Italy’s record high virus toll begs uncomfortable questions

ROME (AP) — Italy could soon reclaim a record that nobody wants — the most coronavirus deaths in Europe.

Italy was the first country in the West to be slammed by COVID-19. It had the benefit of time and experience heading into the fall resurgence because it trailed Spain, France and Germany in recording big new clusters of infections. Yet the virus spread fast and wide, adding 28,000 deaths since September 1.

“Obviously there needs to be some reflection,” former Executive Director Guido Rasi, of the European Pharmaceutical Agency, told state TV after Italy reported a pandemic-high record of 993 deaths in one day.

“This number of nearly 1,000 dead in 24 hours is much higher than the European average.”

Italy added another 761 victims on Friday, bringing its official total to 63,387, just shy of Britain’s Europe-leading 63,603 deaths, according to Johns Hopkins University. Both numbers are believed to greatly underestimate the real toll, due to missed infections, limited testing and different counting criteria.

Still, Italy could overtake Britain despite having six million people fewer than the United Kingdom’s (UK) 66 million, and would trail only the much larger Brazil, India, Mexico and the United States (US). Italy has the world’s second-oldest population after Japan, and the elderly are the most vulnerable to the virus.

Mlitary trucks moving coffins of deceased people on the highway next to Ponte Oglio, near Bergamo, one of the areas worst hit by the coronavirus infection, on their way from Bergamo cemetery to a crematory. PHOTO: AP

The average age of Italian victims has hovered around 80. In addition, 65 per cent of Italy’s COVID-19 deaths had three or more other health problems before they tested positive, such as hypertension or diabetes, according to Italy’s Superior Institute of Health.

But that does not explain the whole picture. Germany has a similarly old demographic and yet its death toll is one-third of Italy’s despite its larger population of 83 million.

Analysts point to Germany’s long-term higher per-capita spending on healthcare, which has resulted in greater intensive care unit (ICU) capacity, better testing and tracing capabilities as well as higher ratios of doctors and nurses to the population. But Germany also imposed an earlier, lighter lockdown this fall and is now poised to tighten it.

He said,”Italy waited too long after infections started picking up in September and October to impose restrictions and didn’t reinforce its medical system sufficiently during the summertime lull.”

Doctors have blamed systemic problems with Italy’s healthcare system, especially in hardest-hit Lombardy, for failing to respond adequately. They have cited the growth of private hospitals in Lombardy in recent years at the expense of public ones. Brain drain and bureaucratic obstacles have resulted in fewer doctors going into practice, while general practitioners have complained of a lack of support despite being the backbone of the system.

Nearly 80,000 Italian health care workers have been infected and 255 doctors have died.

“We asked for a lockdown at the start of November because the situation inside hospitals was already difficult,” said Head of the country’s doctors’ association Dr Filippo Anelli.

“We saw that it worked in the spring and allowed us to get out from under COVID-19. If this had been done, probably today the numbers would be coming down.”

But the Italian government resisted re-imposing a nationwide lockdown this fall, knowing the devastating impact on an economy that was just starting to come back to life after the springtime shutdown.

Instead, on November 3 the government divided the country into three risk zones with varying restrictions. But by then infections had been doubling each week for nearly a month and hospitals were already overwhelmed in Milan and Naples.

In recent weeks, investigative news reports have noted that Italy hadn’t updated its influenza pandemic preparedness plan since 2006 – which could help explain its critical shortage of protective equipment early on and its chaotic initial response to the pandemic. Italy also ranked 31st – between Indonesia and Poland – in a 2019 survey of 195 countries compiled by the Global Health Security Index assessing abilities to respond to a pandemic or other healthcare crisis.

Italy scored particularly poorly in emergency response, preparedness, and communications with healthcare workers during a crisis.

Government officials admit they were caught unprepared but have strongly defended their response to the resurgence as scientifically sound and proportional to prevent the economy from collapsing. Virus Commissioner Domenico Arcuri, said last Thursday that the November restrictions on flattening Italy’s infection curve.