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Italy’s coronavirus death toll is far higher than reported

79 points by adventured 7y ago

lwelrkwnnzsd 7y ago
no it's not - STFU YOU FUCKING LIBERALS!
olliej 7y ago
It seems like this could apply to pretty much every effected country. We know the US has drastically under tested which again results in under reporting.
- topkai22 7y ago
  Had under tested, the rate of testing has increased drastically in the last two weeks. It’s not where we need it to be, but the US is now testing at a rate comparable with any other country.
  - ChristianGeek 7y ago
    Can you provide a source (other than the president) that backs that up?
    - riffraff 7y ago
      It is a very sad state of affairs that a Presidential statements cannot considered reliable anymore.
      - sg47 7y ago
        Random lies don't Presidential statements make.
    - adventured 7y ago
      The US is doing a minimum of ~100,000 tests per day currently (1.2 million total tests at a minimum thus far), although that doesn't capture every private test that is performed. That's double the per capita per day test rate that Britain is functioning at currently and it's also far off the rate that Germany is testing at (the US needs to increase its rate by 2x to 2.5x or so to match Germany) on the excellent testing side of things. Right now it's more fair to say the US would probably fall in the middle of Western Europe on the testing rate. The reason Britain has an extreme 8% mortality rate on its positive cases, is because they aren't testing properly (and haven't been). They'd already be at 100,000+ cases if they were testing just at the rate the US is. France as another example has such an extreme case mortality rate (7%) in part because they're not testing enough people. Their positive result would be far higher than ~60k right now if they were (and that mortality rate would drop considerably). One of the reasons Germany's mortality rate is so low, is they're catching a very large number of all positive cases via massive testing. If the US were testing at the rate of Germany, its case mortality rate (which is around 2.3%) would drop by more than 1/2. This site has done a very good job at bringing together all the available testing data across the states. https://covidtracking.com/data/us-daily https://covidtracking.com/data/us-daily
  - new_realist 7y ago
    Testing latency is still 10 days in most areas, so the results are out of date.
    - matheweis 7y ago
      This will change quickly, take a look at the Abbott RealTime SARS-COV-2 test
  - deleted 7y ago
    [deleted]
  - apaprocki 7y ago
    In NYC, no one is tested unless they require hospitalization. > If your symptoms are mild, you should stay at home and monitor your condition. Testing is only offered to patients who are severely ill and need hospitalization. https://portal.311.nyc.gov/article/?kanumber=KA-03288 https://portal.311.nyc.gov/article/?kanumber=KA-03288
- docdeek 7y ago
  I believe it applies in France - the official mortality statistics reported each evening by the Director General of Health relate to deaths in hospitals, not outside of hospitals such as in nursing homes. While the Director General is clear and transparent about what his statistics represent, the headline figure is generally reported as the death toll each evening…and it is not until the news stories the next day that we’re reminded of the 20 people who died in this nursing home, another 7 who died in this nursing home, and another where the proportion of people suffering from the impact of the virus is even higher. EDIT: Le Monde has a story up about this. They describe the nursing homes in France as a ‘grey zone’ in terms of the death toll right now - everyone knows there are deaths but they are not included in the official figures yet. The article meantions nursing homes in three regions of France that have had, between them, nearly 1000 deaths attributed to COVID-19 so far. None of these deaths are so far counted in the 4000 ‘official deaths’ reported each evening. The article also notes that there are 7400 nursing homes in France, a number that rises to 10,000 if you count similar structures (hospices, for example). Scary times. https://www.lemonde.fr/societe/article/2020/04/01/coronavirus-a-cannes-dans-l-isere-ou-dans-le-puy-de-dome-de-nouveaux-residents-d-ehpad-succombent-a-l-epidemie_6035188_3224.html https://www.lemonde.fr/societe/article/2020/04/01/coronaviru...
flocial 7y ago
http://archive.is/UWxPP http://archive.is/UWxPP
rubber_duck 7y ago
One thing I saw in a news report here is a doctor checking in on the status in Italy - she said that they were not doing autopsies - patient was on a respirator and had symptoms or was confirmed - cause of death corona. So I'm not sure about the reasoning with testing - but I could be wrong.
- _-___________-_ 7y ago
