Protecting our health care workers while protecting our communities during the COVID-19 pandemic: a comparison of approaches and early outcomes in two Italian regions, Italy, 2020

Nancy Binkin; Stefania Salmaso; Federica Michieletto; Francesca Russo

is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.04. 10.20060707 doi: medRxiv preprint In terms of methodological limitations, case and death reporting may have differed between the two regions. Veneto, with its real-time integrated information system, may have had more complete and accurate case reporting. However, if cases and deaths were more likely to be notified than in Veneto than in Lombardy the effect would be to underestimate rates for Lombardy and increase, rather than decrease observed differences in the case and death rates between the two regions. Differences in HCW testing could have also affected our results. HCWs in Veneto who have been in close contact with cases but do not have symptoms are tested three times over fourteen days as part of the policy to keep them on the job. This testing policy in Veneto would likely lead to the detection of more HCW cases compared with Lombardy, but the effect would be in the direction of increasing the observed difference in HCW rates of infection between Veneto and Lombardy. Finally, our denominators for HCWs did not include those employed privately. However, the vast majority of all HCWs in the country are employed by the government and would be unlikely to affect the magnitude of the differences observed between the two regions.