ANALYSIS: Why have there been so many coronavirus deaths in Italy?

The Italian death toll reached 463 on Monday, with Italy now recording more than half of all the deaths reported outside China since the coronavirus outbreak began. But why do there seem to be so many deaths related to the virus in Italy?

ANALYSIS: Why have there been so many coronavirus deaths in Italy?
A woman in Milan. Italy's coronavirus victims had an average age of 81. Photo: Miguel Medina/AFP

Health officials now say the total number of confirmed cases in Italy has passed 9,000.

This is the total number of people in Italy confirmed to have contracted the virus since the beginning of the outbreak, a figure which includes the deceased and 724 recovered patients.

(These numbers are changing daily: view the latest figures here.)

Italy has the highest number of fatalities related to the virus outside China.
What do we know about those who have died?

Fatalities have now been reported in the Italian regions of Lombardy, Emilia-Romagna, Veneto, Marche, Liguria, Piedmont, Lazio, Puglia and Friuli Venezia-Giulia.

The vast majority of cases (over 5,000) as well as deaths (333) have been in Lombardy. The large majority of the deceased were male, and all were Italian citizens, government data shows.

Many were in their 80s or 90s, and were already suffering from serious health problems, including cancer, when the coronavirus infection was detected.

READ ALSO: The everyday precautions to take against coronavirus if you're in Italy

But while Italian health officials have been quick to point out that the people who've died so far have had an average age of 81, many of them with pre-existing health conditions, that fact does very little to reassure people – particularly in a country with a population as elderly as Italy's.

EU statistics show Italy has the oldest population in Europe by almost any count.

It has the lowest percentage of young people, and a higher percentage of those aged over 65 (22.6 percent as of 2018) than any of the other member EU states.

Its median age is now 45.9 years compared to the EU's median of 42.8, higher than any other European country except Germany.

The country's particularly elderly population was cited as a factor in the government's decision to close down all schools in the country until at least March 15th.

Photo: AFP

While the infection rate among young people appears to be low, there are concerns that schoolchildren may more easily pass on infections to their older family members, particularly in a country with such close-knit family ties.

“The measures introduced in these days aim to avoid a large epidemic wave,” Italy’s National Health Institute said in an emailed statement on Thursday.

“In the case of the coronavirus we must consider the fact that Italy has an elderly population, actually much older than the Chinese one, which needs to be protected from the contagion.”

Italian health authorities also advised people over 75 years of age to stay indoors and limit social contact for the next month. The same advice was given to over-65s with health conditions, and to anyone with a respiratory illness.

Is Italy's fatality rate really higher than the global average?

A look at global statistics gives the impression that Italy has a particularly high death toll. But how true is that?

While the global case-fatality ratio for the coronavirus is still being assessed, it is currently estimated at 3.4 percent by the World Health Organization – up from their previous provisional figure of two percent.

This figure is based on WHO studies on Chinese patients. Experts say this figure is likely to change again and add that many cases are probably not being detected.

Infections have probably been underreported given that many are asymptomatic or very mild, the WHO said.

According to Italian government data, 4.25 percent of people confirmed to have the coronavirus in Italy have died, one of the highest rates in the world.

However, again, it is difficult to obtain an accurate figure because of the high probability that many cases both in Italy and globally are going undetected.

Many also believe the fact Italy has carried out tens of thousands of tests on people in the country is one reason why the number of detected cases appears so high. As we wrote last week, Italy was left with little other choice but to conduct blanket testing.

More than 80 percent of patients infected with the virus have mild disease and recover, while 14 percent have severe diseases such as pneumonia, the WHO stated.

Find all The Local's coverage of the coronavirus outbreak in Italy here

Member comments

  1. I’m not the only one to say this – though it does sound callous – that elderly people in their 80s and 90s will die of something and pneumonia has in the past been called “the old man’s friend”. Clearly the authorities will do all they can to stem deaths, but this is what life is about. It would be considerably more concerning if the illness affected young people disproportionately.

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Covid-19: Are Italian live events at risk of being postponed?

As the infection rate rises sharply across the country, Italian virologists are calling for concerts and festivals to be rescheduled.

Covid-19: Are Italian live events at risk of being postponed?

Italy has seen a large increase in the number of Covid-19 cases in recent days, so much so that a number of virologists across the country are now urging the government to postpone major live events in a bid to curb infections. 

According to a new report by Italy’s independent health watchdog, the Gimbe Foundation, 595,349 new cases were recorded in the week from June 29th to July 5th; a worrying 55 percent increase on the previous week. 

In the same time span, the country also registered a 32.8 percent rise in the number of hospitalised patients, which went from 6,035 to 8,003.  

The latest Covid wave, which is being driven by the highly contagious Omicron 5 variant, is a “real cause for concern”, especially in terms of a “potential patient overload”, said Nino Cartabellotta, president of the Gimbe Foundation. 

As Italian cities prepare to host a packed calendar of concerts and festivals this summer, health experts are questioning whether such events should actually take place given the high risk of transmission associated with mass gatherings.

READ ALSO: What tourists in Italy need to know if they get Covid-19

“Rescheduling these types of events would be the best thing to do right now,” said Massimo Ciccozzi, Director of Epidemiology at Campus Bio-Medico University of Rome. 

The summer wave is expected to peak in mid-July but, Ciccozzi warns, the upcoming live events might “delay [the peak] until the end of July or even beyond” and extend the infection curve.

Antonello Maruotti, Professor of Statistics at LUMSA University of Rome, recently shared Ciccozzi’s concerns, saying that live events as big as Maneskin’s scheduled Rome concert are “definitely not a good idea”. 

The Italian rock band are slated to perform at the Circus Maximus on Saturday, July 9th but the expected turnout – over 70,000 fans are set to attend the event – has raised objections from an array of Italian doctors, with some warning that the concert might cause as many as 20,000 new cases.

If it were to materialise, the prospected scenario would significantly aggravate Lazio’s present medical predicament as there are currently over 186,000 Covid cases in the region (nearly 800 patients are receiving treatment in local hospitals). 

Italian rock band Maneskin performing in Turin

Italian rock band Maneskin are expected to perform at the Circus Maximus in Rome on Saturday, July 9th. Photo by Marco BERTORELLO / AFP

But, despite pleas to postpone the event, it is likely that Maneskin’s concert will take place as scheduled.

Alessandro Onorato, Rome’s Tourism Councillor, said that rescheduling is “out of question” and that “all recommendations from the local medical authorities will be adopted” with the help of the event’s organisers and staff on the ground.

At the time of writing, there is also no indication that the Italian government will consider postponing other major live events scheduled to take place in the coming weeks, though the situation is evolving rapidly and a U-turn on previous dispositions can’t be ruled out.

READ ALSO: At a glance: What are the Covid-19 rules in Italy now?

On this note, it is worth mentioning that Italy has now scrapped all of its former Covid measures except the requirement to wear FFP2 face masks on public transport (though not on planes) and in healthcare settings.

The use of face coverings is, however, still recommended in all crowded areas, including outdoors – exactly the point that leading Italian doctors are stressing in the hope that live events will not lead to large-scale infection.

Antonio Magi, President of Rome’s OMCEO (College of Doctors, Surgeons and Dentists), said: “Our advice is to wear FFP2 masks […] in high-risk situations.”

“I hope that young people will heed our recommendations and think about the health risks that their parents or grandparents might be exposed to after the event [they attend].”