  My understanding is that in many countries, the "Covid-19 deaths" count is the number of people who tested positive (i.e. confirmed cases) who subsequently died. This is different to the way deaths are normally attributed to a cause, in that every single death of a person who tested positive is recorded as a Covid-19 death regardless of the severity of their Covid-19 symptoms or any other factors. This has an upward pressure on the reported Covid-19 mortality vs. other diseases. Separately from that, in any country there are of course people dying who were not tested before death and thus were not a confirmed case. They are not recorded as Covid-19 deaths. This has a downward pressure on the reported Covid-19 mortality. The relative magnitude of the upward pressure and the downward pressure are pretty much unknown at this point.
  - npunt 7y ago
    Good summary. One additional thing to point out is the upper bound of the first case is the total covid deaths counted, whereas the upper bound of the second could be much larger.
Pfhreak 7y ago
There's a second order death toll too, because resources that would otherwise be available are being used to treat the pandemic. That means many things that might not be lethal if treated quickly and with the best care, for example injuries from a car accident or a heart attack, are now entering a stressed health care system and likely have worse expected outcomes. Then, all the folks who would normally be secondary concerns and receiving preventative care are now most likely not receiving that care. It's less likely that these develop into death, but could easily turn into serious health complications. It's important to remember that it's not just covid-19 we're dealing with. It's covid-19 plus all the stuff we'd normally be taking care of. We'll be unwinding this ball of yarn for a long time after addressing the virus itself.
- _-___________-_ 7y ago
  Very true. There's a second order reduction in deaths, too. The huge reduction in vehicle traffic leads to far fewer car accidents [0]. The temporary closure of polluting industries improves air quality. Working out the overall impact of this thing will be quite a challenge indeed. [0] A pretty extreme example is here in Vietnam where I'm "sheltering in place" -- normally an average of two people a day die in traffic accidents in Saigon alone. Traffic has been reduced so much (although there isn't a strict lockdown) that it's apparently down to one person in two weeks. Meanwhile, Covid-19 hasn't directly killed anyone in the whole country (according to official figures).
  - bb2018 7y ago
    This will obviously be studied for years but I imagine plotting taking "total deaths in region X for time period Y - total deaths in region X given comparable previous time period Y" will give a pretty good estimate of the complete effect of Covid. It won't be able to pinpoint individual cases but it seems like a very simple and unbiased way of getting the complete delta in deaths due to Covid.
    - _-___________-_ 7y ago
      I mentioned this in another thread but check out http://euromomo.eu/ http://euromomo.eu/ - all-cause mortality vs. baseline for every European country, overall and by age group, going back a decade. There's a time lag because of reporting delay so it will be a few weeks before the current situation in Italy/Spain is well reflected there. It does only have country-level data, so some amount of excess mortality in one sub-country region (e.g. Lombardy) can get diluted by the rest of the country, although Lombardy is 1/6 of the population of Italy so significant excess should show up.
riffraff 7y ago
I cannot read this article ATM, but there was another one a couple days ago on an Italian newspaper, in English, which gets the same conclusion by looking directly at the number of deaths in the period compared with last year. The number seems to be a much better proxy of the gravity of the epidemic than the reported infected. https://www.google.com/amp/s/www.corriere.it/politica/20_marzo_26/the-real-death-toll-for-covid-19-is-at-least-4-times-the-official-numbers-b5af0edc-6eeb-11ea-925b-a0c3cdbe1130_amp.html https://www.google.com/amp/s/www.corriere.it/politica/20_mar...
- _-___________-_ 7y ago
  If you're interested in this perspective, EUROMOMO[0] is worth keeping an eye on. It's the all-cause mortality monitoring data that Europe has collected on a per-country and per-age-group basis for a decade or so, for the purpose of early detection of increased mortality due to e.g. a bad flu season. There is some time lag in the data (probably more than usual right now in Italy/Spain) but increased mortality should show up within a few weeks there. [0] http://euromomo.eu/ http://euromomo.eu/
  - notechback 7y ago
    Really interesting. It currently shows week 12, so the second half of march. It looks like there is overall a lower number, especially for 0-4 year olds. Staying home saves lives beyond covid...?
    - _-___________-_ 7y ago
      Staying home means fewer traffic accidents, and closing businesses means fewer workplace accidents (admittedly not relevant for the 0-4 age group) and maybe lower pollution. So it definitely seems possible that all-cause mortality for some age groups would reduce.
ImpressiveWebs 7y ago
