We employ methods largely exploited in Physics, in the analysis of the evolution of dynamical systems, to study the pattern of the Covid-19 infection in Italy. The techniques we employ are based on the use of logistic function and of its derivative, namely the Hubbert function. The latter is exploited to give a prediction on the number of infected per day. We also mention the possibility of taking advantage from other mathematical tools based e.g. on the Gompertz equation and make some comparison on the different predictive capabilities.
The COVID-19 epidemics, started in China in January 2020, was recognized to have reached Italy around February 20; recent estimates show that most probably the virus circulated in the country already in January, but was not recognized. Data for the early dynamics of COVID-19 in Northern Italy are analyzed.
On March 10, 2020, Italy imposed a national lockdown to curtail the spread of COVID-19. Here we estimate that, fourteen days after the implementation of the strategy, the net reproduction number has dropped below the epidemic threshold - estimated range 0.4-0.7. Our findings provide a timeline of the effectiveness of the implemented lockdown, which is relevant for a large number of countries that followed Italy in enforcing similar measures.
In this paper we propose a Susceptible-Infected-Exposed-Recovered-Dead (SEIRD) differential model for the analysis and forecast of the COVID-19 spread in some regions of Italy, using the data from the Italian Protezione Civile from February 24th 2020. In this study investigate an adaptation of the model. Since several restricting measures have been imposed by the Italian government at different times, starting from March 8th 2020, we propose a modification of SEIRD by introducing a time dependent transmitting rate. In the numerical results we report the maximum infection spread for the three I…
Aim of this manuscript is to show a simple method to infer the time-course of new COVID-19 infections (the most important information in order to establish the effect of containment strategies) from available aggregated data, such as number of deaths and hospitalizations. The method, that was used for HIV-AIDS and was named `back-calculation', relies on good estimates of the distribution of the delays between infection and the observed events; assuming that the epidemic follows a simple SIR model with a known generation interval, we can then estimate the parameters that define the time-varying…
In a recent report we have collected some data about the COVID-19 epidemics in Northern Italy; in this follow-up we analyze how these changed after the mild restrictive measures taken by the Government two weeks ago and the large campaign of public awareness developed in the meanwhile.
The control of Covid 19 epidemics by public health policy in Italy during the first and the second epidemic waves has been driven by using reproductive number Rt(t) to identify the supercritical (percolative), the subcritical (arrested), separated by the critical regime. Here we show that to quantify the Covid-19 spreading rate with containment measures (CSRwCM) there is a need of a 3D expanded parameter space phase diagram built by the combination of Rt(t) and doubling time Td(t). In this space we identify the dynamics of the Covid-19 dynamics Italy and its administrative Regions. The supercr…
The 2019-Novel-Coronavirus (COVID-19) has affected 116 countries (By March 12) and out of more than 118,000 confirmed cases. Understanding the transmission dynamics of the infection in each country which affected on a daily basis and evaluating the effectiveness of control policies is critical for our further actions. To date, the statistics of COVID-19 reported cases show more than 80 percent of infected had a mild case of disease, while around 14 percent of infected experienced a severe one and about 5 percent are categorized as critical disease victims. Today's report (2020-03-12; daily upd…
In a previous note we made an analysis of the spreading of the COVID disease in Italy. We used a model based on the logistic and Hubbert functions, the analysis we exploited has shown limited usefulness in terms of predictions and failed in fixing fundamental indications like the point of inflection of the disease growth. In this note we elaborate on the previous model, using multi-logistic models and attempt a more realistic analysis.
This paper presents an dashboard developed to analyse the outbreak of the Covid-19 infection in Italy considering daily NUTS-3 data on positive cases provided by the Italian Ministry of Health and on deaths derived from Italian regional authorities' official press conferences. Descriptive time series plots are provided together with a map describing the spatial distribution of province cumulative cases and rates. A section on a proposed time-dependent adjusted SIRD model for NUTS-3 regions is also provided in the dashboard.
