Why are so many Italians dying of Covid-19?

Once again, Italians ask themselves: Why is the Covid-19 virus killing more people here than almost anywhere else?

Public health experts say the answer lies in part in demographics. Italy is one of the oldest populations in the world, second only to Japan. Almost one in four Italians is over the age of 65, which is an age group More likely to get sick.

Another factor: multi-generational homes Especially common in ItalyThis could expose the elderly to infection from their younger relatives.

Ago The epidemic beganIn Italy, 95% of those who died from the virus are over the age of 60, and 86% are over 70. In many other countries, deaths are also concentrated among the elderly, but there is a greater proportion of them in Italy.

The death toll in Italy also looks bad on a per capita basis. The country recorded 15.9 deaths from the Coronavirus per 100,000 residents over the past two weeks, compared to 6.3 in Spain, 6.9 in Germany and 8.3 in France, according to the European Center for Disease Prevention and Control.

In March, photos of army trucks carrying the bodies of Covid-19 victims from the crowded city of Bergamo became a symbol of Italy’s tragedy – and a warning to the rest of the world.

After Italy suppressed the first wave with the help of a long and strict lockdown, few Italians believed the high death toll would repeat themselves. Virus infections slowed down considerably in the summer. Millions of Italians have adopted the wearing of masks. Hospitals and the government seemed more prepared.

Casualties in Italy remained modest Even in early fallWhen a second wave of infections swept Spain, France and the United Kingdom. But with the onset of winter, Italy is back to where it was in March: the hardest-hit place in Europe.

On Friday, the Italian government announced another lockdown over the Christmas and New Year holidays, fearing that hospitals could be overrun and deaths could increase in January.

From December 24 to January 6, bars and restaurants will have to close, and there will be restrictions on travel and movement across the country. On certain days, such as Christmas Eve and weekends, most stores must also remain closed.

“There are strong concerns among our experts that the contagion curve may rise during the Christmas holidays,” Italian Prime Minister Giuseppe Conte said on Friday, explaining the new rules.

Despite policies aimed at housing the elderly, the virus has once again spread to nursing homes and hospitals, affecting many people over the age of 65.

However, age alone does not explain Italy’s bleak toll. Antonella Viola, a professor of pathology at the University of Padua, said a nationwide healthcare system that was overburdened and understaffed before the pandemic was also the cause.

Yes, the population is old and weak, and there are pre-existing conditions. “But this cannot be different from the rest of Europe,” said Dr. Viola. There is an obvious problem with the way local healthcare is organized. There are very few doctors. GPs have too many patients to properly care for each one of them. “

In the spring, hospitals in the severely affected parts of northern Italy did not have enough beds to treat all critically ill Covid-19 patients. To avoid a repeat of this, the government sought to increase the number of intensive care beds across the country.

But many hospitals suffered an influx of Covid-19 patients this fall anyway because they did not have enough doctors and nurses to take care of them, in part as a result of decades of spending cuts.

Little has been done to improve care outside of hospitals. Public health experts say many Italian regions have long neglected local healthcare networks, including family doctors. Consequently, many Covid-19 patients who stay at home receive little or no support. Many critically ill people come to hospital too late, if they succeed at all.

Even in the wealthy northern Lombardy region, which houses some of the best hospitals in Europe, the local network of smaller doctors and clinics is not well equipped to care for Covid-19 patients who stay home, especially in remote or mountainous rural areas.

“It is a system that prioritizes hospital care. Guido Marinoni, Lombardy representative of the Italian Doctors’ Association, said,“ We ​​have excellent specialist care, such as intensive care units and transplantation units. But everything related to local medicine and prevention came in second place. This became clear. “

Since the start of the pandemic, about 3.5% of Italians who test positive for the virus have died, according to official data collected by Our World in Data, a non-profit research project based at the University of Oxford – a higher percentage than any other major European country. In Germany, about 1.7% of those who tested positive have surrendered.

Experts say the true rate of death among those infected is much lower, because many carriers of the virus have never been tested.

While Italy spent $ 3,650 on healthcare per capita in 2019, Germany spent $ 6,650, according to OECD data. Average spending among OECD countries is $ 4,224 per person.

“Germany is better equipped and better prepared in general,” said Luciano Gatinone, an Italian professor of anesthesiology and intensive care who is currently studying at the University of Göttingen, Germany.

Write to Margherita Stancati at [email protected]