Why are so many Italians of Kovid-19 dying?


Rome- Italy, the first non-Asian country affected by the coronovirus epidemic earlier this year, is once again battling the world’s deadliest outbreaks.

About 680 people are dying of Kovid-19 in Italy, on an average day, on a par with Brazil and behind only the US, this year, Italy has recorded about 67,900 deaths from the virus, the highest in Europe. , And is ranked fifth in the world — America, Brazil, India and Mexico — all of which have a large population.

Once again, the Italians are asking themselves: Why is Kovid-19 killing more people than almost anywhere else?

Public health experts say the answer lies partly in demographics. Italy has the oldest population in the world, second only to Japan. About one in four Italians is over 65, with an age group more likely to succumb to the disease.

Another factor: Majority homes are particularly common in Italy, potentially exposing older people to infections from their younger relatives.

Since the epidemic began, 95% of those who died of the virus in Italy have crossed 60, and 86% over 70. In many other countries deaths are also concentrated among older people, but in Italy they are proportionally higher.

Italy’s death rate also looks poor on a per capita basis. According to the European Center for Disease Prevention and Control, the country has recorded 15.9 coronavirus deaths for every 100,000 inhabitants in the past two weeks, compared to 6.3 in Spain, 6.9 in Germany and 8.3 in France.

The coffin at a church in Serina near Bergamo, Italy in March.


Photo:

Piercing cruciatti / Agence France-Presse / Getty Image

Military medical personnel worked with police to carry the coffins in Lucca province, Italy, in March.


Photo:

Carlo Kuzoli / ROPI / Zuma Press

In March, images of army trucks carrying the bodies of Kovid-19 victims outside the heavy city of Bergamo became a symbol of Italy’s tragedy – and a warning to the rest of the world.

After Italy suppressed the first wave with the help of a long and hard lockdown, some Italians thought the high death toll would repeat itself. The virus infection slowed down in summer. Millions of Italians adopted masks. The hospital and the government appeared better prepared.

Italy’s infections were even milder in the early fall, when a second wave of contagion began in Spain, France and Britain, but as winter begins, Italy returns to where it was in March: the most hit place in Europe.

On Friday, the Italian government announced another lockdown on Christmas and New Year holidays, fearing that hospitals could flood in January and deaths could also increase.

From 24 December to 6 January, bars and restaurants will have to be closed and there will be travel and movement restrictions across the country. On typical days, such as Christmas Eve and weekends, most shops should remain closed, too.

“There is a strong expectation of the transition curve during the Christmas holiday among our experts,” Italian Prime Minister Giuseppe Conte said in explaining the new rules on Friday.

Despite policies aimed at sheltering older people, the virus has again spread to nursing homes and hospitals, affecting more than 65 people.

Yet age alone does not critically explain Italy. A national health care system that was already uprooted and understood due to the epidemic, said Antonella Viola, a professor of pathology at the University of Padua.

Medical staff treated a patient in the intensive care unit of Rome’s San Filippo Neri Hospital in October.


Photo:

Massimo Percocci / EPA / Shutterstock

“Yes, the population is old and weak, and there are pre-existing conditions. But it cannot be different from the rest of Europe. “There is a clear problem with the way local health care is organized. There are very few doctors. GPs have many patients with each to take care of properly. “

In the spring, hospitals in badly affected parts of northern Italy did not have enough beds to treat all critically ill Kovid-19 patients. To avoid a repeat, the government sought to increase the number of intensive-care beds across the country.

But many hospitals have struggled with the influx of Kovid-19 patients, anyway, because they did not have enough doctors and nurses to care for them, partly as a result of decades of cuts.

And care has been improved outside very few hospitals. Many Italian regions have long-neglected local health care networks, including family doctors, public health experts say. Thus, many Kovid-19 patients living at home have received little or no support. Many seriously ill people arrive at the hospital too late if they make it.

Even in the affluent northern region of Lombardy, which has some of the best hospitals in Europe, the local network of physicians and small clinics is poorly equipped to care for Kovid-19 patients who live at home, especially in remote rural or mountainous areas. In.

“This is a system that prioritizes hospital care. We have excellent specialized care, such as ICUs and transplant units, ”said Guido Marinoni, a Lombardi representative for the Doctors Association of Italy. “But whatever has to do with local medicine and prevention, it was placed second. It has become clear. “

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Since the onset of the epidemic, approximately 3.5% of Italians who tested positive for the virus have died, according to official data in our world data, a nonprofit research project based at the University of Oxford – more than any other Has a high percentage. Major European Countries. In Germany, about 1.7% of people tested positive.

Experts say the actual rate of mortality among infected people is quite low, as many virus-carriers are never tested.

According to data from the Organization for Economic Cooperation for Economic Cooperation and Development, Italy spent $ 3,650 on health care per resident in 2019, while Germany spent $ 6,650. Average spending among OECD countries was $ 4,224 per capita.

“Germany is better equipped and better prepared in general,” said Luciano Gattinoni, an Italian professor of anesthesiology and intensive care who currently teaches at the University of Gottingen, Germany.

Write Margherita Stancati at [email protected]

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