.

1. BOOK
TITLE : Pianura Padana geo-morphology, climate condition prevalence
and distribution of COVID -19 and some other respiratory virus:
Hypotesis of work.
Authors:
1 )mauro luisetto IMA ACADEMY natural science and toxicology branch Italy
29121
2)Naseer Almukthar, Professor, Department of Physiology /College of Medicine,
University of Babylon, Iraq
3) Prof. Giulio Tarro Primario emerito dell’ Azienda Ospedaliera “D. Cotugno”,
Napoli
Chairman della Commissione sulle Biotecnologie della Virosfera, WABT -
UNESCO, Parigi
Rector of the University Thomas More U.P.T.M., Rome
Presidente della Fondazione de Beaumont Bonelli per le ricerche sul cancro -
ONLUS, Napoli
4) Ghulam Rasool Mashori, Full Professor of pharmacology ,Peoples university
of medical and health sciences for Women, Nawabshah,Pakistan
5) Ahmed Yesvi Rafa ,Founder and President, Yugen Research Organization,
Western Michigan University, MI, USA
6) Oleg yurevich Latyshev President of IMA academy RU

2. Keywords :PIANURA PADANA (an Italian area), geomorphological, climate
condition ,covid -19 diffusion ,Worsening factors, air pollution, Regional
mortality rate variability, infection speed , coronavirus belt, wind speed
,meteorological factors, humidity, temperature ,latitude, viruses airborne
transmission
*Corresponding Author: mauro Luisetto , IMA Academy Natural Science,
maurolu65@gmail.com
CHAPTHER 1 ) Abstract
In order to enrich and expand this topic information whit an update searches,
new studies and allows widely benefits international.
Hence this work was written in Italian and English languages.
The recent study was verified the statistical hypotesis of prevalence and
distribution of covid- 19 related some
Relevant division of high way in italy ( especially north regions ) .
The geomorphological characteristic of PIANURA PADANA , an area located in
Italia which is also
Named PO valley ( a low area land between hills and mountains)
This area is surrounded from the north by a close connection with a serial
range ALPI mountains and from south by APPENINI MOUNTAINS have created
since ancient time particular climate condition.
If we observe diffusion of covid -19 in italy at today date is possible to verify a
sort of different velocity in diffusion between north region vs the other .
There are obvious relationship between this “ closed environment “ and
diffusion of some relevant virus?
Pianura padana is famous for its kind of climate with lots of fog in some season,
but also for air pollution as reported by EPHA and other organization.
CHAPTHER 2 ) Introduction

3. It seem that Italian presence and diffusion of covid -19 depends on some
travelers that comes from Wu han and other infected region of the globe, but it
is interesting to notice that the strange diffusion of virus in north Italia not in a
close association with the fact that Chinese from this region not arrive in
south cities of Italy using other european airport.
Starting from this fact we analyze , with an observational approach ( visual
methods) some figure related
PIANURA PADANA geomorphografic condition and its related climate
condition and the recent study asses to verify as hypotesis of work diffusion of
virus according great north high way in the area of north italia.
As Italia is also like a PENINSULA therefore it show high development north
south.
From 35 grades latitude south ( Lampedusa isle ) to 47 grades latitudes north (
ALPI AURINE ) .
FIG. N 1 Italy zone : continental peninsular , insular
It seem that there are I Italy 2 different velocity for diffusion of covid-19 : with
north showing very fast vs south that appear more slowly.

4. Can be related to the famous PIANURA PADANA climate and its enhancement
conditions as well as to air pollution raise due to a huge of factories ? as
industrial area?
All this must be related to the lockdown Italian measure in march – April 2020,
and the red zone of the first phases of virus diffusion in north of Italy.
According a recent interview (18 april 2020) to Professor F. Prodi famous
CLIMATOLOGIST by italian journal it was reported:
“conta il vento, altro grande assente dalla Pianura Padana. Esso diluisce le
concentrazioni degli inquinanti, redistribuendoli negli strati più alti e attenua la
forza contagiosa del virus “.
And in the same interview: “Sono molto preoccupato. La clausura, il distacco
sociale, vengono imposti come unica soluzione possibile per contrastare la
diffusione del Covid-19, implicitamente attribuendo il contagio alla sola
interazione tra persone. Ma non è così, tant'è che la segregazione degli
individui all'interno delle loro abitazioni fatica a portare i vantaggi attesi, pur
essendo al momento assolutamente necessaria.”
All this variable must be strictly applied to the lockdown of Italian measure in
march – April 2020, and the red zone of the first stages of virus diffusion in
north of Italia.
CHAPTHER 3 ) Material and methods
A monitoring approach point out observing some figure related to the topics of
this works and some global relevant literature conclusion is produced to
submit for a wide range of researchers for a new research topics.
From literature and on line resource :
According https://www.scienzainrete.it/articolo/coronavirus-ha-viaggiato-
autostrada/giovanni-sebastiani/2020-04-09

