Thus the Undersecretary for Health urged by a question first signed by Lorefice. “The President of the region, who has hired ad interim the Head Office of the Health Department has asked for the establishment of a special commission to investigate the data communicated to the Ministry of Health, through the ISS portal ”.
APRIL 16 – In a question presented by Marialucia Lorefice and others (Five Stars) and discussed last Wednesday at the Social Affairs Commission of the Chamber asked the Government if, in light of what happened in Sicily after the investigations on alleged irregularities in the transmission of data on the Covid pandemic and the consequent resignation of the Councilor for health (also investigated) it is not considered appropriate to proceed with the appointment of a new commissioner delegated to manage the Coronavirus emergency in the Sicilian region, while ensuring a more incisive and suitable surveillance system to acquire real data on the epidemic.
This is the answer illustrated by the Undersecretary of Health Andrea Costa:
As is known, the regions and autonomous provinces, on the basis of the modification of Title V of the second part of the Constitution following the Constitutional Law no. 3 of 18 October 2001, have organizational and financial autonomy in the field of health and social services, within the territorial area of their competence.
The initial phase of surveillance of the COVID-19 pandemic event by the Ministry of Health dates back to the Ministerial Circular no. 1997 of 22 January 2020.
On 27 February 2020, the Civil Protection Department of the Presidency of the Council of Ministers, through the Ordinance no. 640, has entrusted the epidemiological and microbiological surveillance for COVID-19 to the Istituto Superiore di Sanità.
It is a necessary and useful observation tool, both to inform citizens about the impact and evolution of the epidemic and to offer decision-making support for the public health responses of the health authorities.
The surveillance system is able to “capture” individual cases of confirmed infection with SARS-CoV-2 virus, regardless of the clinical presentation, and is coordinated by the ISS, with a daily production of data in the form of “dash-board“And”open data»And with the production of weekly insights.
The compilation of the cases to be reported to the epidemiological surveillance of COVID-19 takes place through the “Web Platform of the Integrated Surveillance of COVID-19 cases” which, on the dedicated website (COVID-19.iss.it), presents a “User Manual of the Web Platform of the Integrated Surveillance of COVID-19 cases “, in which the indications on the compilation of the surveillance data are detailed.
At the local level, each autonomous region / province has identified one or more referents.
The ISS Department of Infectious Diseases processes and analyzes the Platform data and makes it available to enable analysis of the outbreak across the country.
It is emphasized that the pandemic situation underway appears to be changing, both from an epidemiological / health and a legislative point of view, and therefore may require that the integrated COVID-19 surveillance undergo changes and / or adjustments.
A further source of information on the COVID-19 epidemic is represented by the flow of aggregate data (Ministry of Health / Civil Protection), which collects daily information on the number of diagnostic tests (total swabs performed – swabs processed with molecular test – swabs processed with rapid antigen test), deaths, hospitalizations and ICU admissions, in every province of Italy.
On 26 April 2020, in annex 10 to the decree of the President of the Council of Ministers no. 108, a detailed decision-making algorithm dedicated to the modalities of phase passage was reported, from phase 1 (“lockdown») To phase 2A (initial transition), aimed at modulating the interventions with a view to improvement or epidemic worsening.
This tool has found its concrete application in the phase 2 monitoring system formalized with the decree of the Ministry of Health of 30 April 2020.
With this decree, in fact, the risk monitoring system of an uncontrolled and unmanageable epidemic at regional level in Italy was established.
More specifically, I recall that for the elaboration of the risk calculation, 21 indicators were defined, of which 16 mandatory and 5 optional, which allow to evaluate three aspects of interest for risk assessment: probability of spread of the epidemic, impact on health systems and territorial resilience.
Their complete list is reported in the decree of 30 April 2020.
We have chosen to use multiple indicators from multiple information flows because, especially in emergencies, the risk is higher that the data are affected by the overload of health systems and therefore have a non-optimal completeness and timeliness.
In the context of epidemiology, the robustness of an analysis is considered to be greater when multiple sources of information confirm the same trend (for example, the trend towards an increase in cases).
The data are sent by the local authorities to the regions, which in turn transmit them to the Ministry of Health and the ISS.
On the basis of these data, algorithms are applied which, combined, make it possible to assess the risk for each region on a weekly basis.
The monitoring system provides mechanisms for regular consultation with the technical representatives of the regional health systems and with a national coordination committee set up pursuant to the same decree of 30 April 2020, called the “Control Room”.
THE Report relating to risk classification are published weekly on the institutional website of the Ministry of Health and can be consulted «online“.
Specifically, the Department for Health of the Sicily region specified that the competent regional Department “proceeded to an immediate activation of all the appropriate administrative procedures aimed at verifying the timely transmission of data de quo that of the processes of acquisition of the same by the peripheral structures “.
Furthermore, precisely “in order to ascertain the correctness of the activities carried out up to now by the Department of Health Activities and Epidemiological Observatory, as well as the work of all the actors of the system involved in various capacities”, the President of the region ad interim the Head Office of the Health Department “has asked for the establishment of a special commission to investigate the data communicated to the Ministry of Health, through the ISS portal”.
I conclude by stating that investigations by the judicial authority are underway on the facts in question, on which the utmost institutional trust is placed.
April 16, 2021
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