In article: 09 April 2020 “If the world fails to protect the economy, COVID-19 will damage health not just now but also in the future” by Martin McKee & David Stuckler. “The COVID-19 pandemic is, first and foremost, a health crisis. However, it is rapidly becoming an economic one too. This is not, of course, the first global economic crisis. However, this time it is different.” And according OXFORD ECONOMICS website “We now expect global industrial production to fall sharply in H₁ 2020 and to contract by 2% for the year” April 2020 During the last period (in covid -19 Pandemic) many research and article was published related the various aspect of this severe infectious disease. The public institution of the various countries in the world adopted different strategies: Form social distancing to lockdown, quarantine, isolation, to Heard immunity, diagnostics like nasopharyngeal swab, body temperature, serology DPI like musk and gloves, disinfectants use, sanification procedure, and many other Epidemiological data helped l in this approach but whit is interesting is the various mortality rate Showed by different world region: from about 18% to 8% and also less related the diffusion of the viruses. Many factors seem to be implied but not clearly identified until today. In example it is interesting to verify TAIWAN situation: whit 6 death (at this date) vs. the total HIGH mortality seen in china or in other world region: in TAIWAN government provided musk to population since first time and this seem to contribute in this result. (See interview of Prof. M. Brunori 17 April 2020) Relevant in this the diagnostic availability, ICU beds, right number of pulmonary ventilator, availability of DRUGS ( also experimental trial ) and DPI, disinfectants, oxygen and other. The way of transmission of the virus make possible to verify and control the diffusion person to person but other fact must be taken in consideration: air pollution. Some literature show that the region with high mortality rate seem related to the high air pollution in and indirect way. Many respiratory disease are worsened by exposition (year) in real polluted air. (1) (5) other theory seem to show that the virus diffusion follow the great high way of track transport: North Italy, very industrialize, Belgium and other. According https://www.scienzainrete.it/articolo/coronavirus-ha-viaggiato-autostrada/giovanni-sebastiani/2020-04-09

A hypothesis of work is related some characteristic of Italian relevant way of travel communication. “La diffusione è maggiore vicino ai grandi nodi autostradali The same wu- han is a real industrialized area with high air pollution. According other scientist (Isaac ben Israel) lockdown is not so useful because the time of duration of this pandemic was the same in the various countries about 70 days and then reduce itself. (Recent article).

Whit and observations method some relevant literature is analyzed to produce a global conclusion related to the topics of this work. All literature, and reference presented gives a global image of the hypothesis of work [1-2].

From literature: only few example: According Peterson K Ozili, Thankom Arun Spillover of COVID-19: Impact on the Global Economy 2020 how did a health crisis translate to an economic crisis? Why did the spread of the coronavirus bring the global economy to its knees? The answer lies in two methods by which coronavirus stifled economic activities. First, the spread of the virus encouraged social distancing which led to the shutdown of financial markets, corporate offices, businesses and events. Second, the exponential rate at which the virus was spreading, and the heightened uncertainty about how bad the situation could get, led to flight to safety in consumption and investment among consumers, investors and international trade partners [3]. And by Jaime S. King: the Covid-19 pandemic has brought into sharp focus the need for health care reforms that promote universal access to affordable care [4].

Starting from the observation that the mortality rate and the number of patient whit disease active vary a lot form a region of the world to other ( In similar condition of latitude ) it mean that the various strategy adopted make possible to get the best or the worst strategy. Translate in business- economic field this imply to exit first or not from this global crisis and so this are a really useful instrument: a MANAGEMENT INSTRUMENT. Applied in this crisis in various world nation was created specific TASK FORCES, was applied TIME MANAGEMENT , and RISK ANALISYS methods added to the concept of epidemiology, statistics, and Infectious disease, environmental toxicologist and other scientific discipline. Politics ask to scientist and other expert to help in choosing the really efficacy strategy. Many management tool help in this situation: from scenario analysis to what if analysis to Risk management, strategic plan, strategic management , problem solving, DATA analysis, Time management, to MBO, to HR management, ICT management but, logistic management, supply chain and many other. In this situation rapid availability of data, decision making system, ICT make the differences [5-8].

