COVID-19 Why are so many people dying in Italy?

epa08326600 Italian army soldiers wearing protective suits transport coffins onto military trucks from the Bergamo area to the cemetery of Cinisello Balsamo, near Milan, Cinisello Balsamo, 27 March 2020. Italy now has 80,589 covid-19 cases, 8,215 deaths and 10,361 recovered. EPA-EFE/Andrea Fasani

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Most of us following closely the constant edging up of numbers around the world have posed a question more often than others. Why are so many more people dying in Italy, compared to, say Germany?  As of yesterday’s update by the Italian authorities, out of in excess of 13,000 people lost their lives around the bel paese. That’s significantly more than 10%, far outsripping China’s death rate of 3,274 fatalities from 81,496 cases. Closer to home, Germany has a very low fatality rate of 0.4%, with less than a thousand persons so far succumbing to the novel virus.

Where does this significant discrepancy come from?

The Telegraph quotes Professor Walter Riccardi, a scientific adviser to the Italian Ministry of Health, suggesting two significant reasons: the fact that the country has the second oldest population around the globe as well as the methodology used by hospitals to register these deaths.

Prof Ricciardi explained that the average age currently hospitalised with coronavirus infection is 67 in Italy, while in China it stood at 46 in the peak time of the crisis. 87% of deaths in Italy have concerned patients over the age of 70, an age bracket which according to the World Health Organisation is most at risk.

However, there is also another important anecdote noted by the health expert. He points out that a staggering 9/10ths of deaths relate to patients who had at least one other major underlying condition, sometimes two or three. Yet, after being infected with the virus, hospitals tend to register the passing away as ‘coronavirus-related’, despite the other conditions which could have been critical in their own way. The significant rate of pollution and high smoking rate in Lombardy certainly did not help.

Martin McKee, who lectures about European public health in London, speculates that another reason is likely to be contributing to this apparent anomaly: countries who are suffering the biggest blunt of the crisis are focusing their swabbing on persons showing the most significant symptoms. This could mean that the actual rate of infections in Italy is signicantly higher had people with limited or no symptoms been tested and added to the count. This fact has therefore skewed the proportionality, appearing to show a higher rate of death to a smaller number of cases.

Finally, Dr Mike Ryan, from the WHO, highlights the plight of frontline health care workers, noting that doctors in Italy are dealing with up to 1,200 patients in their care. Unfortunately, this also meant that so far more than 2,000 of them have contracted the virus, some of them even losing their lives, putting additional pressure on an already-strained system.

 

 

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