point 1. If instead the moving average were to be higher than the total average, I would use the moving average as a reference. To give you an idea of how slow the number of Tests performed increased, it took until October to see the moving average being higher than the total average.
What emerged adopting this method is the following graph, where you can see clearly 2 big picks indicating 2 waves that Italy have suffered so far. I believe unfortunately, as I will explain later on, that we are at the beginning of the third wave.
In the second wave, the maximum number of positives cases per day seems to be around 33.000, very similar to what indeed is communicated by the government.
During the first wave instead, while in my calculation I have a maximum of around 25.000 cases a day, in the government data we found a pick of only 6.000!
This substantial difference is due to the modest number of tests performed in the first period, which was completely not enough to track the real situation.
We were completely unprepared. It is not a way to say the government was not adequate to take care of the situation. We were all unprepared. Not only Italy, but all over the world, with the exception I think of Asia.
Asia had already experienced Sars and they implemented effective measures from the beginning. But we were unable to, and in my mind, we still are not doing what would be needed.
Number of Deaths and Recovered cases
What is true for the aggregate figure of cases, is unfortunately true also for the number of people who died because of the virus.
The official number of fatalities for Italy is currently 96.974.
But also here, specially at the beginning, we know many people died without even being tested. Think about what happened in the Nursing Homes where many Elderly left us quickly in the first wave, with no clue of what was really going on. These people are not on the official count, but nevertheless they have painfully left us.
Again, is something that has happened all over the World, not only in Italy. We were unprepared. I remember the evening news at one point showing the Military trucks taking bodies out of Bergamo, because the wood was not enough to make coffins and they didn’t know where to put them anymore. I can never forget that scene for the rest of my days.
I once more took the official figures given every day, calculating the percentage of deaths relative to the new cases announced. I than use this percentage, applying it to my number of “Real Positives.”What I have found, is that while like I said officially we are approaching 100.000 deaths, I believe that the exact number is somewhat close to 180.000!
The only good information I can extract from the previous graph, is that the mortality is now going down. We now possess some clue of how to deal with the virus from a medical point of view. But still around 300 lives are lost every day.
In the same way, I then calculated the “Real” number of Recovered Cases, luckily also bigger than the official one and equal to around 2,8 Million instead of 2,3.
How many people really had Covid in Italy?
The official aggregate number of cases from the beginning is around 2,8 Million.
According to my calculation, it is at least 7,2 Million, equal to around 12% of the total population. To arrive to this number, I proceed in this way:
- As I calculated my “Real” number of deaths and recovered cases, I was able to estimate the mortality for the so-called close cases which had an outcome, either death or recovery. After one year, this theoretical mortality stands at around 6% (180.000 deaths and 2,8 Millions of recovered cases);
- The official mortality rate for the whole world is at 2,75%. Up to today we had officially 2,5 Million fatalities and more than 91 millions closed cases;
- There are no special reasons to think the real average mortality in Italy would be any different from the rest of the world. It could be a bit higher because our population is one of the oldest, but still I doubt that it can be more than double;
- Therefore, considering than the number of deaths is reasonably to be 180.000, and it is possible to estimate how many persons still have Covid (= combined number of “real” cases -”real”death — “real” recovered), it is equally plausible to calculate how many people really could have the Covid, even without displaying any symptoms, or just by showing some minor signs, by simply making a proportion with the world mortality. The result is 7,2 Million people, 12% of Italy population.
Keep in mind it could be even more.
- The absolute number of cases in the World have also surely been underestimated. As we were unable to perform enough tests in Italy, the same is true everywhere. As many people died without being tested, this has happened anywhere. As a result, the real mortality could be smaller, and the combined number of cases therefore much higher.
- Among the younger generation, it seems the virus is not really causing much harm. The mortality rate start to increase higher than 40 years, and it become extremely dangerous to catch Covid over 60–70 years old. It is entirely possible the virus has been circulating much more than we have seen in the official numbers.
And is not entirely negative, as we are finally starting the Vaccine campaigns all around the world, because this could mean a smaller number of people should need it, before we can reach some forms of herd immunity. It is correct to start from the Elders, not only because for them the risk is exceedingly higher, but also as we could be significantly underestimating the number of people under 30, and mostly below 20, who already had the virus. Also, as mortality is much higher in the oldest generations, providing the vaccine to them first, can significantly reduce the daily death toll we are paying. Once the number of daily deaths can go almost to zero, we can consider that probably the virus will still stay in our lives, but with minor consequences.
What is happening right now and what should we do
The first consideration is, unfortunately, I believe we are about to face the third wave.
One of the graphs I was able to derive from my numbers is the following one:
- The blue line indicates the one week moving average of people recovering from the virus. Keep in mind I always consider what I have termed “Real” numbers, coming from my calculations. As we can see, the number of people recovering each day is going down. We had a pick of 34.000 people recovering on 14th December, while now the average is 13.500 and every day seems to be a little less.
- The orange line indicates the one week moving average of the “New Positives” calculated as difference between “Real Daily Positive Tests”, minus the “Real Recovering”, minus the “Real Death.” If this number is below zero, it indicates the absolute figure of persons infected is diminishing, while if it is over zero means the total number of people infected is increasing. Just this very day, we have crossed from below to over 0.
Keep in mind this is a weekly moving average, so it indicates a trend reversal. Also the numbers of “Real” positives, recovering and deaths are calculated using a 21 days moving averages of tests performed. Therefore, the trend we can observe today was originating almost one month ago. I believe this is crucial to understand why we are incapable to force the situation under control. We are to slow to react.
The Occidental way has been to try and keep society as open as possible.The Oriental way has been to shut down everything until the numbers went to zero, and to be very fast to react after. In China right now is enough to detect one to 10 cases into a city district, to close completely that sector, restrict movement and keep everything close until everyone inside that area have been tested. We can discuss how long we want if the approach is “democratic” or not, but there is no denying this is the only way to solve the issue. The toll we are paying is indeed higher than most rigorous countries, not only from the deaths point of view, but at the end also economically.
Now cases are once more on the rise in Italy, and the effect of this trend reversal will start to be more evident in another 14–21 days. But the time to react is not today, it was 14–21 days ago. Being faster and rigorous can completely transform the game, by putting ourselves in front of the curve, while now we are lagging behind.
Unfortunately, this virus is working on an exponential curve. There is no way to stop an exponential increase, if not by totally bringing the index not only below 1, but very close to 0. Going to 0,9 and than opening everything again, will only lead the propagation index over 1 again, and giving the virus 2–3 weeks of advantage is extremely dangerous. Specially now that new variants such as the UK one seems to spread even more rapidly.
I anticipate the only way to end this situation is being as fast as possible to deploy the vaccines, and at the same time to be braver, taking bold decisions and act rapidly and resolutely to annihilate the curve, even by adopting another full lockdown if needed. Any other measure has proven ineffective over this year, and we cannot think that continuing with the same strategy could bring any different result.
This is my take on 365 days of Covid in Italy, on how it has affected my life and how I have tried to cope with the numbers to develop my own perspective, to navigate into uncertain waters and avoid to despair. Better times will come, we have to hold on.