Coronavirus, this is how the ‘Veneto model’ was born and why it should be extended to all of Italy

“In this phase in which some measures of containment and social distancing will be gradually and gradually eliminated, there will certainly be the possibility of new outbreaks appearing. We now have the recipe to turn them off, by now we know it: circumscribe the area, swab everyone, isolate symptomatic and non-symptomatic positive people, and after 7-8 days redo the same thing to take the cases that may have escaped “. Andrea crisanti, director of the Microbiology and Virology Laboratory of the Padua hospital and “father” of the Veneto model, the region that has managed to contain the epidemic so far.

After the outbreak in Vo ‘, the strategy was to do carpet tests and isolate covid-positive patients as well as all contacts. How did we do it? Crisanti explains that he devised a sort of “home-made” method which, together with a “new” hi-tech “machinery for half a million euros”, allowed the hospital in Padua to approach the “milestone of 100 thousand swabs “processed to detect positivity to the new coronavirus.

An operating method made at home

During a live facebook, the virologist explains how the ‘Veneto model’ was born. ‘ “Already on 20 January – says Crisanti – I had made the hospital company aware of the need to develop a diagnostic test that would allow us to identify the positive people at Covid-19, thus starting to develop a fairly complex method because the swab is only a sample, followed by a nucleic acid extraction phase, a reagent distribution phase and then there is a reading phase. I specify all this – he continues – because we have chosen an operating method from the beginning made ‘at home’ without having to refer to suppliers, and it is something that has distinguished us because from the beginning we chose to do a homemade test validating the initial results with those of Spallanzani. With 100% agreement, we started testing people who had the initial criteria identified by WHO. “

Vo ‘challenge

Then, recalls the virologist, “there was the first case of coronavirus in Italy and there came the first challenge: the Veneto Region asked 3,300 inhabitants of Vo ‘Euganeo to test. It was the first stimulus to reorganize the work and flow. We went from one hundred to one thousand tampons a day and then gradually reached the 2,500 daily average of the last few months. This was a fundamental tool, first of all to put out the Vo ‘outbreak “.

The intuition of Crisanti: a hi tech machine to save time and reagents

In order to increase the ability to carry out tests, the purchase of a hi-tech machine capable of analyzing swabs faster using a much smaller quantity of regents has proved decisive. “In my previous experience at Imperial College I had seen fantastic equipment in place – explains Crisanti – that instead of mechanically moving liquids through pipettes it does so with ultrasound at a spectacular speed, and therefore I asked the hospital to buy it knowing only theoretically that would have worked, and I must say it works fine. I publicly thank the trust that has been given to me because it is an instrumentation that costs about half a million euros. ”

Same amount of reagent to analyze many more swabs

The new instrumentation “saved a lot of time and introduced a processing parallelism: now we are able to process 384 swabs at a time in ten minutes”. Not only that: “The previous machine – continues the virologist – needed a quantity of reagents that was five times higher to what we have to use with this machine. ”

This means that with “the purchases we made to obtain 500 thousand reactions, now enough for two and a half million reactions. I know that the Region, which I thank, wants to buy another similar machine to give to another hospital to further increase capacity. I remember that in one of the first meetings made after the first cases we immediately decided to defend the hospital, for this reason most of the swabs were made by the staff and the whole ward in case of suspicious cases – says Crisanti -, including the patients”.

“A recipe to block new outbreaks”

In Veneto, and in Vo ‘in particular, this model worked. “To date, after 6 weeks there has been no case” of Covid-19 “in Vo ‘Euganeo and this should be adopted as a lesson to extinguish future outbreaks. One of the great lessons – underlines the virologist – is that it is possible to extinguish outbreaks and that asymptomatics play an important role. Now a new phase will open which poses great challenges. People want to resume some social activities, return to work, have access to religious services and tampons will serve much more. ” . There will be more people around and “we must have a recipe to possibly block outbreaks”. And this recipe “will necessarily pass for the ability to make tampons “.

The virologist Andrea Crisanti explains how the ‘Veneto model’ was born | Video

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