The efficiency in the ordinary hospital bed management in Italy: an in-depth analysis of intensive care unit in the areas affected by COVID-19 before the outbreak

Fabrizio Pecoraro; Fabrizio Clemente; Daniela Luzi

The number of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus causing coronavirus disease 2019 , is dramatically increasing worldwide [1] . The first person-to-person transmission in Italy was reported on Feb 21st, 2020, and led to an infection chain that represents the largest COVID-19 outbreak outside Asia to date. At the moment, Italy is the second most affected country in the World and the first in Europe, with more than 62000 confirmed cases according to the Italian Department of Civil Protection as of 26th of March 2020. What it is not clearly identified so far is the reasons for the strong involvement of Italy within the European countries [2] and even more why the spread of this epidemic has not followed a uniform pattern on the territory: the diffusion of the disease, at the moment, is focused on the northern regions of the country. This was particularly evident considering that the virus took some days to reach the central and the southern regions of the land. Currently, the 87% of the confirmed actual cases are inhabitants of the northern regions that counts the 55% of the total Italian population. Among them, where the first cases were identified at the end February, is still the region with the majority of individuals infected by the COVID-19 virus. Similar results can be noted considering the hospitalization in general (88% in the northern regions and 42% in ) and in the intensive care unit in particular (85% in the northern regions and 35% in ). This data are provided and daily updated by the Italian Civil Protection Department [3] . These numbers are indicative of the spread of the infection and underline that one the main challenges to be faced by the National and the Regional Health Systems is the management of hospital resources across the country in terms of professionals, medical devices and hospital beds, with a particular attention on the intensive care unit (ICU) [4] .