5. An hypotesis of work is related some characteristic of Italian relevant way of
travel communication .
“La diffusione è maggiore vicino ai grandi nodi autostradali» ( spread is greater
near the major motor-way junctions)
Figure n 2 Italian high way – covid -19 distribution work SEBASTIANI 2020
As the diffusion or transport of coronavirus seem to follow great travel
communication pathway.
North Italia is a known as real industrial area and present whit a high
interconnection more then that of the south region.
However, connected with other part of Italia but also it connected with other
world regions.

6. It is a fact that today some north Italian region are most involved in viruses
diffusion.
In addiction, to other fact shown in this region of north italia there are ALPI
MOUNTAIN and in south part there are existence of the APPENNINI
MOUNTAINS that function and create an particular climate conditions :
PIANURA PADANA
Besides ,other fact proved that in this AREA have great level of air pollution as
it were previously mentioned in many scientific publications.
The mortality rate is variable in all italia region but in Lombardia mortality
represented about 17,9% ( in 7 april 2020)
While in general medium data of mortality in Italy reach about 12,5%, but if
we excluded lombardia region this percent will become 9%.
However , this data depends on the real number of infected peoples ( this data
demonstrate of some problems to be correctly detected related to the
laboratory diagnostic )
Figure n. 3 covid -19 distribution Italy February- march 2020
CHAPTER 4) Results

7. As reported in SEBASTIANI work it is interesting to observe that the APPENINI
MOUNTAIN seem to be a Kind of natural limit that acts as restricted barriers for
spread or diffusion of COVID -19 in high rate( until today).
Anyhow ,this not mean that the diffusion will not go to the south of Italy: now
various cases are registered but what Relevant is the velocity in this process.
In various publication relationship related diffusion of some relevant virus and
air pollution are showed
And the same the influence of latitude and humidity rate, as it were
aforementioned by other Italian researchers .
In a recent POSITION PAPER: “Relazione circa l’effetto dell’inquinamento da
particolato atmosferico e la diffusione di virus nella popolazione” univ. BARI,
BOLOGNA e SIMA :
“Si evidenzia come la specificità della velocità di incremento dei casi di
contagio che ha
interessato in particolare alcune zone del Nord Italia potrebbe essere legata
alle condizioni di
inquinamento da particolato atmosferico che ha esercitato un’azione di carrier
di
boost.
Come già riportato in casi precedenti di elevata diffusione di infezione virale in
relazione ad
elevati livelli di contaminazione da particolato atmosferico, si suggerisce di
tenere conto di
questo contributo sollecitando misure restrittive di contenimento
dell’inquinamento.” (3)

8. Figure n. 4 PIANURA PADANA and geographic morphology :ALPI mountain in
north and APPENINI in the south part
Figure n 5 Air pollution north Italy N02

9. Fig. 6 ITALY diffusion covid- 19 April 2020
Fig 7 Lombardia region involvement
(7 march 2020),formhttps://primapavia.it/cronaca/coronavirus-tutta-la-
lombardia-diventa-zona-rossa/
According PROTEZIONE CIVILE ITALY 12 april 2020:

