Why have so many coronavirus patients died in Italy?

&quot;But there are other factors that may have contributed to Italy’s fatality rates, experts say. This includes a high rate of smoking and pollution - the majority of deaths have been in the northern region Lombardy region, which is notorious for poor air quality.&quot;<p>This was also the case in china, but the age structure is different:<p>&quot;A study in JAMA this week found that almost 40 per cent of infections and 87 per cent of deaths in the country have been in patients over 70 years old.&quot;<p>&quot;An older population skew within the infected population explains most of the disparity in fatality rates between high and low countries. According to a study of the fatalities of COVID-19 cases in Italy, 99% of all deaths had an underlying pathology. Only 0.8% had no underlying condition.&quot;<p>Seems like a perfect storm for the elderly in italy who smoke a lot and most of them having an underlying condition like cardiovascular disease or diabetes II.

No, no, no, the main factor that they do not speak about is testing, simple as that.<p>If you do proper testing, like in South Korea, you detect everybody or almost everybody that has coronavirus, even when they don&#x27;t have symptoms of the illness. That is 7 to 10 times more people detected(and controlled), that can actually transmit the virus.<p>In a country like UK, Portugal or Germany they had copied lots of things that worked in Taiwan, South Korea, Singapur or Japan.<p>Germany could have as many detected cases as Spain, but that will make only 1&#x2F;10 of the real illnesses cases of Spain.<p>In a country like Spain or Italy people in charge are so incompetent that they have only reacted when it was too late.<p>That at the same time forces the entire&#x27;s population to follow quarantine, because without tests you are blind to the people that has the virus without symptoms.<p>Spain&#x27;s Government is today promising a million test kits(broken promises is the seal of Mr Sanchez), in the future, but as of now there are not enough test just for testing all people with symptoms, unless you are a politician or family member of a politician of course.<p>That is the result of not getting preventive stocks early on. They simply could not imagine(and hence prepare) what has happened and just took zero anticipative actions like buying face masks.<p>Those politicians have zero scientific or technical preparation, so they could not understand something as simple as an exponential function.<p>In the case of Spain, they have very well prepared people down the command chain. But the people that takes the decisions are just scientific illiterate.

&gt; “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.<p>How else could deaths be recorded? It would seem negligent to not record someone who died with coronavirus as dying of coronavirus.

&gt; Of the 47,000 people confirmed coronavirus patients in Italy, 4,032 so far have died - with a record increase of 627 in the last 24 hours. By contrast China has almost twice as many cases, 81,250, but 3,253 fatalities.<p>One major problem with this is China&#x27;s reporting and actual figures.

It is the level of testing isn&#x27;t it?<p>Death pr. infected goes from 0.4% (Germany) to 1% (Diamond Princess) to 7.8% (Iran) to 9% (Italy).<p>If you have plenty of resources and you do contact tracing you are going to find many cases and the denominator will be high. If you are pressed on ressources and only test people admitted to hospitals with obvious symptions then the denominator will be low.<p>Demographics, overall population health, polution explains some of it but not a difference of factor 20.

&gt; with a record increase of 627 in the last 24 hours.<p>Worth pointing out that the record increase in 630 deaths was the number of two days ago... Yesterday, the increase in deaths was even bigger: 790 (from 4035 to 4825 total casualties).<p>Source: <a href="https:&#x2F;&#x2F;github.com&#x2F;pcm-dpc&#x2F;COVID-19" rel="nofollow">https:&#x2F;&#x2F;github.com&#x2F;pcm-dpc&#x2F;COVID-19</a>

It depends how a country classifies casualties outside those confirmed cases. Autopsy usually would not be viable given the scarcity of health care staff.