I haven’t read the article due to the paywall, but it’s also worth considering the following quote from the Telegraph on March 23, which quotes Prof Walter Ricciardi, scientific adviser to Italy’s minister of health: > “The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus. > “On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity - many had two or three,” he says. So while it may be true that many deaths have not been reported, it’s also true that many deaths are misreported. Source: https://www.telegraph.co.uk/global-health/science-and-disease/have-many-coronavirus-patients-died-italy/ https://www.telegraph.co.uk/global-health/science-and-diseas...
- triangleman 7y ago
  No, I think it's fair to say that if someone dies for whatever reason and they test positive for COVID-19 then their death should be included in the official total.
  - nordsieck 7y ago
    > I think it's fair to say that if someone dies for whatever reason and they test positive for COVID-19 then their death should be included in the official total. You think that someone who has COVID-19 asymptomatically, and dies from being crushed by a falling piano should be included in the official death total? If you applied the same logic to prostate cancer, probably 50%+ of men "die" of prostate cancer.
    - e98cuenc 7y ago
      You are right strictly speaking, but misleading. In the vast majority of cases of people dying with COVID-19 from another condition, COVID-19 is the reason why this other condition became lethal. That's why it makes sense to attribute the death to COVID-19.
guscost 7y ago
Take on the one hand these untested victims, and on the other the folks who tested positive but did not die of pneumonia or respiratory distress. Right now it’s awfully hard to guess whether the true “death toll” (to the extent that such a vague thing can even be defined) is more or less than the reported number. But folks will try to estimate this retroactively, far into the future.
nickpinkston 7y ago
Here's the full text (coming in multiple comments because of size limit): MILAN—In the town of Coccaglio, an hour’s drive east of here, the local nursing home lost over a third of its residents in March. None of the 24 people who died there were tested for the new coronavirus. Nor were the 38 people who died in another nursing home in the nearby town of Lodi. These aren’t isolated incidents. Italy’s official death toll from the virus stands at 13,155, the most of any country in the world. But that number tells only part of the story because many people who die from the virus don’t make it to the hospital and are never tested. In the areas worst hit by the pandemic, Italy is undercounting thousands of deaths caused by the virus, a Wall Street Journal analysis shows, indicating that the pandemic’s human toll may end up being much greater, and infections far more widespread, than official data indicate. Italy’s hidden death toll shows what could lie in store for the worst-hit areas of the U.S., Europe and many other countries in the weeks ahead if the coronavirus is not tamed fast. The burden that the pandemic puts on health-care systems can cause so many deaths that it is hard to gauge the full human cost. As stretched and sometimes overwhelmed hospitals fight to save their patients, many other people die unseen and uncounted, including elderly people in out-of-the-way locations. In addition, the health-care crisis can lead to a surge of deaths from other causes that would normally be treatable.
- nickpinkston 7y ago
  “There are many more dead than are officially declared. But this is not a j’accuse. People died and they were never tested because time and resources are limited,” Eugenio Fossati, deputy mayor of Coccaglio, says of deaths caused by the virus. Properly tallying the number of deaths from the pathogen can help public-health officials map out a response to the pandemic, such as making sure hospitals are adequately equipped for the emergency. It can also influence how quickly and strictly governments should impose social-distancing measures, and for how long. But collecting accurate data is challenging for Italy and many other countries, due to the speed of the pandemic and the fact that most countries’ public-health institutions are geared toward normal times. The Lombardy region, where this funeral was conducted in Cigole, near Brescia, accounts for 58% of Italy’s official coronavirus deaths. Three weeks after Italy became the first Western democracy to place its whole population under lockdown, the rate of contagion is slowing. But in the northern region of Lombardy, where the epidemic started and remains centered, infections had already spiraled out of control before the lockdown. The provincial cities of Bergamo and Brescia are the two worst hot spots, and have become symbols of Italy’s suffering. In and around those two towns, the real number of deaths is probably at least double the official count of 2,060 in March for Bergamo and 1,278 for Brescia since the outbreak began in late February, according to interviews with local officials, doctors and