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HEALTH

What’s the problem with Italy’s official coronavirus numbers?

There is growing evidence that the death toll and infection rate figures being reported daily by Italian officials may be much lower than the reality.

What's the problem with Italy's official coronavirus numbers?
More testing is needed in Italy for accurate figures, Italian experts have said. Photo: Tiziana Fabi/AFP

Since the coronavirus outbreak began in Italy in late February, the public has been relying on official government data for a picture of how many deaths, cases, and recoveries there have been in each part of the country, and how things are changing.

READ ALSO: How Italy has changed the way it reports the daily coronavirus figures

Italy's Department for Civil Protection releases these statistics daily at around 6pm. The data is then pored over by experts worldwide, looking for evidence that Italy's quarantine measures are containing the spread as hoped – and that other countries can confidently follow its example.

But a growing number of Italian experts have now said these numbers may not be completely reliable.

“For sure, the figures are wrong,” said Matteo Villa, a researcher at the Italian Institute for Political Studies and author of a new study (in Italian) titled ”Coronavirus: Lethality in Italy, between appearance and reality”

He that the death toll may have been underestimated by up to 6,000, or a third of the official total.

In total, Italian authorities have recorded 115,242 cases and 13,915 deaths as of Thursday, April 2nd.

Authorities acknowledge that the data are incomplete, as the death toll doesn't include people who died at home, or in nursing homes, or those who were infected by the virus but not tested.

 

“It is plausible that deaths are underestimated,” Higher Health Institute president Silvio Brusaferro stated. “We report deaths that are signalled with a positive swab. Many other deaths are not tested with a swab.”

The possible scale of the disparity showed up this week when death records for the month of March from different years were compared.

The data showed a very large difference between the number of Covid-19 deaths reported by authorites, and the total death toll in different Italian regions.

Experts have said the only explanation is that coronavirus deaths have been under-reported.

The deaths were “mostly attributable to the virus”, said Villa.

“Some of the increase will be people who die of other illnesses, because they cannot find a hospital bed due to the crisis,” Villa explained, “but that will be partly offset by the decline in road fatalities due to Italy’s lockdown.”

“For every two sufferers in Italy there is another one you can’t see,” he added.

Even higher numbers in Bergamo

Records released by town halls in Bergamo, at the heart of the outbreak in the worst-affected Lombardy region, show a number of uncounted virus deaths which may be even higher than Villa’s estimate.

Bergamo Mayor Giorgio Gori said on Wednesday he does not trust the official figures and thinks the real toll may be twice as high.

The mayor tweeted a newspaper analysis suggesting that the COVID-19 toll in the Bergamo province was “between 4,500 and 5,000, and not the 2,060” officially reported.

The explanation may be that Italy’s count of 115,242 cases is also incomplete, with estimates of the real number ranging from 400,000 to six million.

The mayor also cited analysis showing that 26 percent of Bergamo province's population may have contracted the virus.

Why is Italy's fatality rate so high?

From the offical figures, it appears that the fatalty rate in Italy is around 12 percent.

“That's a nearly impossible number;” Villa told Al Jazeera in a television interview on Thursday.

“We know from other research that the number of people who die are about one percent of those infected,” he said. “So there's something strange going on. Everyone's asking if Italy is special in any way, in terms of why people are dying so much.”

“The simple answer is, clearly not,” he said. “We are not testing enough people.”

These figures have been overestimated throughout the crisis, according to Nino Cartabellotta, a leading Italian public health expert, professor, and president of the Gruppo Italiano per la Medicina Basata sulle Evidenze (GIMBE), Italy's Group for Evidence-based Medicine.

Analysis by GIMBE of the official data appears to show that the mortality rate in Italy has long been well above average. 

Cartabellotta told The Local this rough figure is “undoubtedly overestimated” as “we're only seeing the tip of the iceberg”.

He calculates that, with further testing, the figure would eventually be found to be closer to 2.2 percent, in line with the rate in China.

The head of Italy's Civil Protection Department, Angelo Borrelli, has meanwhile said it's “credible” to believe there up to ten times more cases in reality than officially recorded.

Villa tweeted on Friday that “the difference between the official and plausible total cases is getting deeper.”

The data on official cases is getting “less and less reliable”, he wrote.

Member comments

  1. It is important that the way the figures are collected is not changed, what we need to know is the trend, although the figures are important, at this time we need to be able to see if the measures being taken are working or not. If suddenly the way the reporting is done we will have no idea what is happening.

  2. If this were handled like a real public health issue, we might have more confidence in the numbers being reported. However, every single country has politicized the pandemic because every single government failed to act on years of warnings to prepare for a pandemic and no government wants to admit how badly it has failed. It will be at least a decade before the dust settles and governments are willing/able to allow people to know the extent of the devastation of this pandemic.

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HEALTH

Italy’s schools warned to ‘avoid gatherings’ as Covid cases rise

As Italy’s new school year began, masks and hand sanitiser were distributed in schools and staff were asked to prevent gatherings to help stem an increase in Covid infections.

Italy’s schools warned to ‘avoid gatherings’ as Covid cases rise

Pupils returned to school in many parts of Italy on Monday and authorities said they were distributing masks and hand sanitiser amid a post-summer increase in the number of recorded cases of Covid–19.

“The advice coming from principals, teachers and janitors is to avoid gatherings of students, especially in these first days of school,” Mario Rusconi, head of Italy’s Principals’ Association, told Rai news on Monday.

He added that local authorities in many areas were distributing masks and hand sanitizer to schools who had requested them.

“The use of personal protective equipment is recommended for teachers and students who are vulnerable,” he said, confirming that “use is not mandatory.”

A previous requirement for students to wear masks in the classroom was scrapped at the beginning of the last academic year.

Walter Ricciardi, former president of the Higher Health Institute (ISS), told Italy’s La Stampa newspaper on Monday that the return to school brings the risk of increased Covid infections.

Ricciardi described the health ministry’s current guidelines for schools as “insufficient” and said they were “based on politics rather than scientific criteria.”

READ ALSO:

Recorded cases of Covid have increased in most Italian regions over the past three weeks, along with rates of hospitalisation and admittance to intensive care, as much of the country returns to school and work following the summer holidays.

Altogether, Italy recorded 21,309 new cases in the last week, an increase of 44 percent compared to the 14,863 seen the week before.

While the World Health Organisation said in May that Covid was no longer a “global health emergency,” and doctors say currently circulating strains of the virus in Italy are not a cause for alarm, there are concerns about the impact on elderly and clinically vulnerable people with Italy’s autumn Covid booster campaign yet to begin.

“We have new variants that we are monitoring but none seem more worrying than usual,” stated Fabrizio Maggi, director of the Virology and Biosafety Laboratories Unit of the Lazzaro Spallanzani Institute for Infectious Diseases in Rome

He said “vaccination coverage and hybrid immunity can only translate into a milder disease in young and healthy people,” but added that “vaccinating the elderly and vulnerable continues to be important.”

Updated vaccines protecting against both flu and Covid are expected to arrive in Italy at the beginning of October, and the vaccination campaign will begin at the end of October, Rai reported.

Amid the increase in new cases, Italy’s health ministry last week issued a circular mandating Covid testing on arrival at hospital for patients with symptoms.

Find more information about Italy’s current Covid-19 situation and vaccination campaign on the Italian health ministry’s website (available in English).

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