Related the various MORTALITY RATE and diffusion velocity of the covid -19 disease is possible to conclude that not all the strategy adopted by different countries present the same results. So it is needed by the international and national institution to observe the really best practice. This pandemic is a health and social crisis but with high involvement in business and economic field. Recession and economic crisis is a real scenario if public administrator not choose the really best solution to the pandemic situation. And a more rapid control make possible to come back to business – economic cycle pre virus diffusion. Some measure like lockdown that help in the acute phases of diffusion of the virus can cause stop in many economic field whit great social implication. So the right choose by politics and public institution in re- start after lockdown is real crucial and science Help. (Research work, article, publication, theory et other) A real balances between health and economy must be followed but according science principle and not under fear emotion. Organization, scientific evidence, best practice and the management science surely help in this process. A clear evidence of the pathogenetic process that can explain the various phases of the disease since from first phases to pulmonary phases to cytokine explosion and related phenomena can help in choosing the really best therapy in the right time as well as using the best imaging strategies to stratify the patient risk in objective way. (6) The right therapy in the right phases of the disease (first phases) seem by literature to avoid the most severe consequences. “Huang et al. reported the clinical features and cytokine profile of critically ill patients with COVID-19 in Wuhan, China, and suggested that a cytokine storm (i.e. higher concentrations of granulocyte-colony stimulating factor, interferon gamma-induced protein 10, monocyte chemoattractant protein 1, macrophage inflammatory protein 1α and tumor necrosis factor α) could be associated with the severity of disease “(7). Also the strategy followed by an Italian famous oncologist Prof. CAVANNA in this epidemic situation is a real innovation with result: the physician and his equips goes directly at home of the most fragile patient to verify clinical condition before recovery in ICU of hospital: this produce 2 results: patient health monitoring in early stage, avoiding ICU bed use, reduce in diffusion of virus in hospital settings. (Inversion of paradigm). As reported in articled “The Italian Doctor Flattening the Curve by Treating COVID-19 Patients in Their Homes” TIME 9 April 2020 All this under an prospected approach and not only related historic analysis (2) and under a great global rethinking of actual health care system as well as a global reorganization of social life from work to school University, industry and other to reduce possibility of contacts. Health organization, preventive measure, diagnostics, clinical diagnosis, lockdown, quarantine , isolations of patients, therapy, vaccines , ICT technologies to trace positive patient, right institutional information , smart working and other will be the instrument but correctly managed by public and international institution. In this kind of new catastrophic event, with rapid evolution also PRELIMINARY research can be useful Instrument to give some direction to the physician: see the Tocilizumab, Remdesivir, heparin and other procedure under clinical trial by health authority in some countries. (And reference 8) All this must be verified in large studies but in absence of data it can be a light in obscurity.

1. Luisetto M, Rafa YA, Edbey K, Mashori RG, Ahmad F, Oleg Latyshev YO. Epidemiology and diffusion of some relevant virus: latitude, air pollutants and humidity role. Hypothesis of work: covid 19 effect on the air pollution in some world region: what implications. J Toxicology and Risk Assessment. 2020; 6: 1-13.
2. Luisetto M. Risk analysis vision zero approach, safety accident report what if analysis as new instrument in emergency medicine and pharmacy. 2020.
3. Ozili KP, Thankom A. Spillover of COVID-19: Impact on the Global Economy. 2020; 27.
4. King SJ. Perspective Covid-19 and the Need for Health Care Reform. New England. 2020.
5. Assessing nitrogen dioxide (NO2) levels as a contributing factor to coronavirus (COVID-19) fatality. Science of Total Environment. 2020; 726.
6. Olombi D, Petrini MB, Maffi G, Morelli N, Milanese G, Silva M, et al. Well aerated lung on admitting chest CT to predict adverse outcome in covid -19 pneumonia. Radiology. 2020; 238: 321-329.
7. Zhaoa M. Cytokine storm and immunomodulatory therapy in COVID-19: Role of chloroquine and anti-IL-6 monoclonal antibodies. Int J Antimicrob Agents. 2020.
8. Gautret P, Lagier CJ, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrobial Agent. 2020.