Why is Covid-19 deadlier in Italy than elsewhere?

Spraying disinfectant at the Rialto Bridge in Venice. Photographer: Marco Sabadin/AFP via Getty Images

As the worldwide coronavirus outbreak enters a new month, official statistics show that the pandemic is deadlier in Italy than in any other country.

Some analysts believe that the tragic figures of Italy stem from measurement instead of measures that the country has been taking to confront the epidemic.

As of Wednesday, the novel coronavirus has claimed more than 13,000 lives in Italy since the first death on February 20. With more than 110,000 cases, the mortality rate stands at 11.9 percent, far higher than any other countries that have also experienced a significant outbreak.

World Health Organisation data shows that the country has recorded 218 deaths per million people, again, the highest among major countries.

Each night, civil protection officials hold press briefings with the latest tallies of new infections, cured patients, and deaths from the virus, and the Italian media has various theories as to why the outbreak has been so deadly within Italy’s borders.

“Aside from the number of people in intensive care, all the figures we all see every day are inaccurate,” Luca Foresti, general manager of Santagostino Medical Center said.

“It’s not an intention to mislead. It’s a characteristic of an imperfect, incomplete testing system. We could only have an accurate count of the sick if every person was tested in the same way, whether they had symptoms or not,” he said.

“Instead, governments are only testing people with symptoms or who have been exposed to those who have been infected,” he said.

“And even within Italy, the testing procedure and statistical accounting vary from region to region,” said Foresti.

According to the information collected by analytics firm Statistica, Italy, with a population of around 59 million, has performed little more than 500,000 coronavirus tests as of Tuesday, when the country had recorded more than 100,000 infections, which means less than 1 percent of Italians have been tested and as high as 20 percent of those who have been tested are infectious.

Many of the untested are likely infected with coronavirus with mild symptoms or perhaps no symptoms at all, according to Foresti and other analysts.

There is another question raised by civil protection officials. As hospitals are full of coronavirus patients, should those who die before getting treatment in hospitals be counted as a death caused by the virus?

According to official data, more than one in ten coronavirus cases in the world are in Italy, a country with less than 1 percent of the world’s population.

“To come up with a ratio you need a numerator and a denominator and when it comes to Covid-19 deaths and infections we cannot be sure of either one,” Fabrizio Pregliasco, a research fellow at the University of Milan’s Department of Biomedical Sciences for Health said.

“The virus spread in Italy earlier than it did to France, Germany, the United States, or other countries,” Pregliasco said.

“Those countries are where we were one or two weeks ago.”