Waves of infection and waves of communication. the importance of sharing in the era of Covid-19

On March 11th, 2020, the World Health Organization declared that the novel Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2)-associated disease (Covid-19) could be defined as a pandemic. In Italy, more than 1.6 million cases and 55,576 deaths nationwide were recorded by the end of November. Data concerning CKD suggest that the incidence is remarkably higher than in the general population. For example, the incidence of SARS-CoV-2 was 10 and 18.3% in two haemodialysis (HD) Centres in Wuhan at the beginning of the outbreak in China. Similarly, the hard-hit province of Lecco (Lombardy, Italy) reported 1,838 cases in the general population (0.5%) and 55 cases among the 209 HD patients, thus reaching a rate of 26% in this group during the March outbreak. In the same period, between February 24th and April 9th, the Italian Society of Nephrology reported a prevalence of 3.5% in haemodialysis and of 1.4% in peritoneal dialysis, with a high case fatality rate: 33.7% in HD, 45.6% in PD and 24.7% in kidney transplant patients, thus providing an alarming frame of the impact of Covid-19 in dialysis centres on a national scale. In Lazio region, a limited and possibly reassuring number of cases and deaths (22,000 and 1,000 out of 5,863,785 inhabitants, i.e. 0.37% and 0.01%, respectively, see Fig. 1) had been reported by the end of April 2020.