10. “i casi attualmente- positivi sono 31.265 in Lombardia, 13.672 in Emilia-
Romagna, 12.505 in Piemonte, 10.729 in Veneto, 6.162 in Toscana, 3.817 nel
Lazio, 3.333 in Liguria, 3.114 nelle Marche, 3.057 in Campania, 2.452 in Puglia,
2.082 nella Provincia- autonoma di Trento, 2.030 in Sicilia, 1.742 in Abruzzo,
1.326 in Friuli Venezia Giulia, 1.515 nella Provincia autonoma di Bolzano, 903 in
Sardegna, 795 in Calabria, 687 in Umbria, 588 in Valle d’Aosta, 277 in
Basilicata e 202 in Molise.”
Accordin article published in
https://www.lastampa.it/blogs/2017/11/07/news/inquinamento-atmosferico-
perche-l-aria-della-pianura-padana-e-tra-le-peggiori-d-europa-1.37181946
“climate Network Inquinamento- atmosferico: perché l’aria della Pianura
Padana è tra le peggiori d’Europa?
La relazione è semplice: più polveri, più malattie. Ogni anno questa realtà si
rende- evidente, visibile all’occhio e percepibile dai polmoni
Inquinamento atmosferico: perché l’aria della Pianura Padana è tra le peggiori
d’Europa?
Non vogliamo rinunciare all’automobile.
Non riusciamo a- rinunciare al riscaldamento.
Non possiamo rinunciare all’agricoltura.Ma stiamo rinunciando alla nostra-
salute.
La relazione è semplice: più polveri, più malattie. Ogni anno questa realtà si
rende evidente, visibile all’occhio e percepibile dai polmoni. Secondo l’Agenzia
Europea per l’Ambiente -(EEA) oggi l’inquinamento-- atmosferico provoca
461mila decessi -prematuri l’anno solo in Europa, 20 volte di più delle vittime
per incidenti stradali. Per chi abita in Pianura Padana, una delle zone più
inquinate del continente, sembra un destino inevitabile.
Ma l’inquinamento sta aumentando? Quali sono le cause principali? Come
possiamo difenderci? Il Centro Epson Meteo risponde a queste domande,
impegnandosi nel percorso verso un’aria di qualità. I dati sorprendono: le
principali fonti di PM10 sono estremamente -diversificate, dalle pizze cotte a
legna alle cattive pratiche agricole. L’analisi della Presidente di Italian Climate-
Network S. Giacomin.
L’inquinamento sta davvero aumentando sempre di più?

11. Prendiamo la Lombardia, ben rappresentativa delle concentrazioni complessive
del bacino padano e i cui dati d’inquinamento (in particolare delle polveri
sottili, PM10 su cui ci concentreremo) sono ampiamente disponibili sul sito
dell’ARPA della- Regione. Nonostante le oscillazioni nelle concentrazioni di PM
determinate anche dalle condizioni meteorologiche, i dati dimostrano una
tendenza al miglioramento negli ultimi- decenni. L’aria resta troppo inquinata,
ma l’inquinamento è in calo. Le concentrazioni che si misurano oggi sono
anche di ordini di grandezza inferiori a quelle rilevate negli anni ‘70 ,‘80 e ‘90
del secolo scorso. Uno sforzo mirabile per la Pianura Padana, ma comunque
non sufficiente per rientrare nei limiti di legge (d.lgs 155/2010 che ha recepito
la direttiva- Ue sulla qualità dell’aria) abbondantemente- superati tutti gli anni.
Quali sono le condizioni meteo che tappano il ‘catino padano’?
“I fattori orografici e meteorologici contribuiscono in modo significativo alle
elevate concentrazioni di inquinanti atmosferici che fanno della Val Padana una
delle zone più inquinante d’Europa, nonostante le emissioni siano paragonabili
a quelle di altre aree- sviluppate” - conferma il meteorologo del Centro Epson--
Meteo Flavio Galbiati - “questo perché il ‘catino’ padano è circondato dalla
catena montuosa alpina che influenza il regime dei venti, la cui intensità risulta
generalmente molto debole. Un altro importante fattore è l’elevata frequenza
di situazioni meteorologiche caratterizzate da stabilità atmosferica. Queste
condizioni, tipiche del semestre invernale in caso di alta pressione, hanno
origine dal fenomeno meteorologico dell’inversione termica. In pratica in
atmosfera la temperatura non diminuisce salendo di quota, come ci si
aspetterebbe, ma ad un’altezza di 800/1000 metri si riscontra una temperatura
più alta di quella dello strato- inferiore. Si modifica così la circolazione- locale
dell’aria: quella più fredda dei bassi strati, essendo più densa e più pesante,
non può sollevarsi verticalmente oltre la quota dell’inversione. Si viene a creare
quindi un vero e proprio ‘tappo’ che impedisce il ricambio d’aria, intrappolando
gli inquinanti in prossimità del suolo, dove la loro concentrazione, giorno- dopo
giorno, non potrà che aumentare”. (4)
According Marc Lipsitch et al:“Controlled influenza transmission studies
conducted in mice in the 1960s were the first to suggest that transmissibility
varied with temperature, relative humidity, and season . Experimental-
infections in humans further high-lighted seasonal variation in disease severity
and in the rate of immune sero-conversion . Most recently, the concept that
temperature and relative humidity may alter influenza transmission has been
confirmed in a guinea-pig model . These data, together with laboratory
experiments testing virus survival under- controlled environmental conditions ,
are carefully revisited in the new study by Shaman and Kohn .

