# To Swab or Not to Swab? The Lesson Learned in Italy in the Early Stage of the COVID-19 Pandemic  
[PERSON]  
1 Department of Clinical and Biological Sciences, University of Torino, 10100 Torino, Italy; [EMAIL_ADDRESS] (C.F. ); [EMAIL_ADDRESS] (G.S. ); [EMAIL_ADDRESS] (S.U.) [PERSON]  
2 Department of Mathematics, University of Torino, 10100 Torino, Italy; [EMAIL_ADDRESS] (S.U.) [PERSON]  
1 Department of Clinical and Biological Sciences, University of Torino, 10100 Torino, Italy; [EMAIL_ADDRESS] (C.F. ); [EMAIL_ADDRESS] (G.S. ); [EMAIL_ADDRESS] (S.U.) [PERSON]  
3 Department of Public Health and Pediatric Sciences, University of Torino, 10100 Torino, Italy; [EMAIL_ADDRESS]  
[PERSON]  
1 Department of Clinical and Biological Sciences, University of Torino, 10100 Torino, Italy; [EMAIL_ADDRESS] (C.F. ); [EMAIL_ADDRESS] (G.S. ); [EMAIL_ADDRESS] (S.U.) [PERSON]  
4 Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35121 Padova, Italy; [EMAIL_ADDRESS] (G.L. ); [PERSON].S. ); [PERSON]SS] (I.P. ); [PERSON]] (C.L. ); [EMAIL_ADDRESS] (D.G. );  
5 Department Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; [EMAIL_ADDRESS]  
[PERSON]  
4 Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35121 Padova, Italy; [EMAIL_ADDRESS] (G.L. ); [PERSON].S. ); [PERSON]SS] (I.P. ); [EMAIL_ADDRESS] (C.L. ); [EMAIL_ADDRESS] (D.G. );  
5 Department Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; [EMAIL_ADDRESS]  
[PERSON]  
4 Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, Department  
In order to assess the impact of testing policies, we analyzed the experiences of Piemonte and Veneto, two Italian regions in the North of the country that, while both heavily affected by the pandemic, adopted two opposite strategies to contain the outbreak [5]. Both regions have about 5 million people, with a similar population age structure (see Supplementary Table S1). Piemonte endured 17,690 cases before the middle of April and 3762 hospitalizations; Veneto saw a comparable number of cases (14,432) but about half of the hospitalizations (1660). To control the outbreak, Veneto carried out extensive testing of individuals with both severe and mild symptoms. Moreover, if somebody tested positive, all of the cohabitants were tested or, if tests were not available, they were required to self-quarantine. Besides this, in Vo' Euganeo, a municipality of around 3400 inhabitants, many asymptomatic individuals were tested as part of a pilot study. Specific efforts were put into home diagnosis, with healthcare personnel making a home visit to individuals with suspected COVID-19 for sample collection, preventing them from being exposed or exposing others [6]. Conversely, in Piemonte, the Regional Crisis Management Unit adopted the recommendation issued by the Ministry of Health and the Higher Health Council, which did not consider testing to be clinically informative, based on the knowledge available by the end of February [7]. Consequently, testing was limited to individuals with critical respiratory illnesses with an epidemiological link to a confirmed COVID-19 case, and to health workers who had close contacts with positive COVID-19 patients in the absence of suitable protection. As a result, Piemonte was less proactive in testing than Veneto [8]. Limited testing capacity provided a complementary reason for adopting this strategy [9]. As pointed out during a press conference by the Regional Crisis Management Unit, at the beginning of the emergency in Piemonte only two laboratories could perform swabs, compared to 14 in Veneto. This work aims to understand whether the opposite testing strategies adopted by Veneto and Piemonte impacted the relevant differences in daily hospitalization counts.