EXPLAINED: What is Italy’s ‘scenario 4’ and which regions are already in it?

EXPLAINED: What is Italy's 'scenario 4' and which regions are already in it?
A Covid-19 patient is taken from an ambulance at the San Carlo hospital in Milan on October 28th. Photo: Miguel Medina/AFP
Italian health authorities recommend tough restrictions if the coronavirus situation enters what it calls 'scenario 4'. Here's what that means - and which parts of the country have already reached that point.

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As the Italian government on Monday announced the latest set of restrictions aimed at stemming the spread of Covid-19, Prime Minister Giuseppe Conte said in his speech to parliament's lower house that the “epidemiological picture is in the process of transition towards scenario 4, with particular reference to some regions.”

READ ALSO: Curfew or lockdown: What will be in Italy's latest emergency decree?

But what exactly does that mean?

Here's a closer look at how Italy decides what measures to take in response to the changing coronavirus situation.

What is 'scenario 4'? 

Italy's Higher Health Institute (ISS) earlier this year set out four “risk scenarios” with guidance on appropriate measures for the government to take in each case, in plans titled 'Prevention and response to Covid-19″.

Scenario 4 is the last and most serious provided for in the ISS plan.

Health experts on Friday confirmed that the situation in Italy overall currently corresponds to that described in the less-severe scenario 3, but ministers warn that some areas are already in scenario 4.

The main difference between the two is the Rt number (the rate of transmission), as well as whether the origin of new outbreaks can be successfully traced or not.

Scenario 3 is characterized by “sustained and widespread transmissibility” of the virus with “risks of maintaining the health system in the medium term”, and Rt rates at a regional level between 1.25 and 1.5, the ISS writes.

Scenario 4 is when lockdowns at a local or national level would be considered.
Photo: AFP
Italy would enter scenario 4 if “the regional Rt numbers ​​are predominantly and significantly greater than 1.5”.
The ISS writes that such a scenario “could quickly lead to a high number of cases and clear signs of overload of welfare services, without the possibility of tracing the origin of new cases.”
If this situation is “sustained”, the official plan provides for “very aggressive measures” to be taken, including a national lockdown like that seen in spring if deemed necessary.

The Rt rate rose to 1.70 in the week between October 8 and 21, the latest ISS weekly report said, with significant regional variations.

Which regions are in scenario 4 right now?

Four regions – Calabria, Emilia Romagna, Lombardy, and Piedmont – plus the autonomous province of Bolzano are already in the phase 4 scenario, the ISS said in a report published last week.

Eleven more regions were defined as being at high risk: Abruzzo, Basilicata, Calabria, Liguria, Lombardy, Piedmont, Puglia, Sicily, Tuscany, Valle d'Aosta and Veneto.

Conte said on Monday that the number of at-risk regions would soon rise to 15.


Will these regions be placed under lockdown?
Italy's latest emergency decree, set to come into force by Wednesday, does not specifically mention lockdown measures.
However, it includes a nationwide evening curfew and tougher measures for regions with the highest transmission rates.
The way Italy will decide which regions will undergo which restrictions is to be further detailed under the forthcoming decree, as Conte announced a new three-tier system which is expected to be similar to that used in the UK.
“In the next emergency decree we will indicate three risk scenarios with increasingly restrictive measures.” Conte said on Monday.

The country is to be divided into three bands, with differing “scientific and objective” criteria approved by the Higher Institute of Health, he said.

The worst-affected regions, which he named as Lombardy, Calabria and Piedmont, would face the toughest restrictions.

Find all of The Local's latest coronavirus updates here.

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