While many countries are struggling to contain the novel coronavirus, Italy seems to have been hit especially hard. Of the 63,927 people confirmed to have COVID-19 in Italy, about 9% of them have died (6,077). This is far higher than China with 81,496 confirmed cases and 3,274 deaths (4%), and Germany with 28,863 cases and 118 deaths (0.4%).
Why is Italy suffering so much more?
“There are three factors involved in Italy: one is that it is a much older population, two the health system was overwhelmed, and three there has been a significant loss of health workers because of a high coronavirus infection rate among them,” said Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, to The Telegraph.
Italy has the second oldest population worldwide, a demographic that is having a devastating effect on the country, said Professor Walter Ricciardi, scientific adviser to Italy’s minister of health. A recent study published in JAMA found that 7% of deaths in Italy and 40% of infections were found in patients over 70 years old.
“The age of our patients in hospitals is substantially older – the median is 67, while in China it was 46,” Ricciardi said to The Telegraph. “So essentially the age distribution of our patients is squeezed to an older age and this is substantial in increasing the lethality.”
In addition, not all countries code fatalities in the same manner, making comparisons between countries problematic.
Ricciardi explained: “The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus.
“On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three,” he said to The Telegraph.
Other factors are not working in Italy’s favor. Italians have a high rate of smoking and the country’s air pollution is quite high. These, coupled with the overwhelming surge on the nation’s health care system, have contributed to Italy’s high fatality rate. Unfortunately, over 2,000 Italian healthcare workers have been infected with COVID-19 and have needed to be quarantined.
“Doctors in Italy haven’t been dealing with one or two patients in care… but up to 1,200,” said Dr. Mike Ryan, health emergencies program executive director at the World Health Organization, to The Telegraph. “The fact they’re saving so many is a small miracle in itself.”