Italy’s mortality rate in 2020 ‘highest recorded since World War II’

Italy in the past year recorded the highest mortality rate seen in the post-war period, according to new figures released on Thursday.

Italy's mortality rate in 2020 'highest recorded since World War II'
An inscription reading "Forever in my heart" with flowers on a grave in Bergamo, in a section where people who died from Covid-19 have been buried. (Photo by MIGUEL MEDINA / AFP)

“In 2020, total deaths from all causes were the highest ever recorded in our country since the Second World War,” national statistics agency Istat stated in a new report.

In the sixth report on the impact of Covid-19, produced jointly by Istat and the Higher Institute of Health (ISS), Italy’s resident population recorded 746,146 deaths in 2020 and from January-April 2021 – making the figure 100,526 higher than the previous five-year average.

CHARTS: How many people has Italy vaccinated so far?

“Considering the changes in standardised mortality rates obtained by relating deaths to the population with the same age structure, mortality in 2020 showed an increase of 9 percent nationally compared to the average from the five-year period 2015-2019,” stated the report.

As well as the mortality rate, the report summarised the main characteristics of the spread of Covid-19 and analysed the latest epidemic phase of the first four months of 2021, including the effects of the vaccination rollout.

Central and southern Italy ‘do not show significant changes’

According to the report’s health data, the picture differs by region.

The areas showing significantly higher increases compared to the national average are Piedmont, Valle D’Aosta, Lombardy and the autonomous province of Trento.

In broad terms, there’s a north-south divide as the regions of central and southern Italy “do not show significant changes”, stated the report.

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Analysing the spread of the virus in the first few months of 2021, the provinces with the highest incidence rates were those in the north-east.

The provinces of Bologna, Gorizia, Forlì-Cesena, Udine, Rimini and Bolzano recorded the highest figures.

At the other end of the scale, some of the lowest incidence rates appear in some provinces of Sardinia – South Sardinia, Oristano and Sassari, in Calabria – Catanzaro, Cosenza and Crotone, and Sicily – Ragusa, Enna and Agrigento.

‘One in five’ deaths from Covid-19

The age group that has been the most affected by the virus are those between 65-79, with the highest percentage of deaths caused by Covid-19.

One in five deaths in this age group is attributable to Covid-19, revealed the report.

The below figure shows the daily trend in fatalities between February 2020 and April 2021.

The highest number of daily deaths in Italy due to the coronavirus was recorded on March 28th, 2020 with a total of 928, while in the second wave the peak was on November 19th with 805 deaths, the study showed.

For the first four months of 2021, the study revealed that the average age of confirmed Covid-19 cases is going down.

12 percent of cases were under 14 years old, 17 percent were between 15 and 29 years old, 52 percent between 30 and 64 years old, and 20 percent were over 65 years old.

READ ALSO: Italy’s economic prospects improve as virus numbers fall further

The 0-49 age group now accounts for 58 percent of reported cases compared with 52 percent for the whole of 2020.

The median age group of confirmed Covid-19 cases in the first 4 months of 2021 decreased to 40-44 years, while for those reported by December 31st 2020 it was 45-49 years.

The statistics are improving for the older population.

Also in the analysis of the first four months of 2021, compared to 2020, a further decrease in percentages of infections was recorded in the very elderly population – 80 years and older – and a lowering of the age of reported cases overall.

The drop in deaths in the over 80s compared with March 2021 “explains 70 percent of the drop in total deaths observed between March 2021 and March 2020”, the report showed.

The study also revealed a gender imbalance.

Men have been affected the most, as “the estimated contribution of Covid-19 deaths to overall mortality confirms that the impact is more pronounced in the male gender,” added the report.

Impacts of the vaccination rollout

These decreases are “a sign of how the vaccination campaign, recommendations and prevention measures implemented have been successful in reducing disease transmission in the elderly population,” stated the report.

The analysis also put this change down to “increased diagnostic capacity and contact tracing activities that have facilitated the identification of cases among the younger population”, as the study notes that this category is more usually asymptomatic.

Such tracing activities include identifying if you have come into contact with a person testing positive for Covid through apps such as ‘Immuni‘.

READ ALSO: Covid-19: Italy aims to vaccinate 80% of the population by end of September

The below chart from Our World in Data shows Italy’s accelerating vaccination campaign, now ahead of the EU average for the share of people who have received one shot.

Some 40.5 million vaccinations have been administered in Italy with a total of 13,654,623 people fully vaccinated, making up just over a quarter of the population over 12 years old, the latest government figures show.

“The second ISS report on the impact of Covid-19 vaccination in the Italian population showed a progressive reduction in the risk of SARS-CoV-2 infection, hospitalisation and death,” noted the study.

It added that vaccinations have considerably lowered risk, with a 95 percent reduction starting from the seventh week after the first vaccine shot is administered.

“Since March 2021, the positive effects of the vaccination campaign, which has prioritised protecting the most fragile population, are beginning to be observed,” stated the report.

The graph shows the trend in the number of Covid-19 cases reported in Italy by date of collection/diagnosis. The epidemic curve shows that the impact of the second wave, in terms of the total number of daily cases reported, is much higher than that of the first wave. During the second wave, the curve dropped in the first months of the year and then rose again at the end of February, albeit more moderately than at the peak recorded in Italy at the beginning of September. Source: Istat.