funeral-service providers and comparisons with the numbers of deaths from past years. People are also dying of other ailments because hospitals are too overloaded with coronavirus cases to give them the treatment they need, doctors and local officials say. Some 85 people died in the whole of last year in Coccaglio, a town near Brescia of 8,700 residents. In March of this year alone, the town’s main church bell has sounded the death knell 56 times. Only 12 of the deaths were officially attributed to the coronavirus. “We know the real number is higher, and we mourn them, knowing full well why they died,” says Mr. Fossati, the deputy mayor. “It’s a hard truth to accept.” Another problem is that the number of virus carriers is also vastly undercounted. Italy has reported about 111,000 confirmed cases of coronavirus, but testing is mostly limited to those who show symptoms. Many virus carriers with no symptoms aren’t tested. Officials and health experts estimate the true number of infected people at anywhere from hundreds of thousands to six million. The uncertainty about the death toll and the number of infected people makes it difficult to establish the true fatality rate of Covid-19, the respiratory disease caused by the virus. Estimates by epidemiologists of the fatality rate still range widely, but it is generally thought to be between 1% and 3% of those infected.
freyir 7y ago
Even if they can't test everyone who dies for Covid-19, I'm sure Italy is recording the total number of deaths. It should be possible to determine how much the total death rate increased each week or month relative to the average death rate over the past few years. EDIT: I found a non-paywall version of the article on MSN and that's essentially what they're reporting. "Nowhere in Italy has been harder hit than Bergamo, a city of about 120,000 people. In March 2019, 125 people died in the city. This March, 553 people died." https://www.msn.com/en-us/news/world/italys-coronavirus-death-toll-is-far-higher-than-reported/ar-BB122vvc?li=BBnb7Kz https://www.msn.com/en-us/news/world/italys-coronavirus-deat...
- thu2111 7y ago
  But remember that last year there was a flu season and this year there wasn't - deaths over this winter were far lower. The comparison of March to March would look like that even if there was a virus exactly as dangerous as flu but that hit in the spring instead of winter, because so many fragile people survived the winter.
- jsnell 7y ago
  More comprehensive data, accounting for the majority of the province rather than one city: https://www.ecodibergamo.it/stories/bergamo-citta/coronavirus-the-real-death-tool-4500-victims-in-one-month-in-the-province-of_1347414_11/ https://www.ecodibergamo.it/stories/bergamo-citta/coronaviru... 4.5k excess deaths in March, on a total population of 607k.
fxj 7y ago
The Eu is monitoring mortality in europe at this website: http://www.euromomo.eu/ http://www.euromomo.eu/ It goes back several years and you can clearly see the last influenza pandemics (2017). It also show the mortality for each member country and of course italy. At the moment there is no increase in mortality there. They write on their website: Note concerning COVID-19 related mortality as part of the all-cause mortality figures reported by EuroMOMO Over the past few days, the EuroMOMO hub has received many questions about the weekly all-cause mortality data and the possible contribution of any COVID-19 related mortality. Some wonder why no increased mortality is observed in the reported mortality figures for the COVID-19 affected countries. The answer is that increased mortality that may occur primarily at subnational level or within smaller focal areas, and/or concentrated within smaller age groups, may not be detectable at the national level, even more so not in the pooled analysis at European level, given the large total population denominator. Furthermore, there is always a few weeks of delay in death registration and reporting. Hence, the EuroMOMO mortality figures for the most recent weeks must be interpreted with some caution. Therefore, although increased mortality may not be immediately observable in the EuroMOMO figures, this does not mean that increased mortality does not occur in some areas or in some age groups, including mortality related to COVID-19.
rurban 7y ago
More than 54.000? That was the number of deaths with the last big flu in Italy 2014. It's also still half of the death toll in a typical flu season. The flu IFR is 1% for years in Italy, the COVID-19 IFR in most countries at about 0.6%. But thanksfully pneumonia deaths are so much more media triggery than normal flu deaths. https://www.ijidonline.com/article/S1201-9712(19)30328-5/fulltext https://www.ijidonline.com/article/S1201-9712(19)30328-5/ful...
- MagnumOpus 7y ago
  Your source says 20,250 excess deaths from 14/15 winter?
  - rurban 7y ago
    "A mortality rate of 10.7 per 1,000 inhabitants was observed in the winter season 2014/2015 (more than 375,000 deaths in absolute terms), corresponding to an estimated 54,000 excess deaths (+9.1%) as compared to 2014"