I find this article disingenuous and misleading to readers. Yes, there are cultural and demographic differences between Italy, China and Germany, but the subtitle claims a level of certainty that the experts interviewed in the piece do not support.<p>&gt; &quot;The country&#x27;s high death toll is due to an ageing population, overstretched health system and the way fatalities are reported&quot;<p>This can be read with a level certainty that minimizes the seriousness of this virus for English speaking readers that may be faced with making life saving choices over the next week.<p>Further, the Italian expert interviewed __in the article__ underlines the importance of not searching for explanations, because right now it is hard to be certain.<p>&gt; “It’s too early to make a comparison across Europe,” he says. “We do not have detailed sero-surveillance of the population and we do not know how many asymptomatic people are spreading it.”<p>Unfortunately the author chooses to make exactly such a comparison in the fourth paragraph!<p>&gt; In very crude terms, this means that around eight per cent of confirmed coronavirus patients have died in Italy, compared to four per cent in China. By this measure Germany, which has so far identified 13,000 cases and 42 deaths, has a fatality rate of just 0.3 per cent.<p>This is a moment where we need very concise and accurate information. Even if this article comes from a reputable source, I find it misses that mark.<p>I find significantly more enlightening the ISS&#x27;s (Istituto di Sanità Superiore) info-graphics which are prepared quasi-daily. [1] They are translated into english. [2]<p>Stay safe out there.<p>[1]: <a href="https:&#x2F;&#x2F;www.epicentro.iss.it&#x2F;coronavirus&#x2F;sars-cov-2-sorveglianza-dati" rel="nofollow">https:&#x2F;&#x2F;www.epicentro.iss.it&#x2F;coronavirus&#x2F;sars-cov-2-sorvegli...</a> [2]: <a href="https:&#x2F;&#x2F;www.epicentro.iss.it&#x2F;coronavirus&#x2F;bollettino&#x2F;Infografica_21marzo%20ENG.pdf" rel="nofollow">https:&#x2F;&#x2F;www.epicentro.iss.it&#x2F;coronavirus&#x2F;bollettino&#x2F;Infograf...</a>

It is very hard not to think that also the number of deaths (not only that of cases) is under-reported. For instance, the Major of Bergamo, one of the few not entirely rotten politicians, claims that actual deaths in the Province in the last days have been 4 times the reported deaths. He verified the figures with the other majors. Who died at home, and there have been many, has not been tested.<p>Here the interview:<p><a href="https:&#x2F;&#x2F;www.huffingtonpost.it&#x2F;entry&#x2F;giorgio-gori-chiudete-tutto-anche-le-fabbriche_it_5e74ad81c5b63c3b648e6263?utm_hp_ref=it-giorgio-gori" rel="nofollow">https:&#x2F;&#x2F;www.huffingtonpost.it&#x2F;entry&#x2F;giorgio-gori-chiudete-tu...</a><p>And it is very hard not to think that the most plausible explanation for the anomaly is shortage in ICUs.

&gt; 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.<p>But people who died without a diagnose for the Coronavirus are deemed to be dead not because of it.<p>From <a href="https:&#x2F;&#x2F;www.reuters.com&#x2F;article&#x2F;us-health-coronavirus-italy-homes-insigh&#x2F;uncounted-among-coronavirus-victims-deaths-sweep-through-italys-nursing-homes-idUSKBN2152V0" rel="nofollow">https:&#x2F;&#x2F;www.reuters.com&#x2F;article&#x2F;us-health-coronavirus-italy-...</a><p>&gt; in the city of Bergamo, there were 108 more deaths in the first 15 days of March this year compared to 2019 (164 deaths in 2020 vs. 56 deaths in 2019) according to the mayor of the city Giorgio Gori. During this period, 31 deaths were attributed to the coronavirus (less than 30% of the additional deaths this year)<p>&gt; &quot;There are significant numbers of people who have died but whose death hasn&#x27;t been attributed to the coronavirus because they died at home or in a nursing home and so they weren&#x27;t swabbed,&quot; said the mayor<p>Granted, the sample and time interval is small to draw conclusions. But we&#x27;ll know (perhaps when it&#x27;s too late) what&#x27;s the real death-toll of the coronavirus is.<p>tl;dr: The death count is not generous; probably the other way around. By, perhaps, a very big margin.