12. Additional evidence on mechanisms of seasonality comes from- population-
level studies, which typically attempt to correlate fluctuation in meteorological
variables with influenza epidemiological data in a specific locale.
reinterpretation of experimental data on survival of airborne influenza virus
particles demonstrates that virus- survival increases with low levels of vapor
pressure. The authors note that vapor pressure is minimal during winter in
indoor and outdoor settings in temperate regions and conclude that vapor
-pressure is a parsimonious mechanism of influenza seasonality, consistent
with increased disease transmission in winter.”(5)
Jeffrey Shaman et al: “Influenza A incidence peaks during winter in temperate-
regions. The basis for this pronounced seasonality is not understood, nor is it
well documented how influenza A transmission principally occurs. Previous-
studies indicate that relative humidity (RH) affects both influenza virus
transmission (IVT) and influenza virus survival (IVS). we reanalyze these data
to explore the effects of absolute humidity on IVT and IVS. We find that
absolute humidity (AH) constrains both trans-mission efficiency and IVS much
more significantly than RH. In the studies presented, 50% of IVT variability and
90% of IVS variability are explained by AH, whereas, respectively, only 12%
and 36% are explained by RH. In temperate -regions, both outdoor and indoor
AH possess a strong seasonal- cycle that minimizes in winter. This seasonal
cycle is consistent with a wintertime increase in IVS and IVT and may explain
the seasonality of influenza. Thus, differences in AH provide a single, coherent,
more physically sound explanation for the observed variability of IVS, IVT and
influenza seasonality in temperate regions. This hypothesis can be further
tested through future, additional laboratory, epidemiological and modeling
studies.Absolute- humidity is predicted to increase in a warming -world . The
findings presented here indicate that such changes would decrease IVS and IVT
rates. This potential outcome, as well as any effects on the seasonality of
influenza -incidence, needs to be explored carefully through additional
laboratory and modeling experiments”.(6)
According a Preprint SCAFETTA N :“This paper investigates whether the
Severe Acute Respiratory Syndrome CoronaVirus 2 (SARSCoV-2) pandemic –
also known as CoronaVIrus Disease 19 (COVID-19) – could have been favored
by specific weather- conditions. It was found that the 2020 winter weather in
the region of Wuhan (Hubei, Central China) – where the virus first broke out in
December and spread widely from January to February 2020–was strikingly
similar to that of the Northern Italian provinces of Milan, Brescia and Bergamo,
where the pandemic has been very severe from February to March. The
similarity suggests that this pandemic worsens under weather temperatures-
between 4°C and 11°C. Based on this result, specific isotherm world- maps
were generated to locate, month by month, the world regions that share similar
temperature ranges. From January to March, this isotherm zone extended
mostly from Central- China toward Iran, Turkey, West-Mediterranean- Europe