79 points by adventured 7y ago

no it's not - STFU YOU FUCKING LIBERALS!

It seems like this could apply to pretty much every effected country. We know the US has drastically under tested which again results in under reporting.

topkai22 7y ago
Had under tested, the rate of testing has increased drastically in the last two weeks. It’s not where we need it to be, but the US is now testing at a rate comparable with any other country.
- ChristianGeek 7y ago
  Can you provide a source (other than the president) that backs that up?
  - riffraff 7y ago
    It is a very sad state of affairs that a Presidential statements cannot considered reliable anymore.
    - sg47 7y ago
      Random lies don't Presidential statements make.
  - adventured 7y ago
    The US is doing a minimum of ~100,000 tests per day currently (1.2 million total tests at a minimum thus far), although that doesn't capture every private test that is performed. That's double the per capita per day test rate that Britain is functioning at currently and it's also far off the rate that Germany is testing at (the US needs to increase its rate by 2x to 2.5x or so to match Germany) on the excellent testing side of things. Right now it's more fair to say the US would probably fall in the middle of Western Europe on the testing rate. The reason Britain has an extreme 8% mortality rate on its positive cases, is because they aren't testing properly (and haven't been). They'd already be at 100,000+ cases if they were testing just at the rate the US is. France as another example has such an extreme case mortality rate (7%) in part because they're not testing enough people. Their positive result would be far higher than ~60k right now if they were (and that mortality rate would drop considerably). One of the reasons Germany's mortality rate is so low, is they're catching a very large number of all positive cases via massive testing. If the US were testing at the rate of Germany, its case mortality rate (which is around 2.3%) would drop by more than 1/2. This site has done a very good job at bringing together all the available testing data across the states. https://covidtracking.com/data/us-daily https://covidtracking.com/data/us-daily
- new_realist 7y ago
  Testing latency is still 10 days in most areas, so the results are out of date.
  - matheweis 7y ago
    This will change quickly, take a look at the Abbott RealTime SARS-COV-2 test
- deleted 7y ago
  [deleted]
- apaprocki 7y ago
  In NYC, no one is tested unless they require hospitalization. > If your symptoms are mild, you should stay at home and monitor your condition. Testing is only offered to patients who are severely ill and need hospitalization. https://portal.311.nyc.gov/article/?kanumber=KA-03288 https://portal.311.nyc.gov/article/?kanumber=KA-03288
docdeek 7y ago
I believe it applies in France - the official mortality statistics reported each evening by the Director General of Health relate to deaths in hospitals, not outside of hospitals such as in nursing homes. While the Director General is clear and transparent about what his statistics represent, the headline figure is generally reported as the death toll each evening…and it is not until the news stories the next day that we’re reminded of the 20 people who died in this nursing home, another 7 who died in this nursing home, and another where the proportion of people suffering from the impact of the virus is even higher. EDIT: Le Monde has a story up about this. They describe the nursing homes in France as a ‘grey zone’ in terms of the death toll right now - everyone knows there are deaths but they are not included in the official figures yet. The article meantions nursing homes in three regions of France that have had, between them, nearly 1000 deaths attributed to COVID-19 so far. None of these deaths are so far counted in the 4000 ‘official deaths’ reported each evening. The article also notes that there are 7400 nursing homes in France, a number that rises to 10,000 if you count similar structures (hospices, for example). Scary times. https://www.lemonde.fr/societe/article/2020/04/01/coronavirus-a-cannes-dans-l-isere-ou-dans-le-puy-de-dome-de-nouveaux-residents-d-ehpad-succombent-a-l-epidemie_6035188_3224.html https://www.lemonde.fr/societe/article/2020/04/01/coronaviru...

