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ROME (Reuters) – In late November, doctor Maurizio Cappiello visited more than 130 patients in the emergency room of the Cardarelli hospital in the southern Italian city of Naples. More than two-thirds had COVID-19.
The virus, which was mainly confined to Italy’s industrial north during the first spring wave, now also ravaged the poor south, overwhelming its fragile public health system.
“Despite our efforts, it was impossible to help them as we would have liked and convey a sense of humanity, we tried to be quick and focus on the most critical,” said Cappiello, a senior official at Italy’s ANAAO-ASSOMED national medical union. he told Reuters.
Campania, the populous region around Naples, had just 430 coronavirus deaths on June 15. The total has now risen to more than 2,300, as Italy’s total death toll has surpassed that of Great Britain to become the highest in Europe.
Italy, the first Western country to be affected by the virus in March, won praise for apparently having managed to control its outbreak in the summer. Now questions are being raised again about why more people apparently die of COVID-19 in Italy than in other wealthy nations.
Among the explanations often offered are its elderly population; a social structure in which young people often live with the elderly, exposing them to the virus; an underfunded health system; and lack of preparation and organization.
“During the summer, when daily cases were low, we could not hire more staff and we did not make any reorganization plans,” said Naples doctor Cappiello.
DEATHS PER CAPITA
According to Worldometers data, Italy has recorded 65,011 deaths from COVID-19 since February, compared to 64,170 in Britain, 57,911 in France and 47,624 in Spain, three other European nations severely affected by the disease.
On a per capita basis, Italy ranks 37th in the world in number of cases, but fourth in deaths, with 1,076 COVID deaths per million people. This compares with 943 in Great Britain, 886 in France and 924 in the United States.
The only state in the European Union with a higher per capita mortality rate is Belgium with 1,546, the worst in the world.
Countries count deaths from COVID in slightly different ways, and medical experts cautioned against jumping to conclusions, saying a clearer picture will only emerge when excessive numbers of deaths are available for the entire year.
But officials acknowledge that Italy has suffered more than most and attribute the blame in large part to the fact that it has many older citizens who have proven especially vulnerable.
According to Eurostat data for 2019, Italy had the oldest population in Europe, with 22.8% of its population over 65. It also ranks as one of the countries with the longest life expectancy in the world: 83 years.
But doctors say that while Italians live a long time, they are not particularly healthy. A 2017 report from the health association Osservatorio Nazionale said that 71% of those over 65 had at least two underlying health conditions. Almost half of this age group took at least five different medications a day.
“There is a very dangerous nexus between the high number of elderly people here and (the high number of) health conditions. We are paying a very, very high price for this,” Health Minister Roberto Speranza told La7 television channel. .
The first wave of the pandemic, which claimed approximately 35,000 lives, was concentrated in the north, where some emergency rooms were quickly overwhelmed, a problem that raised the death toll as doctors were forced to decide who to treat now. who to deal with. had to walk away.
HEALTH COURTS
Doctors hoped that the knowledge gained from the initial contagion would help them dramatically reduce deaths in any new outbreak. However, as the second wave spreads across the country, Stefano Centani, a professor of respiratory diseases at the University of Milan, said the death rate remains high.
“Unfortunately, it does not seem that we have made much progress. Perhaps we have even made it worse. This will have to be analyzed,” he said.
The prolonged underfunding of the public health service is likely partly to blame, he said.
“We are paying 20 years, maybe more, of constant cuts to health resources … When this pandemic broke out, all our problems were exposed.”
Speranza also lamented spending cuts introduced more than a decade ago to try to help contain the mounting national debt.
“The biggest problem is the lack of doctors. You can buy masks, respirators and protective clothing on the international market, but you can’t buy doctors, you can’t buy nurses, you can’t buy personnel,” he said.
“In Italy, for 15 years, we have had a rule that blocked personnel spending at 2004 levels minus 1.4%. This is incredible.”
(Reporting by Crispian Balmer, Angelo Amante and Emilio Parodi, edited by Gavin Jones and Angus MacSwan)
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