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You don’t die the same way everywhere: Covid-19 hits so different in each Italian region that there are significant differences, even almost five times, between one and another.
This is where there are more deaths
This is what emerged from an in-depth study conducted by the National Observatory of Health in the Italian Regions of the Catholic University of Rome. There Lombardy holds this sad record with a mortality rate that has reached 5.4% of the positives, while Campania is the region that registered the lowest number of deaths with 1.3% of positives. From the beginning of the pandemic 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.
According to data published by the Istituto Superiore di Sanità updated as of December 2, age media of positive patients who died from Sars-Cov-2 is 80 years: the trend in the average age of patients who died positive for the virus, as of the third week of February, has increased to 85 years (first week of July) to then drop slightly below 80 years from September. Focusing attention on the last two months of the pandemic (October-December) that coincided with the second wave, it was highlighted that the levels of mortality 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 reasons These analyzes confirm what has already emerged since the beginning of the Covid-19 emergency, that is, that the pandemic has had intensity and lethality. diverse: in our country, the first wave essentially “saved” the Center-South and the Islands compared to the tormented North (think Lombardy and the province of Bergamo); the second, on the other hand, for the trips related to summer vacations, developed throughout the territory, while highlighting significant differences between Regions, especially with regard to the number of deaths from Covid-19. This evidence should be analyzed and understood by medical science and by experts in the organization of health systems because the differences found are not solely attributable to the fragility of the elderly population, the most affected by the virus. It becomes very difficult to understand and establish the reasons for these differences regional areas to look for among a wide range of factors: organizational deficiencies, initial delays in understanding the severity of the emergency, deficits in infection tracking systems, different levels of virus aggression, individual behaviors, and government choices central and local.
The case of Lombardy
Another possible interpretation is that some territories have been affected by a high level of mobility, all those places where most of the social and economic relations take place. It is very likely that these areas have been subject to a higher risk of contagion: it is not surprising that Lombardy is the region with the highest travel intensity and is where a very high number of infections have been recorded. But this is not the only explanation.
“Poor health level.” “The causes are multiple and it will be necessary to make a study of all the factors. Some already know it, including the basic level of health of our elders: it is true that we are one of the longest-lived nations, the elderly live longer but with many pathologies. Basically, they are sicker than the elderly in Germany or Northern Europe ”: this is what Roberta Siliquini, Senior Lecturer at the Department of Public Health and Pediatric Sciences at the University of Turin and member of the Scientific Secretariat told us. .
Pollution and health system. Professor Siliquini also highlights a factor that, in the first months of the pandemic, some studies linked to the strong circulation of the virus between some provinces of Lombardy, Emilia and Piedmont. “There may be, and deserves a thorough study, even a factor contamination: We know that the Po Valley is the most polluted area in the whole of Europe. “To make a negative difference, however, the health system of each region weighs heavily as well and above all, which” highlighted important gaps that are probably not had previously stood out thanks to the excellence of the professionals. Structural and organizational gaps have emerged in all their negative magnitude at a time of crisis and emergency, ”Siliquini told us.
“Hospital-centered system”. But why does the Lombardy region have this lethality? “It has an extremely strong health service but very focused on the hospital, people are going to be treated for tumors and complex interventions thanks to the excellence of the institutes that carry out trials, but all this was done in detriment of the health system for primary care. Unfortunately, this disease also and above all requires extremely rapid management of symptoms “, says the professor. Attention, it is not just a Lombard problem: in almost all Regions the primary care system has totally failed: due to a tampon, the The elderly waited up to 10 days waiting for the symptoms to pass on their own. “Delayed treatment in already weakened and sick subjects greatly worsens the prognosis.”
The difference between regions
The Health Observatory study highlights how the Aosta Valley, in relation to inhabitants, it is the Region with the highest rate of deaths from Covid to date: 3.11 per 10,000, compared to a rate of new infections of 150.4 per 10,000 inhabitants. The death data are especially high when compared with those of the autonomous province of Bolzano, which, for a similar number of infections (151.7 per 10,000 inhabitants), has an incidence of deaths equal to 1.94. Very high mortality even in Friuli Venezia Giulia where, compared to an incidence of 82.0 per 10 thousand inhabitants, a mortality rate of 2.82 per 10 thousand 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, and with Tuscany, 85.3 infections and 1.51 deaths always every 10 thousand. The Regions, on the other hand, have the largest low Among the deaths and infections in the period considered (December 6, 2020) are 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). To these is added Campania with 85.3 infections and 1.1 deaths per 10,000 inhabitants.
“Avoid mistakes in the future”. “The variability observed in our country is also found between European countries“, Comments Alessandro Solipaca, Scientific Director of the Observatory, who hopes”reflections attentive to the experience that is maturing around the world, to avoid mistakes and prevent other possible future health emergencies. Will have to be established – Continue Solipaca – Which of the following factors influenced the effects and dynamics of the pandemic on the population: aggressiveness of the virus, performance of health systems, or incomplete data due to the monitoring system?”.
“There is no digitization”
An atavistic problem in our country is also true backwardness (to be polite) technological compared to other European countries not to mention nations like Japan, light years away. “As a country system we suffer from non-existent digitization, especially in health: many Regions, if they admit me to hospital X, they do a CT scan and they transfer me to hospital Y, the doctors can’t see it and they have to do it again” , said. Professor Solipaca said. “There is no computer system, data flows, that follow the patient. When it happened with Covid, the computer system and the data did not speak to each other: then I do not know anything about the patient’s previous pathologies. That prevents timely treatment. , the immediate recognition of the most fragile patients, loses a lot of money due to repeated examinations and has a negative impact on the quality of care ”, he concludes.