In the night of February 20, 2020, the first case of novel coronavirus disease (COVID-19) was confirmed in the Lombardy Region, Italy. In the week that followed, Lombardy experienced a very rapid increase in the number of cases. We analyzed the first 5,830 laboratory-confirmed cases to provide the first epidemiological characterization of a COVID-19 outbreak in a Western Country. Epidemiological data were collected through standardized interviews of confirmed cases and their close contacts. We collected demographic backgrounds, dates of symptom onset, clinical features, respiratory tract speci…
We present a compartmental mathematical model with demography for the spread of the COVID-19 disease, considering also asymptomatic infectious individuals. We compute the basic reproductive ratio of the model and study the local and global stability for it. We solve the model numerically based on the case of Italy. We propose a vaccination model and we derive threshold conditions for preventing infection spread in the case of imperfect vaccines.
We have proposed an SEIR compartmental mathematical model. The prime objective of this study is to analyze and forecast the pandemic in Italy for the upcoming months. The basic reproduction number has been calculated. Based on the current situation in Italy, in this paper, we will estimate the possible time for the end of the pandemic in the country. The impact of lockdown and rapid isolation on the spread of the pandemic are also discussed. Further, we have studied four of the most pandemic affected regions in Italy. Using the proposed model, a prediction has been made about the duration of p…
In this work, the SIR epidemiological model is reformulated so to highlight the important {\em effective reproduction number}, as well as to account for the {\em generation time}, inverse of the {\em incidence rate}, and the {\em infectious period} (or {\em removal period}), inverse of the {\em removal rate}. The aim is to check whether the relationships the model poses among the various observables are actually found in the data. The study case of the second through the third wave of the Covid-19 pandemic in Italy is taken. Given its scale invariance, initially the model is tested with refere…
I use a very simple deterministic model for the spread of Covid-19 in a large population. Using this to compare the relative decay of the number of deaths per day between different regions in Italy, Spain and England, each applying in principle the same social distancing procedures across the whole country, I obtain an estimate of the total fraction of the population which had already become infected by April 10th. In the most heavily affected regions, Lombardy, Madrid and London, this fraction is higher than expected, i.e. $\approx 0.3$. This result can then be converted to a determination of…
COVID-19 has forced quarantine measures in several countries across the world. These measures have proven to be effective in significantly reducing the prevalence of the virus. To date, no effective treatment or vaccine is available. In the effort of preserving both public health as well as the economical and social textures, France and Italy governments have partially released lockdown measures. Here we extrapolate the long-term behavior of the epidemics in both countries using a Susceptible-Exposed-Infected-Recovered (SEIR) model where parameters are stochastically perturbed to handle the un…
In this paper, we firstly propose SQIARD and SIARD models to investigate the transmission of COVID-19 with quarantine, infected and asymptomatic infected, and discuss the relation between the respective basic reproduction number $R_0, R_Q$ and the stability of the equilibrium points of model. Secondly, after training the related data parameters, in our numerical simulations, we respectively conduct the forecast of the data of US, South Korea, Brazil, India, Russia and Italy, and the effect of prediction of the epidemic situation in each country. Furthermore, we apply US data to compare SQIARD …
Several European countries have suspended the inoculation of the AstraZeneca vaccine out of suspicion of causing deep vein thrombosis. In this letter we report some Fermi estimates performed using a stochastic model aimed at making a risk-benefit analysis of the interruption of the delivery of the AstraZeneca vaccine in France and Italy. Our results clearly show that excess deaths due to the interruption of the vaccination campaign injections largely overrun those due to thrombosis even in worst case scenarios of frequency and gravity of the vaccine side effects.
Using the classical Susceptible-Infected-Recovered epidemiological model, an analytical formula is derived for the number of beds occupied by Covid-19 patients. The analytical curve is fitted to data in Belgium, France, New York City and Switzerland, with a correlation coefficient exceeding 98.8%, suggesting that finer models are unnecessary with such macroscopic data. The fitting is used to extract estimates of the doubling time in the ascending phase of the epidemic, the mean recovery time and, for those who require medical intervention, the mean hospitalization time. Large variations can be…
Several epidemiological models have been proposed to study the evolution of COVID-19 pandemic. In this paper, we propose an extension of the SUIHTER model, first introduced in [Parolini et al, Proc R. Soc. A., 2021] to analyse the COVID-19 spreading in Italy, which accounts for the vaccination campaign and the presence of new variants when they become dominant. In particular, the specific features of the variants (e.g. their increased transmission rate) and vaccines (e.g. their efficacy to prevent transmission, hospitalization and death) are modeled, based on clinical evidence. The new model i…
We give some numerical observations on the total number of infected by the SARS-CoV-2 in Italy. The analysis is based on a tanh formula involving two parameters. A polynomial correlation between the parameters gives an upper bound for the time of the peak of new infected. A numerical indicator of the temporal variability of the upper bound is introduced. The result and the possibility to extend the analysis to other countries are discussed in the conclusions.
