Peer Review History

Original SubmissionApril 10, 2020
Decision Letter - Pasquale Abete, Editor

PONE-D-20-10315

Is social connectedness a risk factor for the spreading of COVID-19 among older adults? The Italian paradox

PLOS ONE

Dear DR. LIOTTA,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Kind regards,

Pasquale Abete

Academic Editor

PLOS ONE

Additional Editor Comments (if provided):

The manuscript is interesting but it merits a minor revision.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The study is a of great interest. The variables included in the model explains more than 70% of the variation of the proportion of infected patients aged >80 years. The idea comes from the evidence of spread of disease in family clusters and thus the extensive intergenerational contact as a possible determinant of the severity of the pandemic among the older Italian adults. Interestingly the study demonstrates the pandemic was more severe in regions with higher family fragmentation and increased availability of residential health facilities. The Nursing Home experience need a more accurate description. I guess that the negative experience of Lombardy, where with a regional law (DELIBERAZIONE N° XI / 2906 Seduta del 08/03/2020) RSA were dedicated to low intensity care for COVID patients, should be cited and discussed as potential cause of COVID spreading.

Reviewer #2: The authors analyzed the percentage of infected patients aged >80 years, available nursing home beds, COVID-19 incidence rate, and the number of days from when the number of positive tests exceeded 50 (epidemic maturity). They included in the analysis mean household size and percentage of households comprising one person, in the region. The authors found that paradoxically, the results are opposite of what was previously reported. They concluded that the pandemic was more severe in regions with higher family fragmentation and increased availability of residential health facilities.

The manuscript is very interesting and topic. I have only a concern. do you have some data about COVID-related letality and/or mortality?

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Reviewer #1: Yes: Francesco CACCIATORE

Reviewer #2: No

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Revision 1
Decision Letter - Pasquale Abete, Editor

Is social connectedness a risk factor for the spreading of COVID-19 among older adults? The Italian paradox

PONE-D-20-10315R1

Dear Dr. LIOTTA,

We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.

Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication.

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If your institution or institutions have a press office, please notify them about your upcoming paper to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, you must inform our press team as soon as possible and no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

With kind regards,

Pasquale Abete

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

No comments.

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: I have no more suggestions to improve your manuscript. The paper is suitable for publication in present form

Reviewer #2: The authors have been addressed all questions arised. The manuscript may be acceptable to be published in PONE.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

Reviewer 1

thank you for your answer. We now mention in the discussion the regional law you indicated with a short comment

Reviewer 2

Thank for your answer. There are data about COVID-19 related mortality and letality, however they are not yet provided as age-specific rate at regional level. This prevented us from any further analyses, since the paper is based on data fully available to the public. However, there are growing evidences of the dramatic impact on nursing home residents survival (see https://www.epicentro.iss.it/coronavirus/pdf/sars-cov-2-survey-rsa-rapporto-2.pdf also cited in the paper).

Attachments
Attachment
Submitted filename: rebuttal letter to the reviewers.docx
Formally Accepted
Acceptance Letter - Pasquale Abete, Editor

PONE-D-20-10315R1

Is social connectedness a risk factor for the spreading of COVID-19 among older adults? The Italian paradox

Dear Dr. liotta:

I am pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

If your institution or institutions have a press office, please notify them about your upcoming paper at this point, to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org.

For any other questions or concerns, please email plosone@plos.org.

Thank you for submitting your work to PLOS ONE.

With kind regards,

PLOS ONE Editorial Office Staff

on behalf of

Prof. Pasquale Abete

Academic Editor

PLOS ONE

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