Delta in Cagliari
(Where is Sardinia?)
Cagliari, COVID-19: Weekly situation update
Encouraging data for Sardinia: the 7-day cumulative incidence has fallen to 101… the lowest value in 6 weeks! In Cagliari Metropolitan Area, the incidence has decreased by 40% in a week (from 222 to 134), and in South Sardinia by 30%. Is this the combined effect of mass vaccination, Green Pass and August outdoor living?
16 August 2021
1. Over the last 7 days, the situation in Cagliari has been stable. In other Sardinian provinces, however, the 7-day cumulative incidence has progressed: Southern Sardinia, +27%; Oristano, +60%; Sassari, +33% (see first figure below: “Sardegna COVID-19: 7-day incidence”). In the last 7 days, the number of hospitalized patients has increased by 28%.
2. The worrying data is currently the evolution of the percentage of positive COVID-19 tests (see second figure below: “Sardegna COVID-19: Test positivity”). After reaching this year’s low at the end of June, the cumulative 7-day positivity is around reaching 10%. Delta is gaining ground.
9 August 2021
Over the last 8 days, the epidemiological situation in the Cagliari Metropolitan Area has been stable with a high 7-day incidence of 300 cases per 100.000 (see the figures below). Is this the beginning of end of the 4th wave? Or is it the calm before the storm?
If you don’t know the answer, don’t worry: nobody knows. Even the world’s most prominent experts, for example our friend and colleague Eric Topol, struggle to interpret the current evolution of pandemic, especially in countries where only half of the population is fully vaccinated. (Read, for example, Wallace-Wells D. “Too Many People Are Dying Right Now “It’s hard to look at these indicators and feel at all optimistic,” explains scientist Eric Topol. Intelligencer 2021, published 8 August. Full text: https://nymag.com/intelligencer/2021/08/too-many-people-are-dying-of-covid-19-right-now.html”).
1 August 2021
In Sardinia, the Delta variant is now the dominant strain. This new variant is at least twice as transmissible as the variant that circulated in Sardinia in 2020. Data from Scotland, Singapore and Canada suggest that Delta may also lead to an increase in hospitalizations of 50% to 100%.
Yesterday, in the Metropolitan City of Cagliari (hence referred to as ‘Cagliari’), the 7-day cumulative incidence per 100,000 people (‘7-day incidence’) reached an all-time high of 321. (Remember: this value indicates that for every 100,000 people in Cagliari, there have been 321 new cases over the last 7 days.) Yesterday’s value of 321 is well above the previous record of 196 on 16 April, 2021 (see the first figure below).
Today, the situation in Cagliari is comparable to other touristic hotspots in Europe. Of note, in these places, the 7-day incidence among people 20 to 29 years of age is three to four times higher than in the general population. In Cagliari, we would therefore assume the 7-day incidence of young adults to be around 1000. In other words, at least 1 in every 100 people 20 to 29 years old is currently infected with the more transmissible and possibly more dangerous Delta variant.
Since 9 July, at a low of 33, the number of hospitalized patients in Sardinia has more than doubled to 74. This is far below the previous ‘record’ of 621 hospitalized patients on 9 December 2020. However, over the coming weeks, this number will continue to rise, as will rise the number of people in intensive care units and the number of deaths from COVID-19.
Data from the United Kingdom (UK) have shown that vaccines are having a decisive impact on the current fourth COVID-19 wave. Compared with previous waves, the number of people hospitalized for COVID-19 in the UK has been reduced by around 75%. In Cagliari, we expect hospital services to be saturated again only if the circulation of the Delta variant is 4 times higher than during previous waves. As the previous peak was 196 (16 April), only a 7-day incidence of more than 700 is likely to saturate hospitals and other health care services.
Today – 1 August 2021 – nobody can predict if the 7-day incidence of over 300 in Cagliari is near a peak or if it will continue to increase beyond 700 or even 1000. It might never happen. If it happens, Sardinia might be in Zona Rossa by the end of the month. It is therefore paramount to consider preventive measures, both at the personal and community level.
3. Preventive measures
3.1. Personal measures
- People living in Cagliari – Reduce social interactions, especially with adolescents and younger adults in their twenties, in particular if you are not vaccinated. Wear face masks in gatherings (even if not mandated by the authorities) and maintain physical distancing outside the home. Your risk of being infected with SARS-CoV-2 is higher today than during previous waves (see below, #4).
- People living outside the Cagliari – Reduce as much as possible contact with people from Cagliari.
- Tourists – Avoid Cagliari. Sardinia is a great island with plenty of other amazing locations.
- Non-vaccinated people living in Cagliari – Get your first vaccine injection. Those who are vaccinated are well protected against the Delta strain, but those who are not vaccinated remain exceedingly and increasingly vulnerable. If the fourth wave continues to intensify, non-vaccinated people, especially those who have frequent contact with adolescents and young adults, will have a risk of being infected with SARS-CoV-2 up to 10 times higher than during the previous waves of April 2020, November 2020 and April 2021.
3.2. Public health measures
Given 1) the increased transmissibility of the Delta variant, 2) a lower vaccine efficacy in protecting against the Delta variant and 3) insufficient vaccine coverage in Cagliari, so-called ‘non-pharmaceutical interventions’ (NPIs) are needed to reduce the transmission of the new variant.
- Isolating Cagliari from the rest of Sardinia – As long as there is a huge difference in SARS-CoV-2 circulation between the Sardinian provinces (see the first figure below), travel between the Metropolitan City of Cagliari and the other provinces should be restricted. From 15:00 on Friday until 6:00 on Monday, and from 20:00 until 6:00 during the other days, only justified essential travel should be allowed.
- Curfew – If the 7-day incidence in the Metropolitan City of Cagliari exceeds 500, a 22:00-05:00 curfew should be implemented.
- Universal masking – Health authorities should immediately consider universal indoor and outdoor masking in the Metropolitan City of Cagliari to reduce transmission of the Delta variant.
- Accelerated vaccination – Health authorities should make every effort to vaccinate as many people in Cagliari and Sardinia as possible in the shortest period of time.
The COVID-19 epidemic situation in Cagliari is not yet out of control but could become so soon. There is still time to take proactive preventive measures. Political leaders will be judged by their ability to protect the people of Cagliari and the people of Sardinia.
Data source: Protezione civile
- Cagliari (Metropolitan City): 430.634
- Sud Sardegna: 347.005
- Oristano: 156.078
- Nuoro: 206.843
- Sassari: 489.634