In this paper we develop a predictive model for the spread of COVID-19 infection at a provincial (i.e. EU NUTS-3) level in Italy by using official data from the Italian Ministry of Health integrated with data extracted from daily official press conferences of regional authorities and from local newspaper websites. This integration is mainly concerned with COVID-19 cause specific death data which are not available at NUTS-3 level from open official data data channels. An adjusted time-dependent SIRD model is used to predict the behavior of the epidemic, specifically the number of susceptible, i…
Coronavirus disease (COVID-2019) is a severe ongoing novel pandemic that is spreading quickly across the world. Italy, that is widely considered one of the main epicenters of the pandemic, has registered the highest COVID-2019 death rates and death toll in the world, to the present day. In this article I estimate an autoregressive integrated moving average (ARIMA) model to forecast the epidemic trend over the period after April 4, 2020, by using the Italian epidemiological data at national and regional level. The data refer to the number of daily confirmed cases officially registered by the It…
We apply optimal control theory to a generalized SEIR-type model. The proposed system has three controls, representing social distancing, preventive means, and treatment measures to combat the spread of the COVID-19 pandemic. We analyze such optimal control problem with respect to real data transmission in Italy. Our results show the appropriateness of the model, in particular with respect to the number of quarantined/hospitalized (confirmed and infected) and recovered individuals. Considering the Pontryagin controls, we show how in a perfect world one could have drastically diminish the numbe…
The impact of the outbreak of COVID-19 on health has been widely concerned. Disease risk assessment, prediction, and early warning have become a significant research field. Previous research suggests that there is a relationship between air quality and the disease. This paper investigated the impact of the atmospheric environment on the basic reproduction number (R$_0$) in Australia, South Korea, and Italy by using atmospheric environment data, confirmed case data, and the distributed lag non-linear model (DLNM) model based on Quasi-Poisson regression. The results show that the air temperature…
Background. The paper concerns the SARS-CoV2 (COVID-19) pandemic that, starting from the end of February 2020, began spreading along the Italian peninsula, by first attacking small communities in north regions, and then extending to the center and south of Italy, including the two main islands. Objective. The creation of a forecast model that manages to alert the decision-making bodies and, in particular, the healthcare system, to hinder the emergence of any other pandemic outbreaks, or the arrival of subsequent pandemic waves. Methods. A new mathematical model to describe the pandemic is give…
Initially emerged in the Chinese city Wuhan and subsequently spread almost worldwide causing a pandemic, the SARS-CoV-2 virus follows reasonably well the SIR (Susceptible-Infectious-Recovered) epidemic model on contact networks in the Chinese case. In this paper, we investigate the prediction accuracy of the SIR model on networks also for Italy. Specifically, the Italian regions are a metapopulation represented by network nodes and the network links are the interactions between those regions. Then, we modify the network-based SIR model in order to take into account the different lockdown measu…
We study a simple realistic model for describing the diffusion of an infectious disease on a population of individuals. The dynamics is governed by a single functional delay differential equation, which, in the case of a large population, can be solved exactly, even in the presence of a time-dependent infection rate. This delay model has a higher degree of accuracy than that of the so-called SIR model, commonly used in epidemiology, which, instead, is formulated in terms of ordinary differential equations. We apply this model to describe the outbreak of the new infectious disease, Covid-19, in…
During the COVID-19 outbreak, it is essential to monitor the effectiveness of measures taken by governments on the course of the epidemic. Here we show that there is already a sufficient amount of data collected in Italy to predict the outcome of the process. We show that using the proper metric, the data from Hubei Province and Italy has striking similarity, which enables us to calculate the expected number of confirmed cases and the number of deaths by the end of the process. Our predictions will improve as new data points are generated day by day, which can help to make further public decis…
The spread of the coronavirus (COVID-19), starting in late 2019, has determined in Italy several interventions aimed to prevent saturation of the health system. We have examined the effects of such measures by proposing a mean-field model describing the spread of the infection based on a simple diffusion process where all the observable variables (number of people still positive to the infection, hospitalized and fatalities cases, healed people, and total number of people that has contracted the infection) depend on average parameters, namely diffusion coefficient, infection cross-section, and…