13. (Italy, Spain and France) up to the United State of America, coinciding with the
geographic regions most affected by the pandemic from January to March. It is
predicted that next spring,as the weather gets warm,the pandemic will likely
worsenin northern regions(United Kingdom, Germany, East Europe, Russia and
-North America)while the situation will likely improve in the southern
regions(Italy and Spain). However,in autumn,the pandemic could come back
and affect the same regions again. The Tropical- Zone and the entire Southern
Hemisphere, but in restricted southern- regions, could avoid a strong pandemic
because of the sufficiently warm weather during the entire year. Google-Earth-
Pro interactive-maps are provided as supplements”(7)
Chen P-s et al :“The spread of influenza and highly pathogenic avian- influenza
(H5N1) presents a significant threat to human health. Avian influenza outbreaks
in downwind areas of Asian dust storms (ADS) suggest that viruses might be
transported by dust -storms
We developed a technique to measure ambient- influenza and avian influenza
viruses. We then used this technique to measure concentrations of these
viruses on ADS days and background days, and to assess the relationships
between ambient influenza and avian influenza viruses, and air pollutants.
A high-volume air sampler was used in parallel with a filter cassette to evaluate
spiked- samples and un-spiked samples. Then, air samples were monitored
during ADS seasons using a filter- cassette coupled with a real-time
quantitative polymerase chain reaction (qPCR) assay. Air samples were
monitored during ADS- season (1 January to 31 May 2006).
We successfully quantified ambient influenza virus using the filtration/real-time
qPCR method during ADS days and back-ground days. this is the first report
describing the concentration of influenza virus in ambient air. In both the
spiked and un-spiked samples, the concentration of influenza virus sampled
using the filter cassette was higher than that using the high-volume sampler.
The concentration of ambient influenza- A virus was significantly higher during
the ADS days than during the background days.
Our data imply the possibility of long-range transport of influenza virus.”
Cui et al :“Ecologic analysis conducted among 5 regions with 100 or more
SARS cases showed that case fatality rate increased with the increment of API
(case fatality = - 0.063 + 0.001 * API). Partially ecologic study based on short-
term exposure demonstrated that SARS- patients from regions with moderate
APIs had an 84% increased risk of dying from SARS compared to those from

14. regions with low APIs (RR = 1.84, 95% CI: 1.41–2.40). Similarly, SARS patients
from regions with high APIs were twice as likely to die from SARS compared to
those from regions with low- APIs. (RR = 2.18, 95% CI: 1.31–3.65). Partially
ecologic analysis based on long-term exposure to ambient air pollution showed
the similar- association.
Our studies demonstrated a positive- association between air pollution and
SARS case fatality in Chinese population by utilizing publicly- accessible data
on SARS statistics and air pollution indices. Although ecologic fallacy and
uncontrolled confounding effect might have biased the results, the possibility of
a detrimental effect of air pollution on the prognosis of SARS patients deserves
further investigation” (9)
Q YE et al :“This study investigated whether respiratory syncytial virus (RSV)
infection in children was associated with ambient temperature and air-
pollutants in Hangzhou-China. A distributed lag non-linear model (DLNM) was
used to estimate the effects of daily meteorological data and air
pollutants on the incidence of RSV infection among children. A total of 3650
childhood RSV infection cases were included in the study. The highest air-
pollutant concentrations were in January to May and October to December
during the year. The yearly RSV-positive rate was 10.0 % among children with
an average age of 4.3 months. The highest RSV-positive rate occurred among
patients 0 to 3 months old. Children under 6.5 months old accounted for 80 %
of the total patients infected by RSV. A negative correlation was found between
ambient- temperature and RSV infection, and it was strongest with minimum
-ambient temperature (r = −0.804, P < 0.001). There was a positive correlation
between the infection rate and the particulate matter (PM) 2.5 (r = 0.446, P <
0.001), PM10 (r = 0.397, P < 0.001), SO2 (r = 0.389, P < 0.001), NO2 (r =
0.365, P < 0.001) and CO (r = 0.532, P < 0.001). The current study suggested
that temperature was an important- factor associated with RSV infection
among children in Hangzhou. Air pollutants significantly increased the risk of
RSV infection with dosage, lag and cumulative effects.” (10)
“the unprecedented 2015 outbreaks of highly pathogenic avian influenza (HPAI)
H5N2 in the U.S. devastated its poultry industry and resulted in over $3 billion
economic impacts. Today HPAI continues eroding poultry operations and
disrupting animal protein supply- chains around the world. Anecdotal evidence
in 2015 suggested that in some cases the AI virus was aerially introduced into
poultry houses, as abnormal bird- mortality started near air inlets of the
infected houses. This study modeled air- movement trajectories and virus
concentrations that were used to assess the probability or risk of airborne
transmission for the 77 HPAI cases in Iowa. The results show that majority of
the positive cases in Iowa might have received airborne- virus, carried by fine
particulate matter, from infected farms within the state (i.e., intrastate) and
infected farms from the neighboring states (i.e., interstate). The modeled
airborne- virus concentrations at the Iowa recipient sites never exceeded the
minimal infective doses for poultry; however, the continuous exposure might