flocial 7y ago

http://archive.is/UWxPP http://archive.is/UWxPP

rubber_duck 7y ago

One thing I saw in a news report here is a doctor checking in on the status in Italy - she said that they were not doing autopsies - patient was on a respirator and had symptoms or was confirmed - cause of death corona. So I'm not sure about the reasoning with testing - but I could be wrong.

_-___________-_ 7y ago
My understanding is that in many countries, the "Covid-19 deaths" count is the number of people who tested positive (i.e. confirmed cases) who subsequently died. This is different to the way deaths are normally attributed to a cause, in that every single death of a person who tested positive is recorded as a Covid-19 death regardless of the severity of their Covid-19 symptoms or any other factors. This has an upward pressure on the reported Covid-19 mortality vs. other diseases. Separately from that, in any country there are of course people dying who were not tested before death and thus were not a confirmed case. They are not recorded as Covid-19 deaths. This has a downward pressure on the reported Covid-19 mortality. The relative magnitude of the upward pressure and the downward pressure are pretty much unknown at this point.
- npunt 7y ago
  Good summary. One additional thing to point out is the upper bound of the first case is the total covid deaths counted, whereas the upper bound of the second could be much larger.

Pfhreak 7y ago

There's a second order death toll too, because resources that would otherwise be available are being used to treat the pandemic. That means many things that might not be lethal if treated quickly and with the best care, for example injuries from a car accident or a heart attack, are now entering a stressed health care system and likely have worse expected outcomes. Then, all the folks who would normally be secondary concerns and receiving preventative care are now most likely not receiving that care. It's less likely that these develop into death, but could easily turn into serious health complications. It's important to remember that it's not just covid-19 we're dealing with. It's covid-19 plus all the stuff we'd normally be taking care of. We'll be unwinding this ball of yarn for a long time after addressing the virus itself.

_-___________-_ 7y ago
Very true. There's a second order reduction in deaths, too. The huge reduction in vehicle traffic leads to far fewer car accidents [0]. The temporary closure of polluting industries improves air quality. Working out the overall impact of this thing will be quite a challenge indeed. [0] A pretty extreme example is here in Vietnam where I'm "sheltering in place" -- normally an average of two people a day die in traffic accidents in Saigon alone. Traffic has been reduced so much (although there isn't a strict lockdown) that it's apparently down to one person in two weeks. Meanwhile, Covid-19 hasn't directly killed anyone in the whole country (according to official figures).
- bb2018 7y ago
  This will obviously be studied for years but I imagine plotting taking "total deaths in region X for time period Y - total deaths in region X given comparable previous time period Y" will give a pretty good estimate of the complete effect of Covid. It won't be able to pinpoint individual cases but it seems like a very simple and unbiased way of getting the complete delta in deaths due to Covid.
  - _-___________-_ 7y ago
    I mentioned this in another thread but check out http://euromomo.eu/ http://euromomo.eu/ - all-cause mortality vs. baseline for every European country, overall and by age group, going back a decade. There's a time lag because of reporting delay so it will be a few weeks before the current situation in Italy/Spain is well reflected there. It does only have country-level data, so some amount of excess mortality in one sub-country region (e.g. Lombardy) can get diluted by the rest of the country, although Lombardy is 1/6 of the population of Italy so significant excess should show up.

riffraff 7y ago

I cannot read this article ATM, but there was another one a couple days ago on an Italian newspaper, in English, which gets the same conclusion by looking directly at the number of deaths in the period compared with last year. The number seems to be a much better proxy of the gravity of the epidemic than the reported infected. https://www.google.com/amp/s/www.corriere.it/politica/20_marzo_26/the-real-death-toll-for-covid-19-is-at-least-4-times-the-official-numbers-b5af0edc-6eeb-11ea-925b-a0c3cdbe1130_amp.html https://www.google.com/amp/s/www.corriere.it/politica/20_mar...