In this note we analyze the temporal dynamics of the coronavirus disease 2019 outbreak in China, Italy and France in the time window $22/01-09/03/2020$. A first analysis of simple day-lag maps points to some universality in the epidemic spreading, suggesting that simple mean-field models can be meaningfully used to gather a quantitative picture of the epidemic spreading, and notably the height and time of the peak of confirmed infected individuals. The analysis of the same data within a simple susceptible-(confirmed) infected-recovered-deaths model indicates that the kinetic parameter that des…
COVID-19 is a new type of coronavirus disease which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It originated in China in the month of December 2019 and quickly started to spread within the country. On 31st December 2019, it was first reported to country office of World Health Organization (WHO) in China. Since then, it has spread to most of the countries around the globe. However, there has been a recent rise in trend in believing that it would go away during summer days, which has not yet been properly investigated. In this paper, relationship of daily number o…
The ongoing Coronavirus Disease 2019 (COVID-19) pandemic threatens the health of humans and causes great economic losses. Predictive modelling and forecasting the epidemic trends are essential for developing countermeasures to mitigate this pandemic. We develop a network model, where each node represents an individual and the edges represent contacts between individuals where the infection can spread. The individuals are classified based on the number of contacts they have each day (their node degrees) and their infection status. The transmission network model was respectively fitted to the re…
We analyzed 5,484 close contacts of COVID-19 cases from Italy, all of them tested for SARS-CoV-2 infection. We found an infection fatality ratio of 2.2% (95%CI 1.69-2.81%) and identified male sex, age >70 years, cardiovascular comorbidities, and infection early in the epidemics as risk factors for death.
The aim of this paper consists in the application of a recent epidemiological model, namely SEIR with Social Distancing (SEIR--SD), extended here through the definition of a social distancing function varying over time, to assess the situation related to the spreading of the coronavirus Covid--19 in Italy and in two of its most important regions, i.e., Lombardy and Campania. To profitably use this model, the most suitable values of its parameters must be found. The estimation of the SEIR--SD model parameters takes place here through the use of Differential Evolution, a heuristic optimization t…
The outbreak of COVID-19 in 2020 has led to a surge in interest in the mathematical modeling of infectious diseases. Such models are usually defined as compartmental models, in which the population under study is divided into compartments based on qualitative characteristics, with different assumptions about the nature and rate of transfer across compartments. Though most commonly formulated as ordinary differential equation (ODE) models, in which the compartments depend only on time, recent works have also focused on partial differential equation (PDE) models, incorporating the variation of a…
During the current Covid-19 pandemic in Italy, official data are collected with medical swabs following a pure convenience criterion which, at least in an early phase, has privileged the exam of patients showing evident symptoms. However, there are evidences of a very high proportion of asymptomatic patients (e. g. Aguilar et al., 2020; Chugthai et al, 2020; Li, et al., 2020; Mizumoto et al., 2020a, 2020b and Yelin et al., 2020). In this situation, in order to estimate the real number of infected (and to estimate the lethality rate), it should be necessary to run a properly designed sample sur…
While COVID-19 is rapidly propagating around the globe, the need for providing real-time forecasts of the epidemics pushes fits of dynamical and statistical models to available data beyond their capabilities. Here we focus on statistical predictions of COVID-19 infections performed by fitting asymptotic distributions to actual data. By taking as a case-study the epidemic evolution of total COVID-19 infections in Chinese provinces and Italian regions, we find that predictions are characterized by large uncertainties at the early stages of the epidemic growth. Those uncertainties significantly r…
The presence of a large number of infected individuals with few or no symptoms is an important epidemiological difficulty and the main mathematical feature of COVID-19. The A-SIR model, i.e. a SIR (Susceptible-Infected-Removed) model with a compartment for infected individuals with no symptoms or few symptoms was proposed by Giuseppe Gaeta, arXiv:2003.08720 [q-bio.PE] (2020). In this paper we investigate a slightly generalized version of the same model and propose a scheme for fitting the parameters of the model to real data using the time series only of the deceased individuals. The scheme is…
This paper is concerned with the design of intermittent non-pharmaceutical strategies to mitigate the spread of the COVID-19 epidemic exploiting network epidemiological models. Specifically, by studying a variational equation for the dynamics of the infected in a network model of the epidemic spread, we derive, using contractivity arguments, a condition that can be used to guarantee that, in epidemiological terms, the effective reproduction number is less than unity. This condition has three advantages: (i) it is easily computable; (ii) it is directly related to the model parameters; (iii) it …