In Italy, from the start of the epidemic “with evidence of transmission” on February 20th 2020 until April 30th 2021, 4,035,367 positive Covid-19 cases were reported, the health data showed.

Of that figure, 1,867,940 were logged in the first four months of 2021, making up 46 percent of the total sum.

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How Europe’s population is changing and what the EU is doing about it

The populations of countries across Europe are changing, with some increasing whilst others are falling. Populations are also ageing meaning the EU is having to react to changing demographics.

How Europe's population is changing and what the EU is doing about it

After decades of growth, the population of the European Union decreased over the past two years mostly due to the hundreds of thousands of deaths caused by the Covid-19 pandemic.

The latest data from the EU statistical office Eurostat show that the EU population was 446.8 million on 1 January 2022, 172,000 fewer than the previous year. On 1 January 2020, the EU had a population of 447.3 million.

This trend is because, in 2020 and 2021 the two years marked by the crippling pandemic, there have been more deaths than births and the negative natural change has been more significant than the positive net migration.

But there are major differences across countries. For example, in numerical terms, Italy is the country where the population has decreased the most, while France has recorded the largest increase.

What is happening and how is the EU reacting?

In which countries is the population growing?

In 2021, there were almost 4.1 million births and 5.3 million deaths in the EU, so the natural change was negative by 1.2 million (more broadly, there were 113,000 more deaths in 2021 than in 2020 and 531,000 more deaths in 2020 than in 2019, while the number of births remained almost the same).

Net migration, the number of people arriving in the EU minus those leaving, was 1.1 million, not enough to compensate.

A population growth, however, was recorded in 17 countries. Nine (Belgium, Denmark, Ireland, France, Cyprus, Luxembourg, Malta, Netherlands and Sweden) had both a natural increase and positive net migration.

READ ALSO: IN NUMBERS: Five things to know about Germany’s foreign population

In eight EU countries (the Czech Republic, Germany, Estonia, Spain, Lithuania, Austria, Portugal and Finland), the population increased because of positive net migration, while the natural change was negative.

The largest increase in absolute terms was in France (+185,900). The highest natural increase was in Ireland (5.0 per 1,000 persons), while the biggest growth rate relative to the existing population was recorded in Luxembourg, Ireland, Cyprus and Malta (all above 8.0 per 1,000 persons).

In total, 22 EU Member States had positive net migration, with Luxembourg (13.2 per 1 000 persons), Lithuania (12.4) and Portugal (9.6) topping the list.

Births and deaths in the EU from 1961 to 2021 (Eurostat)

Where is the population declining?

On the other hand, 18 EU countries had negative rates of natural change, with deaths outnumbering births in 2021.

Ten of these recorded a population decline. In Bulgaria, Italy, Hungary, Poland, and Slovenia population declined due to a negative natural change, while net migration was slightly positive.

In Croatia, Greece, Latvia, Romania and Slovakia, the decrease was both by negative natural change and negative net migration.

READ ALSO: Italian class sizes set to shrink as population falls further

The largest fall in population was reported in Italy, which lost over a quarter of a million (-253,100).

The most significant negative natural change was in Bulgaria (-13.1 per 1,000 persons), Latvia (-9.1), Lithuania (-8.7) and Romania (-8.2). On a proportional basis, Croatia and Bulgaria recorded the biggest population decline (-33.1 per 1,000 persons).

How is the EU responding to demographic change?

From 354.5 million in 1960, the EU population grew to 446.8 million on 1 January 2022, an increase of 92.3 million. If the growth was about 3 million persons per year in the 1960s, it slowed to about 0.7 million per year on average between 2005 and 2022, according to Eurostat.

The natural change was positive until 2011 and turned negative in 2012 when net migration became the key factor for population growth. However, in 2020 and 2021, this no longer compensated for natural change and led to a decline.

READ ALSO: IN NUMBERS: One in four Austrian residents now of foreign origin

Over time, says Eurostat, the negative natural change is expected to continue given the ageing of the population if the fertility rate (total number of children born to each woman) remains low.

This poses questions for the future of the labour market and social security services, such as pensions and healthcare.

The European Commission estimates that by 2070, 30.3 per cent of the EU population will be 65 or over compared to 20.3 per cent in 2019, and 13.2 per cent is projected to be 80 or older compared to 5.8 per cent in 2019.

The number of people needing long-term care is expected to increase from 19.5 million in 2016 to 23.6 million in 2030 and 30.5 million in 2050.

READ ALSO: How foreigners are changing Switzerland

However, demographic change impacts different countries and often regions within the same country differently.

When she took on the Presidency of the European Commission, Ursula von der Leyen appointed Dubravka Šuica, a Croatian politician, as Commissioner for Democracy and Demography to deal with these changes.

Among measures in the discussion, in January 2021, the Commission launched a debate on Europe’s ageing society, suggesting steps for higher labour market participation, including more equality between women and men and longer working lives.

In April, the Commission proposed measures to make Europe more attractive for foreign workers, including simplifying rules for non-EU nationals who live on a long-term basis in the EU. These will have to be approved by the European Parliament and the EU Council.

In the fourth quarter of this year, the Commission also plans to present a communication on dealing with ‘brain drain’ and mitigate the challenges associated with population decline in regions with low birth rates and high net emigration.

This article is published in cooperation with Europe Street News, a news outlet about citizens’ rights in the EU and the UK.