15. have increased airborne- infection risks. In the worst-case scenario (i.e.,
maximum virus shedding rate, highest emission- rate, and longest half-life), 33
Iowa cases had > 10% (three cases > 50%) infection probability, indicating a
medium to high risk of airborne- transmission for these cases. Probability of
airborne HPAI infection could be affected by farm type, flock size, and distance
to previously infected farms; and more importantly, it can be markedly reduced
by swift depopulation and inlet air filtration. The research results provide
insights into the risk of airborne- transmission of HPAI virus via fine dust
particles and the importance of preventative and containment strategies such
as air filtration and quick depopulation of infected flocks.”(11)
According a Preprint :“Oliveiros et al. regressed the doubling time of COVID-19
cases by temperature and humidity, and they did not find significant
association for wind speed. In our study, though wind- speed was not an
important factor if modeled singly, it is a necessary factor in the final model
and adding wind speed in the model would significantly improve model
prediction performance”(12)
According L.Settis et al preprint “we present the first results of the analyses
that we have performed on 34 PM10 samples of outdoor/airborne PM10 from
an industrial site of Bergamo Province, collected with two different air
samplers over a continuous 3-weeks period, from February 21 st to March 13
th. Because of the nature of the sample, and considering that the sampling
has not been carried out for clinical- diagnostic purposes but for environmental
-pollution tests (taking also into account that filters were stored for at least
four weeks before undergoing molecular genetic analyses, as consequence of
the Italian shutdown), we can confirm to have reasonably demonstrated the
presence of SARS-CoV-2 viral RNA by detecting highly specific “RtDR gene” on
8 filters.”(13)
According to L.Morawska et al : “Is it likely that the SARS-CoV-2 virus spreads
by air? Its predecessor, SARS-CoV-1, did spread in the air. This was reported in
several studies and retrospectively explained the pathway of transmission in
Hong- Kong’s Prince of Wales Hospital (Li et al., 2005, Xiao et al., 2017;12., Yu
et al., 2005), as well as in health care facilities in Toronto, Canada (Booth et al.
2005), and in aircraft (Olsen et al. 2003). These studies concluded that airborne
transmission was the main transmission route in the indoor cases studied.
Other examples of airborne transmission of viral- infections include the spread
of Norwalk-like virus between school children (Marks et al. 2003), and the
transmission of influenza A/H5N1 virus between ferrets (Herfst et al. 2012). A
World Health Organization (WHO 2009)- review of the evidence stated that viral
infectious diseases can be transmitted across distances relevant to indoor
environments by aerosols (e.g. airborne infections), and can result in large
clusters of infection in a short period. Considering the many similarities

16. between the two SARS viruses and the evidence on virus- transport in general,
it is highly likely that the SARS-CoV-2 virus also spreads by air (Fineberg 2020).
Experts in droplet dynamics and airflow in buildings agree on this (Lewis
2020).”(14)
According Sander Hersft et al :“Highly pathogenic avian influenza A/H5N1 virus
can cause morbidity and mortality in humans but thus far has not acquired the
ability to be transmitted by aerosol or respiratory droplet (“airborne
-transmission”) between humans. To address the concern that the virus could
acquire this ability under natural conditions, we genetically modified A/H5N1
virus by site-directed mutagenesis and subsequent serial passage in ferrets.
The genetically modified A/H5N1 virus acquired mutations during passage in
ferrets, ultimately becoming airborne- transmissible in ferrets. None of the
recipient ferrets died after airborne infection with the mutant A/H5N1 viruses.
Four amino acid substitutions in the host receptor-binding protein
hemagglutinin, and one in the polymerase complex protein basic polymerase 2,
were consistently present in airborne-transmitted viruses. The transmissible-
viruses were sensitive to the antiviral drug oseltamivir and reacted well with
antisera raised against H5 influenza vaccine strains. Thus, avian A/H5N1
influenza viruses can acquire the capacity for airborne transmission between
mammals without recombination in an intermediate host and therefore
constitute a risk for human pandemic influenza.” (16)
According YU IT et al in an article published in new England journal of medicine
2004 was written:
“There is uncertainty about the mode of transmission of the severe acute
respiratory syndrome SARS - virus. We analyzed the temporal and spatial
distributions of cases in a large community outbreak of SARS in Hong Kong and
examined the correlation of these data with the three-dimensional spread of a
virus-laden aerosol plume that was modeled using studies of airflow -dynamics.
We determined the distribution of the initial 187 cases of SARS in the Amoy-
Gardens housing complex in 2003 according to the date of onset and location
of residence. We then studied the association between the location (building,
floor, and direction the apartment unit faced) and the probability of infection
using logistic- regression. The spread of the airborne, virus-laden aerosols
generated by the index patient was modeled with the use of airflow-dynamics
studies, including studies performed with the use of computational fluid-
dynamics and multizone modeling. For building E, apartment units (not
persons) on the middle and upper floors had higher probabilities of infection
than did units on lower floors, with an odds ratio of 5.15 (95 percent
confidence interval,2.6 to 10.3; P<0.001) for the middle floors and 3.1 (95
percent confidence interval, 1.6 to 6.2; P<0.01) for the upper floors. The risk of
infection was highest (odds ratio, 14.5; 95 percent confidence interval, 5.5 to
38.4) for units that faced direction Ab