The COVID-19 epidemic is the last of a long list of pandemics that have affected humankind in the last century. In this paper, we propose a novel mathematical epidemiological model named SUIHTER from the names of the seven compartments that it comprises: susceptible uninfected individuals (S), undetected (both asymptomatic and symptomatic) infected (U), isolated (I), hospitalized (H), threatened (T), extinct (E), and recovered (R). A suitable parameter calibration that is based on the combined use of least squares method and Markov Chain Monte Carlo (MCMC) method is proposed with the aim of re…
A great issue of discussion of an infectious disease is its basic reproduction number R0, which provides an estimation of the contagiousness of the disease. When R0 > 1, the disease spread will potentially lead to an outbreak, such that of the ongoing COVID-19 pandemics. During the evolution of an outbreak, various non-pharmaceutical interventions are employed, the impact of which is frequently assessed by the reduction that they introduce to the effective reproduction number Rt; reduction below 1 is an indication of eventual dying out of the disease spread. Motivated by the fact that R0 essen…
We present a simple analytical model to describe the fast increase of deaths produced by the corona virus (COVID-19) infections. The 'D' (deaths) model comes from a simplified version of the SIR (susceptible-infected-recovered) model known as SI model. It assumes that there is no recovery. In that case the dynamical equations can be solved analytically and the result is extended to describe the D-function that depends on three parameters that we can fit to the data. Results for the data from Spain, Italy and China are presented. The model is validated by comparing with the data of deaths in Ch…
OBJECTIVES: to describe the first wave of the COVID-19 pandemic with a focus on undetected cases and to evaluate different post-lockdown scenarios. DESIGN: the study introduces a SEIR compartmental model, taking into account the region-specific fraction of undetected cases, the effects of mobility restrictions, and the personal protective measures adopted, such as wearing a mask and washing hands frequently. SETTING AND PARTICIPANTS: the model is experimentally validated with data of all the Italian regions, some European countries, and the US. MAIN OUTCOME MEASURES: the accuracy of the model …
In this paper we introduce a space-dependent multiscale model to describe the spatial spread of an infectious disease under uncertain data with particular interest in simulating the onset of the COVID-19 epidemic in Italy. While virus transmission is ruled by a SEIAR type compartmental model, within our approach the population is given by a sum of commuters moving on a extra-urban scale and non commuters interacting only on the smaller urban scale. A transport dynamic of the commuter population at large spatial scales, based on kinetic equations, is coupled with a diffusion model for non commu…
In late December 2019, a novel strand of Coronavirus (SARS-CoV-2) causing a severe, potentially fatal respiratory syndrome (COVID-19) was identified in Wuhan, Hubei Province, China and is causing outbreaks in multiple world countries, soon becoming a pandemic. Italy has now become the most hit country outside of Asia: on March 16, 2020, the Italian Civil Protection documented a total of 27980 confirmed cases and 2158 deaths of people tested positive for SARS-CoV-2. In the context of an emerging infectious disease outbreak, it is of paramount importance to predict the trend of the epidemic in o…
The importance of spatial networks in the spread of an epidemic is an essential aspect in modeling the dynamics of an infectious disease. Additionally, any realistic data-driven model must take into account the large uncertainty in the values reported by official sources, such as the amount of infectious individuals. In this paper we address the above aspects through a hyperbolic compartmental model on networks, in which nodes identify locations of interest, such as cities or regions, and arcs represent the ensemble of main mobility paths. The model describes the spatial movement and interacti…
As the COVID-19 outbreak is developing the two most frequently reported statistics seem to be the raw confirmed case and case fatalities counts. Focusing on Italy, one of the hardest hit countries, we look at how these two values could be put in perspective to reflect the dynamics of the virus spread. In particular, we find that merely considering the confirmed case counts would be very misleading. The number of daily tests grows, while the daily fraction of confirmed cases to total tests has a change point. It (depending on region) generally increases with strong fluctuations till (around, de…
We provide a probabilistic SIRD model for the COVID-19 pandemic in Italy, where we allow the infection, recovery and death rates to be random. In particular, the underlying random factor is driven by a fractional Brownian motion. Our model is simple and needs only some few parameters to be calibrated.