_-___________-_ 7y ago
If you're interested in this perspective, EUROMOMO[0] is worth keeping an eye on. It's the all-cause mortality monitoring data that Europe has collected on a per-country and per-age-group basis for a decade or so, for the purpose of early detection of increased mortality due to e.g. a bad flu season. There is some time lag in the data (probably more than usual right now in Italy/Spain) but increased mortality should show up within a few weeks there. [0] http://euromomo.eu/ http://euromomo.eu/
- notechback 7y ago
  Really interesting. It currently shows week 12, so the second half of march. It looks like there is overall a lower number, especially for 0-4 year olds. Staying home saves lives beyond covid...?
  - _-___________-_ 7y ago
    Staying home means fewer traffic accidents, and closing businesses means fewer workplace accidents (admittedly not relevant for the 0-4 age group) and maybe lower pollution. So it definitely seems possible that all-cause mortality for some age groups would reduce.

ImpressiveWebs 7y ago

I haven’t read the article due to the paywall, but it’s also worth considering the following quote from the Telegraph on March 23, which quotes Prof Walter Ricciardi, scientific adviser to Italy’s minister of health: > “The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus. > “On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity - many had two or three,” he says. So while it may be true that many deaths have not been reported, it’s also true that many deaths are misreported. Source: https://www.telegraph.co.uk/global-health/science-and-disease/have-many-coronavirus-patients-died-italy/ https://www.telegraph.co.uk/global-health/science-and-diseas...

triangleman 7y ago
No, I think it's fair to say that if someone dies for whatever reason and they test positive for COVID-19 then their death should be included in the official total.
- nordsieck 7y ago
  > I think it's fair to say that if someone dies for whatever reason and they test positive for COVID-19 then their death should be included in the official total. You think that someone who has COVID-19 asymptomatically, and dies from being crushed by a falling piano should be included in the official death total? If you applied the same logic to prostate cancer, probably 50%+ of men "die" of prostate cancer.
  - e98cuenc 7y ago
    You are right strictly speaking, but misleading. In the vast majority of cases of people dying with COVID-19 from another condition, COVID-19 is the reason why this other condition became lethal. That's why it makes sense to attribute the death to COVID-19.

guscost 7y ago

Take on the one hand these untested victims, and on the other the folks who tested positive but did not die of pneumonia or respiratory distress. Right now it’s awfully hard to guess whether the true “death toll” (to the extent that such a vague thing can even be defined) is more or less than the reported number. But folks will try to estimate this retroactively, far into the future.

nickpinkston 7y ago

Here's the full text (coming in multiple comments because of size limit): MILAN—In the town of Coccaglio, an hour’s drive east of here, the local nursing home lost over a third of its residents in March. None of the 24 people who died there were tested for the new coronavirus. Nor were the 38 people who died in another nursing home in the nearby town of Lodi. These aren’t isolated incidents. Italy’s official death toll from the virus stands at 13,155, the most of any country in the world. But that number tells only part of the story because many people who die from the virus don’t make it to the hospital and are never tested. In the areas worst hit by the pandemic, Italy is undercounting thousands of deaths caused by the virus, a Wall Street Journal analysis shows, indicating that the pandemic’s human toll may end up being much greater, and infections far more widespread, than official data indicate. Italy’s hidden death toll shows what could lie in store for the worst-hit areas of the U.S., Europe and many other countries in the weeks ahead if the coronavirus is not tamed fast. The burden that the pandemic puts on health-care systems can cause so many deaths that it is hard to gauge the full human cost. As stretched and sometimes overwhelmed hospitals fight to save their patients, many other people die unseen and uncounted, including elderly people in out-of-the-way locations. In addition, the health-care crisis can lead to a surge of deaths from other causes that would normally be treatable.

