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.

Log in here to leave a comment.
Become a Member to leave a comment.


Is Italy’s government planning to scrap all Covid measures?

The new Italian government has announced the end of some remaining Covid health measures. Here's a look at what will - and won't - change.

Is Italy’s government planning to scrap all Covid measures?

Few Covid-related restrictions remain in Italy today, six months after the nationwide ‘state of emergency’ ended.

The previous government had kept only a handful of precautionary measures in place – which the new government, led by Giorgia Meloni, must now decide whether or not to keep.

The cabinet is holding a meeting on Monday and will issue a decree this week detailing any changes to the health measures.

Many expect the government to scrap all measures entirely by the end of the year, after Meloni and her party criticised the way Mario Draghi’s administration handled the pandemic throughout its tenure. 

Meloni clearly stated in her first address to parliament last Tuesday that “we will not replicate the model of the previous government” when it comes to managing Covid.

READ ALSO: Five key points from Meloni’s first speech as new Italian PM

While she acknowledged that Italy could be hit by another Covid wave, or another pandemic, she did not say how her government would deal with it.

Meanwhile, new health minister Orazio Schillaci issued a statement on Friday confirming the end of several existing measures, saying he “considers it appropriate to initiate a progressive return to normality in activities and behaviour”.

Workplace ban for unvaccinated medical staff

Schillaci confirmed that the ministry will allow doctors, nurses and other healthcare professionals to return to work after being suspended because they refuse to get vaccinated against Covid-19.

Those who refuse vaccination will be “reintegrated” into the workforce before the rule expires at the end of this year, as part of what the minister called a “gradual return to normality”.

They will be allowed to return “in light of the worrying shortage of medical and health personnel” and “considering the trend of Covid infections”, the statement said.

Fines issued to healthcare staff aged over 50 who refused vaccination would also be cancelled, it added.

There were some 1,579 doctors and dentists refusing vaccination at the end of October, representing 0.3 percent of all those registered with Italy’s National Federation of the Orders of Physicians, Surgeons and Dentists (Fnomceo) 

Daily Covid data reports

Schillaci also confirmed in the statement that the health ministry will no longer release daily updates on Covid-19 contagion rates, hospital cases and deaths, saying this would be replaced by a weekly update.

It said it would however make the data available at any time to relevant authorities.

Mask requirement in hospitals to stay?

The requirement to wear face masks in hospitals, care homes and other healthcare facilities expires on Monday, October 31st.

At a meeting on the same day the government is expected to decide whether to extend the measure.

READ ALSO: What can we expect from Italy’s new government?

While the government had looked at scrapping the requirement, it reportedly changed stance at the last minute on Monday after facing heavy criticism from health experts.

Media reports published while the meeting was in progress on Monday said government sources had indicated the measure would in fact be extended.

Confirmation is expected to come later on Monday.

Italy’s face mask rules in care homes and healthcare facilities are up for renewal. Photo by Thierry ZOCCOLAN / AFP

‘Green pass’ health certificate

There is no indication that the new government plans to bring back any requirements to show a ‘green pass’: the digital certificate proving vaccination against or recent recovery from Covid, or a negative test result.

The pass is currently only required for entry to healthcare facilities and care homes, and this is expected to remain the case.

‘Dismantling the measures’

Some of the confirmed changes were strongly criticised by Italy’s most prominent healthcare experts.

Head of the Gimbe association for evidence-based medicine, Nino Cartabellotta, said the focus on cancelling fines for unvaccinated healthcare workers was “irrelevant from a health point of view .. but unscientific and highly diseducative”.

He told news agency Ansa it was “absolutely legitimate” for a new government to discontinue the previous administration’s measures, but that this “must also be used to improve everything that the previous government was unable to do”.

The government should prioritise “more analytical collection of data on hospitalised patients, investments in ventilation systems for enclosed rooms … accelerating coverage with vaccine boosters,” he said.

However, the plan at the moment appeared to be “a mere dismantling of the measures in place,” he said, “in the illusory attempt to consign the pandemic to oblivion, ignoring the recommendations of the international public health authorities”.