The COVID-19 epidemic that emerged in Wuhan China at the end of 2019 hit Italy particularly hard, yielding the implementation of strict national lockdown rules (Phase 1). There is now a hot ongoing debate in Italy and abroad on what the best strategy is to restart a country to exit a national lockdown (Phase 2). Previous studies have focused on modelling possible restarting scenarios at the national level, overlooking the fact that Italy, as other nations around the world, is divided in administrative regions who can independently oversee their own share of the Italian National Health Service.…
We propose a novel data-driven framework for assessing the a-priori epidemic risk of a geographical area and for identifying high-risk areas within a country. Our risk index is evaluated as a function of three different components: the hazard of the disease, the exposure of the area and the vulnerability of its inhabitants. As an application, we discuss the case of COVID-19 outbreak in Italy. We characterize each of the twenty Italian regions by using available historical data on air pollution, human mobility, winter temperature, housing concentration, health care density, population size and …
The current pandemic caused by the coronavirus SARS-CoV-2 is having negative health, social and economic consequences worldwide. In Europe, the pandemic started to develop strongly at the end of February and beginning of March 2020. It has subsequently spread over the continent, with special virulence in northern Italy and inland Spain. In this study we show that an unusual persistent anticyclonic situation prevailing in southwestern Europe during February 2020 (i.e. anomalously strong positive phase of the North Atlantic and Arctic Oscillations) could have resulted in favorable conditions, in…
In all Countries the political decisions aim to achieve an almost stable configuration with a small number of new infected individuals per day due to Covid-19. When such a condition is reached, the containment effort is usually reduced in favor of a gradual reopening of the social life and of the various economical sectors. However, in this new phase, the infection spread restarts and a quantitative analysis of the regrowth is very useful. We discuss a macroscopic approach which, on the basis of the collected data in the first lockdown, after few days from the beginning of the new phase, outli…
A Nine-Compartment Nonlinear Epidemic Model with Spline-Based Identification of Time-Varying Transmission and Vaccination Dynamics: Application to the COVID-19 Third Wave in Italy
University of Palermo（巴勒莫大学）；University of Bayreuth（拜罗伊特大学）；Regional Health Care and Social Agency of Lodi, Azienda Socio-Sanitaria Territoriale (ASST) Lodi（洛迪地区卫生与社会服务机构，地方社会卫生企业（ASST）洛迪）；InEmbryo S.r.l.s.（InEmbryo有限公司）；Department of Internal Medicine “PROMISE”, University of Palermo（巴勒莫大学“PROMISE”内科学系）
IMT School for Advanced Studies Lucca（卢cca高等研究院）；TREE-TOWER S.R.L.（TREE-TOWER有限责任公司）
Computational models for the simulation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic evolution would be extremely useful to support authorities in designing healthcare policies and lockdown measures to contain its impact on public health and economy. In Italy, the devised forecasts have been mostly based on a pure data-driven approach, by fitting and extrapolating open data on the epidemic evolution collected by the Italian Civil Protection Center. In this respect, SIR epidemiological models, which start from the description of the nonlinear interactions between…
Extended Kalman Filter-Based State Estimation for a Nine-Compartment Nonlinear Epidemic Model -- Convergence Analysis and In-Silico Benchmark Calibrated on the COVID-19 Third Wave in Italy
University of Palermo（巴勒莫大学）；InEmbryo S.r.l.s.（InEmbryo有限公司）
Several analytical models have been used in this work to describe the evolution of death cases arising from coronavirus (COVID-19). The Death or `D' model is a simplified version of the SIR (susceptible-infected-recovered) model, which assumes no recovery over time, and allows for the transmission-dynamics equations to be solved analytically. The D-model can be extended to describe various focuses of infection, which may account for the original pandemic (D1), the lockdown (D2) and other effects (Dn). The evolution of the COVID-19 pandemic in several countries (China, Spain, Italy, France, UK,…
