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Until March 28, 2020, there were ∼90,000 confirmed cases of coronavirus disease (COVID-19) in Italy, with 26,000 in-patients, 3,800 patients in intensive care units (ICUs), 40,000 positive in home isolation, and 10,000 deaths, according to the Italian Civil Protection bulletin1. Italy currently has the highest COVID-19 mortality rate worldwide, even compared to the People’s Republic of China where the number of COVID-19 deaths totaled over 3,000 cases, including potential re-infections. Globally, there are ∼570,000 cases and 26,000 deaths due to COVID-19. According to the World Health Organization (WHO) as of March 28, 2020, the number of COVID-19 positive cases in Spain is increasing, with 64,000 infected cases and 5,000 deaths. In the United States, in the span of a few days, there were 85,000 cases and 1,200 deaths due to COVID-19; Germany has 48,000 confirmed cases, and France has 32,000 cases with 600 deaths2. After a short respite with 9,000 COVID-19 cases and only 140 deaths, the infection has resurged and the number of confirmed cases are continuously increasing in South Korea3. An analysis of the data in the daily updates communicated by the Civil Protection, showed thatmost of the COVID-19 cases and deaths are limited to Northern Italy—especially Lombardy, Emilia Romagna, Veneto, and Piedmont—with the numbers fortunately decreasing toward central and southern Italy, and very few cases documented in Basilicata1. The most severely affected regions are also the regions where healthcare services have always been considered excellent; the hospitals of Lombardy and Veneto are the Italian centers of excellence with regard to standard protocols and management for many diseases, especially neoplastic conditions, and there was a high rate of passive migration of patients from the South to northern hospitals. The Lombardy region has a higher number of intensive care and resuscitation beds compared to southern Italy; unfortunately, these places are fast running out of hospital beds and facing challenges in the provision of primary care for conditions other than COVID-19, necessitating the transfer of numerous patients to other regions4. The situation would probably have been considerably worse if the regions of Southern Italy had the highest number of COVID-19 cases. These numbers confirm the fact that we are facing a pandemic, which was declared by theWHO a few days ago.

Coronavirus Disease (COVID-19) in Italy: Analysis of Risk Factors and Proposed Remedial Measures