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Italy has confirmed they're only testing people in the at-risk groups. That would explain their high rate of hospitalizations and old people being infected.

Also, it seems the disease can still reemerge in some people being treated with antivirals. This isn't an unusual pattern, where a viral infection can be supressed to the point of being undetectable and untransmissible but then resurfaces after some time. Still that's a positive outcome when someone is infected by high viral loads.