17. (unit 8 on each floor), and it was also significantly elevated in apartment units
that faced direction
Ad (unit 7) . The units that faced directions Da (unit 6) and Dc (unit 5) appeared
to have a
slightly lower risk of infection than the other- units.
Results of the test for heterogeneity were statistically significant (P<0.001) for
both floor level and direction.
For buildings B, C, and D, the variation among the three categories of floor
level was statistically-
significant (P = 0.01), but the variation among the eight directions was of only
borderline significance (P = 0.06). For middle-level floors and for directions Ad,
Ba, and Da there was a significantly higher risk of infection than on the lower
-floors and in direction Cb, respectively. In the analyses stratified ac- cording to
building, only the model for building C showed significant heterogeneity among
floor levels and directions. The odds ratios for the middle- level floors (16.3)
and for apartment units coded Da (9.9) were statistically significant, whereas
those for the upper-level floors (7.2) and for units coded Ad (6.4) were of
borderline significance. Lo- cation (floor level and direction) was not statistically
significant for buildings B and D., in building B, all apartment units with
windows that faced direction D (either at the front or the side) — that is, the
direction from which the wind blew from building E — had high odds ratios,
between 0 and 5.2;
An investigative team from the World Health Organization found that traps in
the floor
drains in many of the housing units seemed not to have been filled with water
for long periods; the seals in the traps thus dried out, and as a result, a
connection was opened to the vertical soil stack (drainage pipe).
The investigative- team suggested that an exhaust fan that was running
behind a closed
door in the bathroom could have drawn fine drop- lets or aerosols from the soil
stack into the bathroom through the unsealed floor drain and thereby
contaminated the bathroom. The exhaust fan could have transported
contaminated droplets or aerosols from the bathroom into the air shaft. These
contaminated- droplets or aerosols could have been carried
upward by the natural air current and could have entered other apartment
units, even units several floors away from the source of infection, if the virus-
laden aerosols had reached an open window in building D, two directions the
windows faced were of borderline significance — namely, Ab(odds ratio, 6.3)
and Ba (odds ratio, 6.3). We repeated the modeling assuming five or six
residents in each unit and obtained similar results (data not shown).

18. Our epidemiologic- analysis, experimental studies, and airflow simulations
support
the probability of an airborne spread of the SARS virus in the outbreak in Amoy
Gardens. Virus-laden aerosols generated in the vertical soil stack of unit 7 in
building E returned to the bathroom through the dried-up seals of the floor-
drain traps and then entered the air shaft, probably by means of suction
created by an exhaust fan. The aerosols moved up-ward owing to the buoyancy
of the warm, humid air within the air shaft and could enter apartment units
that bordered the air shaft on the upper floors because of the negative
pressure created by the exhaust fans or the action of wind- flows around the
building.
The horizontal spread of infection to other units in building E was by movement
of the air between
apartment units. After the plume reached the top of the air shaft in building E,
the virus was spread to some units at certain heights in buildings B, C, and D
by the action of a predominant northeasterly wind.
Our hypothesis adequately explains the temporal and spatial distribution of
cases of SARS.
This hypothesis remains to be confirmed by further analytic epidemiologic,
environmental, and experimental -studies and should have important public
health implications for the prevention and control of SARS, should the disease
recur.
Airborne spread of the virus appears to explain this large community outbreak
of SARS, and future efforts at prevention and control must take into
consideration the potential for airborne- spread of this virus.”(17)

