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This is nothing new and it is not surprising either. But these are numbers that need to be studied thoroughly. Covid-19 does not cause the same mortality everywhere, but manifests itself with extreme variability in Italian regions, ranging from a high of 5.4% positives in Lombardy to a low of 1.3% in Campania, with an average of 3.5% nationwide. If we focus on the October-December period, in particular on the data from October 12 to December 6, it is observed that the mortality levels from Covid-19 in Italian regions vary significantly, with the same prevalence of new infections and regardless of the age structure of the resident population.
What are the regions most affected by Covid in Italy?
This can be deduced from the analysis of the data currently available relative to the last 2 months in Italy and those registered since the beginning of the health crisis in Europe prepared by the National Observatory of Health in the Italian Regions of the Catholic University, Rome campus . The analyzes confirm what has already emerged from the data since the beginning of the Covid-19 emergency, namely that the pandemic has had different intensity and lethality both in Italy and in Europe. This evidence should be analyzed and understood by medical science and by experts in the organization of health systems, since the differences found are not solely attributable to the fragility of the elderly population, the most affected by the virus.
It is by no means straightforward or obvious to understand the reasons for regional and European differences, which must be looked for among a very wide range of factors: organizational deficiencies, initial delays in understanding the severity of the emergency, deficiencies in infection tracking systems , different levels. of the aggressiveness of the virus, individual behaviors and elections of central and local governments.
Hypotheses, many hypotheses. As the second in which some territories are affected by a high level of mobility, these are places where most of their social and economic relationships take place. These areas, in all probability, have been subjected to a greater risk of contagion, Lombardy, for example, is the Region with the highest intensity of movements and where a very high number of infections has been registered.
In Italy 65,011 deaths from Covid: 36.7% in Lombardy
Since the health emergency began until December 14, 65,011 deaths have been registered in our country, of which 36.7% occurred in Lombardy, 11.0% in Piedmont and 10.2% in Emilia-Romagna . The relationship between deaths and infections (lethality) stands at 3.5% at the national level, Lombardy experiences the highest value, 5.4%, the Region with the lowest is Campania with 1.3%.
According to data published by the National Institute of Health of Italy, updated to December 2, the average age of positive patients who died from SARS-CoV-2 is 80 years, the average age increases to 82 years. The trend in the average age of the deceased patients with positive SARS-CoV-2, from the third week of February 2020, has increased substantially to 85 years (first week of July) and then has fallen slightly below 80 years since September.
The difference between the first and second wave of coronavirus in Italy
The first wave of Covid actually affected only one part of our country, the Center-North, while in the rest of Italy the infections were very limited. The second phase was developed throughout the territory, however, it continues to highlight significant differences between the regions, especially with respect to the number of deaths from Covid-19.
“The relaxation of attention has favored infections in the summer, especially among young people and this has rekindled and probably anticipated the second phase of the pandemic – spoega Walter Ricciardi, Senior Lecturer in General and Applied Hygiene at the Catholic University and Director of the Observatory – It was an error that also involved the Southern Regions of Italy in the pandemic, already in difficulties with their Health Systems and that in the first phase had only been affected by the health emergency. The reopening of schools, although a duty , and the easing of traffic restrictions have increased the spread of infections. “
Let’s look at the data from October to December, in particular the data from October 12 to December 6: it is clear that the mortality levels from Covid-19 in the Regions vary significantly, with the same prevalence of new infections and regardless of the structure age of the population. resident. The following reflection is based on the trend of deaths, recorded over 2 weeks, relative to infections in the previous 2 weeks, to take into account the time lapse between diagnosis and death.
Comparing the period from November 23 to December 6 with that of October 26 to November 8, we can observe a significant increase in the variability of the incidence of deaths and infections among the Regions with the highest level of infections.
Valle d’Aosta is the region with the highest mortality rate from Covid-19
Valle d’Aosta is the region with the highest rate of deaths from Covid-19 to date: 3.11 per 10,000 inhabitants, compared to a rate of new infections of 150.4 per 10,000 inhabitants. The number of deaths is particularly high when compared with that of the Bolzano Public Administration, which for a similar number of infections, 151.7 per 10,000 inhabitants, has an incidence of deaths equal to 1.94 per 10,000 inhabitants. The high level of mortality is also recorded in Friuli Venezia Giulia where, compared to an incidence of 82.0 per 10,000 inhabitants, a mortality rate of 2.82 per 10,000 is observed. Also in this case, it is a high relationship between deaths and number of infections when compared to Veneto, 88.5 infections per 10,000 inhabitants and 1.87 deaths per 10,000 inhabitants, and with Tuscany, 85.3 infections. and 1.51 deaths per 10,000 inhabitants.
In the time slot considered, Calabria (33.41 infections and 0.47 deaths per 10,000 inhabitants), Marche (51.4 and 0.86), Lazio (62.78 and 0.95) and Umbria (77.59 and 1.25) are the Regions with the lowest ratio between deaths and infections, to these is added Campania (85.3 infections and 1.1 deaths per 10,000 inhabitants) which occupies the lower left quadrant, the one with the highest level of infections to the national average.
“The variability that is observed in our country is also found between European countries”, says Alessandro Solipaca, scientific director of the Observatory, who expects “careful reflections on the experience that is maturing around the world, to avoid errors and prevent other future emergencies. It will be necessary to establish – continues Solipaca – which of the following factors influenced the effects and dynamics of the pandemic in the population: aggressiveness of the virus, performance of Health Systems or incomplete data from the tracking system. ” It is necessary to implement more effective surveillance systems than the one that currently exists in Italy and the rest of European countries, part of the variability observed in the data is undoubtedly due to the imprecision with which contagion cases are recorded and their follow-up. “concludes Solipaca.
Countries with the highest number of infections in relation to 10,000 residents
The highest number of infections in relation to 10,000 residents is registered in Luxembourg (626.8), followed by the Czechoslovak Republic (522.9) and Belgium (519.0). The least affected by the pandemic are Finland (51.2), Greece (110.1) and Latvia (115.1). The highest mortality is found in Belgium (15.3), Italy (10.15) and Spain (9.9), while Finland (0.8), Cyprus (0.8) and Estonia (1.0) are the least affected countries.
Paying attention to the relationship between deaths and infected people (lethality), even the analyzes at the European level register a high variability, the comparison with the elderly population (over 65 years) shows a non-significant correlation, that is, the excess mortality of the infected does not depend, or depends to a small extent, on the elderly structure of the population. In short, in simple terms: not everything can be explained with “in Italy we die more than abroad from Covid because we are a larger population”. Also in Europe, when analyzing the fatality registered in individual countries in relation to the percentage of older people, significant differences can be observed. For example, in the group with the highest proportion of elderly, the fatality ranges from 1.3 in Latvia to 3.1 per 10,000 inhabitants in Bulgaria; In countries with the lowest percentage of older people, the fatality ranges from 0.5 in Cyprus to 3.5 per 10,000 registered in Great Britain.
Italy, as we have seen, has a high fatality rate, given a contagion rate that places us in the central range of the European ranking. From the data we know that deaths occurred mainly among the elderly and our country, at a European level, is the first for the proportion of elderly people, but, as we have just reported, this only partially explains this mortality. As just mentioned, the worst situation is in Great Britain, the country with the highest fatality, despite having a relatively young population compared to many other European states. Ireland also shows a high fatality relative to the proportion of older people. In general, there are very different situations with respect to fatality for the same proportion of the elderly population, so the reasons must be understood. It will take a little time.
