#15,176
Although Italy has reported nearly 27,000 new COVID-19 cases and almost 4,100 deaths over the past 7 days, this is actually an improvement over what they were reporting just two weeks ago. Daily case counts are down about 30% compared to the highs we were seeing then, and recent daily deaths are down nearly as much from their peak.
Of course, these official counts of cases and deaths are presumed to be a significant undercount, but recent trends suggest that after more than 3 weeks of lockdown and extreme social distancing, these measures have helped to flatten the curve.For now, Italy's numbers appear to have plateaued. How long it will take to lower community transmission enough to safely relax their societal restrictions and re-open for business is the $64 question, and one that many other countries currently climbing the epi curve are anxious to learn.
As we've noted previously, Italy's apparent Case Fatality Rate (CFR) is a horrendous 12.4%, but that is likely inflated by an undercounting of mild and moderate cases who were never tested.There are reasons to believe, however, that Italy's CFR may be higher than a lot of other countries, due to patient demographics and comorbidities, and the epidemic's impact on the healthcare delivery system.
First today's statistics from Italy's MOH, then a link to a preprint (non-peer-reviewed) article that attempts to unravel some of the reasons behind Italy's high death rate.
I've only reproduced the abstract of the preprint article, so follow the link to read the full 15-page PDF file.
The situation in Italy: April 6, 2020, 6.00 p.m.
CURRENTLY POSITIVE 93187
DECEASED 16523
HEALED 22837
Press conference at 6 pm on April 6th
132,547 total cases, 93,187 people currently positive, 16,523 died and 22,837 recovered.
Among the 93,187 positives:
- 60,313 are in home isolation
- 28,976 hospitalized with symptoms
Read the tables
- 3,898 in intensive care
Excess Mortality from COVID-19: Lessons Learned from the Italian Experience
Paolo Pasquariello and Saverio Stranges *
Version 1 : Received: 4 April 2020 / Approved: 6 April 2020 / Online: 6 April 2020 (15:17:12 CEST)
How to cite: Pasquariello, P.; Stranges, S. Excess Mortality from COVID-19: Lessons Learned from the Italian Experience. Preprints 2020, 2020040065 (doi: 10.20944/preprints202004.0065.v1).
Abstract
There is much discussion among clinicians, epidemiologists, and public health experts about why case fatality rate from COVID-19 in Italy (at 12.1% as of April 2, 2020, versus a global case fatality rate of 5.2%) is considerably higher than estimates from other countries (especially China, South Korea, and Germany).
In this article, we propose several potential explanations for these differences. We suggest that Italy’s overall and relative case fatality rate, as reported by public health authorities, is likely to be inflated by such factors as heterogeneous reporting of coronavirus-related fatalities across countries and the iceberg effect of under-testing, yielding a distorted view of the global severity of the COVID-19 pandemic.
We also acknowledge that deaths from COVID-19 in Italy are still likely to be higher than in other equally affected nations due to its unique demographic and socio-economic profile. Lastly, we discuss the important role of the stress imparted by the epidemic on the Italian healthcare system, which weakened its capacity to adequately respond to the sudden influx of COVID-19 patients in the most affected areas of the country, especially in the Lombardy region.
