
Ask HN: How is actually Italy confirming SARS-Cov2 cases? - dakrisht
Italy is at 53,000+ confirmed cases of SARS-Cov2.<p>This would assume they have tested upwards of 200,000+ patients in order to get a 25% infection rate.<p>I&#x27;m using 25% as a conservative figure. If you liberally drop this down to 10% infected tested, we&#x27;d have to be at 500,000+ successfully administered, processed and reported RT-PCR tests.<p>Side note: Roche&#x27;s best machines, for example, can process 4,100 RT-PCR tests in a fully automated fashion and this not just a machine on a desktop, but a full-blown assembly line operation.<p>Intriguing.
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dx034
I'm not sure about the testing regime they use but they publish the number of
people tested on a daily basis. The data is available on wikipedia [1],
currently they stand at ~233,000.

As an orientation, Germany doesn't publish aggregated numbers but federal
organizations said in an interview that at the moment, ~100-150k tests per
week are performed, so the positive rate there should be <5%. But I'm not sure
how reliable that number is. Local test centers don't have to report all tests
(just positive ones) so I'm not even sure if the government has that info.

[1]
[https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_I...](https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Italy)

~~~
yash1th
They also publish it on github [1]

[1] [https://github.com/pcm-dpc/COVID-19/blob/master/dati-
andamen...](https://github.com/pcm-dpc/COVID-19/blob/master/dati-andamento-
nazionale/dpc-covid19-ita-andamento-nazionale.csv)

------
DrNuke
The quick answer is any emerged, severe case or death with the suspected
presence of bilateral interstitial pneumonia (which symptoms are now well
known globally) is registered as a covid case. It is fair enough when
hospitals are out of capacity and people just die at home. The underlying
point is Lombardy is suspected to have x5-x10 active circulating covid cases,
which would put mortality at the same and more coherent, global rate. The fact
that co-morbidity cases are all put into the same coronavirus basket is what
makes numbers so high, but please consider these are all people who would not
die today without coronavirus, and there is really no allowed time or
resources to make better classification when more and more cases come knocking
at the door daily.

~~~
easytiger
> The quick answer is any emerged, severe case or death with the suspected
> presence of bilateral interstitial pneumonia (which symptoms are now well
> known globally) is registered as a covid case.

It's not really acceptable in a country than loses between 8-24k people a year
to influenza strains anyway.

Are you sure this is true? Another post claims all dead are tested.

~~~
DrNuke
Dead are all tested... when dead. If coronavirus accelerates the passing away
of chronically ill or severely ill people, would you count that as a covid
death? Italy does, that’s the point. And it is not influenza, please stop
that, the particular pneumonia associated with covid is viral instead of
bacterial, and there is no antibiotic for that, only drugs (experimental,
allowed for compassionate use) mitigating the quick and deadly inflammation
effects.

~~~
easytiger
I see your point.

Italy always fares poorly year on year on flu seasons

[https://www.sciencedirect.com/science/article/pii/S120197121...](https://www.sciencedirect.com/science/article/pii/S1201971219303285)

> We estimated excess deaths of 7,027, 20,259, 15,801 and 24,981 attributable
> to influenza epidemics in the 2013/14, 2014/15, 2015/16

> And it is not influenza, please stop that,

I never asserted that it was, if you read the comment you will see that I was
asserting that they usually fare poorly in influenza seasonal outbreaks. For
the same reasons it's faring poorly with cv19

------
VladimirGolovin
>> Roche's best machines, for example, can process 4,100 RT-PCR tests in a
fully automated fashion

What's this number? Tests conducted per day? The number of DNA patterns known
to the analyzer?

~~~
dakrisht
Roche’s Cobas 8800 can do roughly ~4100 tests per day and this is a massive
full-room setup.

Many other RT-PCR capable machines exist out there (800 is the total number in
Europe cumulative) but this assumes an efficient point-of test > courier > lab
> results process which many countries simply lack.

[https://news.ycombinator.com/item?id=22575661](https://news.ycombinator.com/item?id=22575661)

------
Jaxkr
Based on symptoms and where the people were geographically.

One or two tests can confirm cases for a whole town. They simply (and safely)
assume that all flu-like illnesses coming from a certain area are covid.

~~~
ramblerman
Wow really. Do you have a source for that?

Because if true, combine that with the facts that

\- 87% of deaths occur at home and not in ICU [1]

\- median age of deaths is 80 years old [2]

Are all deaths just being counted as Covid-19 (without test then)? I think it
would be really interesting to compare baseline deaths in February/March from
previous years to this one.