19. Figure n. 8 Distribution of Cases of SARS Infection in Buildings A to G in the
Amoy Gardens Housing Estate. ( from reference n 17 )
The prevailing wind (red- arrows) during the period of possible exposure was
northeasterly, or roughly perpendicular to the exterior walls of apartment units
Dc and Da in building E. The distance between buildings E and B is 60 m. The
direction from which the wind -blew shifted from nearly north to east and even
southeast. The red dot in building E indicates the unit that the index patient-
visited. The directional indicator for the units at the lower right-hand corner
indicates the direction each unit faced. In the directional code (Ab, Ad, Ba, Bc,
Cb, Cd, Da, Dc) used to designate an apartment unit, uppercase letters denote
front-facing windows and lowercase letters side-facing windows.
Fig. n 9 Model of the Movement of the Virus-Laden Plume. ( from reference n. 17)
According to our computational fluid-dynamics modeling, the buoyant plume (blue)
rose from the air shaft between two- housing units in building E (yellow) and was

20. carried by a northeasterly wind toward the middle-level floors in buildings C and D.
The L-shape structure (Panels A and B) was a nearby construction site that blocked the
wind flowing toward lower-level floors in buildings E, C, and D. The wake flow of the
construction site created a region of negative air- pressure in the space between
buildings E, C, and D (Panel B) that caused the plume to bend downward, toward
buildings C and D
Finally it is interesting to observe that in 8 of march following some news about
a RED ZONE in lombardia by institution produced lots of people in the night to
go in south- region using train.
But it is not possible to verify if in this people there was or not positive one to
covid -19.
This fact can be a factor to be taken in consideration in the diffusion of virus in
south.

21. Fig. 10 Median annual ITALIA temperature
Related climate is possible to verify that , observing fig.8 it seem there are 2
different ZONE
In north vs south.
Fig. 11 world most polluted regions No2

22. Fig.12 coronavirus belt – latitude
screenshot from the University of Maryland study shows coronavirus hotspots
along the same climate band. (Screengrab)
Fig. 13v 11 gennaio 2020 Pressione al suolo e vettori vento Pianura padana

23. And according Prof. Giulio Tarro related covid -19 spread in Italy:
“In Italy the regions more hit are the same ones that have the greatest
productive activity and therefore more millions of tons of special products.”(18)
CHAPTER 5) Discussion and conclusion
The HYPOTESYS of this work It is ranged as opinions of the authors to verify if
the climate condition of PIANURA PADANA and air pollution level may
contribute or not in the speed and severity of global covid -19 great diffusion
in north of Italy as a severe disease.
Factors such kind of geomorphological environment with specific climate
condition and natural separation by mountains presence at north and south
of italia.
In this study the strange velocity in diffusion in north vs south of Italy need new
research: observing lethality rate of Lombardia 17,9 % vs 9 % of the rest of
Italy it seem that could be 2 different AREA in Italy related this virus diffusion.
Latitude, climate , air pollution and what other factor acts ? as well as to known
people direct attachement ( contamination ) and those subclinical infected
persons?
Only The lockdown strategies produced this?
And the role played by high way diffusion ( trucks and other road transport of
goods )in cross APPENINI MOUTNAINS is a fact to be taken in consideration?
The relationship between air pollution and respiratory disease , acute and
chronic are a scientific
Proof of relationship.
In spite of this work have offer some aspect in diffusion of disease but the
authors submit to the researcher the need to verify this HYPOTESYS OF WORK
in diffusion – spread of Covid -19 in Italian regions.

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26. Other web references
https://www.liberoquotidiano.it/news/italia/22183857/coronavirus_franco_prodi_
pietro_senaldi_aria_infezione_libero.html
Clarifications :
Some part of this work are in Italian language in order to follow the original
author meaning
This work is produced without any diagnostic or therapeutic intent , only to
produce
HYPOTESIS of work to be submitted to the researcher.
All the rules . governative and regionals normatives, all the measure taken by
Italian and World health organization related preventing the diffusion of covid
19 must to be followed and this work not is produced to avoid this .
All the figure are presented only for scientific scope and the references of
original article are reported.
Conflict of interests: no