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The analysis of the data on total deaths in Italy, in the fourth report carried out by the National Institute of Statistics (Istat) and the Istituto Superiore di Sanità (Iss), and published yesterday, December 30, focuses onimpact of the Covid-19 epidemic on the total mortality of the resident population in the period January-November 2020. In the period between February and November 2020 they enrolled 57,647 deaths occurred in people positive for Covid-19 (with date of death on November 30). It is interesting to note that the number of deaths registered in the period from June to November 2020 is equivalent to 40.4% of the global figure: we are talking about 23,295 deaths in six months. In general, in the observed months it is estimated 84 thousand deaths more than the average 2015-2019.
However, Istat recalls that the relationship between the deaths reported to Integrated Surveillance and the excess mortality in the period February-November 2020 cannot determine what the real contribution of Covid-19 was. This is due to two reasons: the existence of methodological problems related to the consolidation of databases (both for integrated surveillance and Istat) and the Difficulty identifying deaths caused by Covid-19 when these occur in patients with numerous comorbidità.
From the end of February to November, deaths from Covid-19 represent 9.5% of the total deaths of the period: during the first epidemic wave (February-May) this participation was 13%, while in the second wave the total contribution of Covid-19 deaths increased to 16% nationwide (with a considerable increase in November).
Differences between the first and second waves
Between February and November 30, 2020 they were diagnosed in all 1,651,229 positive cases of Covid-19. The year is divided into two phases, coinciding with the two waves of the coronavirus epidemic, distinguishing between the first, February-May 2020, in which the virus was felt mainly in the North, and the second wave, September- November. 2020. Between the two phases there was a transition time, in the summer months, in which the spread of the virus was very contained, until the end of September, when there were many outbreaks throughout the country. Istat announces that as of the end of September 2020 (beginning of the second wave) cases have increased rapidly again at an exponential rate in most parts of the country. Only since mid-November has there been a decrease in incidence.
Deaths from Covid-19 in 2020
During the first phase of the health emergency, that is, from March to May, they counted 211 thousand dead, 50 thousand more than the average of the same period registered in previous years, 2015-2019. Of these 211 thousand, more than 45 thousand were residents in the north of the country. Going into more detail, the increase in the Northern Regions registered almost a doubling of deaths in March (+ 94.5% compared to the average for the same month in the 2015-2019 period) and an increase of + 75.0% in April.
In the period from June to September, that is, during the transition phase of the spread of the Covid-19 epidemic, a reduction in total mortality which showed, in all Autonomous Regions / provinces, the number of deaths from all causes registered in 2020 in line with the reference values for the period 2015-2019.
Something has changed with the second wave, already since the first half of October. In absolute terms, it is estimated for the months of October and November 2020 an increase in deaths from all causes of more than 31,700 units. The excess of deaths during the second wave in October is 13% and the variation is the same in both the north and the center-south; while in November there was again a difference between the different areas of the country: the increase in mortality was 61.4% in the North, 39.3% in the Center and 34.7% in the South. However, the increase in registered deaths is more pronounced in the north.
The increase in deaths Region by Region
Even in many northern regions, excess total mortality in November exceeds that of the peak from March to April: in Aosta Valley (+ 139.0% compared to + 71.0% in April), in Piedmont (+ 98.0% in November compared to + 77.0% in April), Veneto (+ 42.8% compared to + 30.8% in April), and Friuli Venezia Giulia (+ 46.9% vs + 21.1%). The increase in deaths registered in November is lower than that observed in the first wave of the epidemic only in Lombardy (+ 66% in November compared to + 192% in March and + 118% in April) and in Emilia romagna (+ 34.5% compared to + 69% in March).
The increase in deaths in different age groups
If we consider the contributions by age group of deaths from Covid-19 to overall mortality, it can be seen how, at the national level, mortality from Covid-19 has contributed to the 4% of overall mortality in the 0-49 age group, a8% in the 50-64 age group, 11% in the age group 65-79 years and 8% in individuals eighty years or older.
The excess of around 50 thousand deaths due to the complex of causes found at the national level for the period March-May 2020, compared to the average for the same period of the years 2015-2019, is due by 72% to the increase in deaths from the population aged 80 and over (36,000 and 400 more deaths in this age group.
The increase in mortality in the 65-79 age group is equivalent to 23% of the excess deaths corresponding to the first wave of the Covid-19 epidemic (March-May 2020 period); In absolute terms, the increase, compared to the average figure for 2015-2019, is 11,700 deaths (which together in this age group amount to just under 53,000).
In the months of October and November, the second wave, a similar phenomenon is observed: the global increase in deaths exceeds 31 thousand seven hundred units, of which more than 23 thousand more deaths in the age group 80 years and older (who covers 74% of the increase in total deaths in the two months).
Regarding the age group from 0 to 49 years, during almost the entire period considered, monthly deaths in 2020 are lower than the average for 2015-2019, with the exception of the March and November data referring to men residing in the North, for which an increase of 11% and 4.9% respectively is observed. Why was the mortality of the younger population in 2020 generally lower than the 2015-2019 average? On the one hand, Istat explains, we must consider the lower lethality of the epidemic below fifty years. In addition, the reduction in mortality due to some of the main causes that affect this segment of the population, such as accidental causes: with the confinement and the consequent blocking of mobility and many productive activities, the youngest segment of the population also played a role. population was less exposed. at risk.
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