[1] [https://www.tgcom24.mediaset.it/cronaca/coronavirus-in-
lomba...](https://www.tgcom24.mediaset.it/cronaca/coronavirus-in-
lombardia-9-morti-su-10-mai-giunti-in-terapia-
intensiva_16362350-202002a.shtml)

[2]
[https://www.epicentro.iss.it/coronavirus/bollettino/Report-C...](https://www.epicentro.iss.it/coronavirus/bollettino/Report-
COVID-2019_17_marzo-v2.pdf)

~~~
dakrisht
This is another valid point and disturbing point.

Italians are most likely counting most if not all deaths as SARS-Cov2 deaths.

1) A large amount of the elderly are going to hospitals because of pre-
existing conditions that might be flaring up or presenting as they normally
do. They enter the clinic > get complications > get marked down as dying from
SARS-Cov2. And/or they acquire hospital acquired pneumonia (HAP).

2) I’ve read the ISS report cover to cover and yes, nearly ALL deaths are due
to 1) age greater than 70, 2) 75% showing 2 (two) or more per-existing
conditions with a staggering 99% showing 1 (one) or more pre-existing
conditions. Let’s not forget the above comment (HAP or other hospital acquired
infections from SARS-Cov2, Influenza, whatever).

3) Seeing a death count YOY would be beneficial here indeed.

I don’t think ANYBODY will be able to answer my initial question here.

There is _NO WAY_ in hell the Italians have tested over 200,000 patients for
SARS-Cov2 in a matter of 2-3 weeks due to:

1) such capacity simply _does not exist_

2) Italians have been under quarantine and when they weren’t they were
drinking coffee and not lining up for tests.

3) the time of test > result trajectory > reported data is impossible

4) such high throughout testing capacity simply does not exist

Where are these magic numbers coming from? :)

~~~
liqu0rice
> 1) such capacity simply does not exist

Germany is able to conduct more than 160,000 tests per week. I do not know the
numbers for Italy, but why shouldn't they be able to reach that number over
2-3 weeks?

~~~
dakrisht
Apples to oranges. Can not compare Italy with Germany.

Germans are willingly being tested, there process, order, proactive testing.
In Italy everyone is 1) quarantined for the past 2 weeks and 2) didn’t even
give a crap about this prior to the quarantine.

Italy is triaging, out of hospital space, vastly over estimating numbers, and
probably using models with some accuracy to report their numbers. Unless
someone can PROVE this otherwise.

Their death rate is what it is due to a very elderly population, with 2 or
more co-morbidities, in understaffed and overwhelmed hospitals full of chaos,
and infection.

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ecesena
As of today they did 275,468 tests:
[https://docs.google.com/spreadsheets/d/1xAyDSpzEp3n4iiu54_XL...](https://docs.google.com/spreadsheets/d/1xAyDSpzEp3n4iiu54_XL6MQxNXtrOnHSZf8zx2HZgEU/edit#gid=833526927)

This is a post (sorry, in Italian) that describes the "strategy" adopted to
test people, that of course varies by region. tl;dr: in regions like Lombardia
(the most affected) they can almost only test people who really show severe
signs, therefore the rate is around 38%.

[https://www.ilpost.it/2020/03/20/tampone-test-
coronavirus/](https://www.ilpost.it/2020/03/20/tampone-test-coronavirus/)

Official data is here: [https://github.com/pcm-
dpc/COVID-19](https://github.com/pcm-dpc/COVID-19), I just put it in a
spreadsheet for easier consumption.

Edit: forgot a link

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lurquer
The answer is obvious and not fairly deniable.

But, one isn't permitted to voice it.

~~~
scusely
What is it? I have no idea.

~~~
lurquer
The medical system in Italy sucks. The northern region sees a scandalously
high number of elderly die every day in the winter. Upwards of 200 a day. The
issue is political.

Covid is a convenient cover for the scandal. If you die in Lombardy -- for any
reason -- you are listed as a covid patient. It's fraud.

Plain and simple.

(Incidentally, its not all of Italy... just the northern region.)

The number of tests is equally bullshit. As another poster in this thread
alluded to -- and I think there is a link up there -- the number is an
'estimate'.

~~~
denulu
Normally it's 250 deaths > 65 years per week, which would make it 36 per day

[https://www.epicentro.iss.it/influenza/FluNews18-19#mortalit...](https://www.epicentro.iss.it/influenza/FluNews18-19#mortalita)

~~~
lurquer
From the source, translated:

"During the sixteenth week of 2019 mortality was lower than expected, with a
daily average of 190 deaths compared to the expected 200."

Read Italian news from the past few years regarding then northern region; the
numbers of geriatric deaths -- far in excess of other EU members -- has been a
long-running scandal.

More data here:
[https://www.sciencedirect.com/science/article/pii/S120197121...](https://www.sciencedirect.com/science/article/pii/S1201971219303285)

I trust you've read the recent Telegraph article revealing that only 12% of
reported Italian covid deaths could be directly attributed to covid.

But, I'm not that concerned about persuading you. If you wish to believe there
is something unique about northern Italy -- while 100 miles to the south,
east, west, and north the mortality rates are utterly different, so be it.