nickpinkston 7y ago
“There are many more dead than are officially declared. But this is not a j’accuse. People died and they were never tested because time and resources are limited,” Eugenio Fossati, deputy mayor of Coccaglio, says of deaths caused by the virus. Properly tallying the number of deaths from the pathogen can help public-health officials map out a response to the pandemic, such as making sure hospitals are adequately equipped for the emergency. It can also influence how quickly and strictly governments should impose social-distancing measures, and for how long. But collecting accurate data is challenging for Italy and many other countries, due to the speed of the pandemic and the fact that most countries’ public-health institutions are geared toward normal times. The Lombardy region, where this funeral was conducted in Cigole, near Brescia, accounts for 58% of Italy’s official coronavirus deaths. Three weeks after Italy became the first Western democracy to place its whole population under lockdown, the rate of contagion is slowing. But in the northern region of Lombardy, where the epidemic started and remains centered, infections had already spiraled out of control before the lockdown. The provincial cities of Bergamo and Brescia are the two worst hot spots, and have become symbols of Italy’s suffering. In and around those two towns, the real number of deaths is probably at least double the official count of 2,060 in March for Bergamo and 1,278 for Brescia since the outbreak began in late February, according to interviews with local officials, doctors and funeral-service providers and comparisons with the numbers of deaths from past years. People are also dying of other ailments because hospitals are too overloaded with coronavirus cases to give them the treatment they need, doctors and local officials say. Some 85 people died in the whole of last year in Coccaglio, a town near Brescia of 8,700 residents. In March of this year alone, the town’s main church bell has sounded the death knell 56 times. Only 12 of the deaths were officially attributed to the coronavirus. “We know the real number is higher, and we mourn them, knowing full well why they died,” says Mr. Fossati, the deputy mayor. “It’s a hard truth to accept.” Another problem is that the number of virus carriers is also vastly undercounted. Italy has reported about 111,000 confirmed cases of coronavirus, but testing is mostly limited to those who show symptoms. Many virus carriers with no symptoms aren’t tested. Officials and health experts estimate the true number of infected people at anywhere from hundreds of thousands to six million. The uncertainty about the death toll and the number of infected people makes it difficult to establish the true fatality rate of Covid-19, the respiratory disease caused by the virus. Estimates by epidemiologists of the fatality rate still range widely, but it is generally thought to be between 1% and 3% of those infected.

freyir 7y ago

Even if they can't test everyone who dies for Covid-19, I'm sure Italy is recording the total number of deaths. It should be possible to determine how much the total death rate increased each week or month relative to the average death rate over the past few years. EDIT: I found a non-paywall version of the article on MSN and that's essentially what they're reporting. "Nowhere in Italy has been harder hit than Bergamo, a city of about 120,000 people. In March 2019, 125 people died in the city. This March, 553 people died." https://www.msn.com/en-us/news/world/italys-coronavirus-death-toll-is-far-higher-than-reported/ar-BB122vvc?li=BBnb7Kz https://www.msn.com/en-us/news/world/italys-coronavirus-deat...

thu2111 7y ago
But remember that last year there was a flu season and this year there wasn't - deaths over this winter were far lower. The comparison of March to March would look like that even if there was a virus exactly as dangerous as flu but that hit in the spring instead of winter, because so many fragile people survived the winter.
jsnell 7y ago
More comprehensive data, accounting for the majority of the province rather than one city: https://www.ecodibergamo.it/stories/bergamo-citta/coronavirus-the-real-death-tool-4500-victims-in-one-month-in-the-province-of_1347414_11/ https://www.ecodibergamo.it/stories/bergamo-citta/coronaviru... 4.5k excess deaths in March, on a total population of 607k.

fxj 7y ago

The Eu is monitoring mortality in europe at this website: http://www.euromomo.eu/ http://www.euromomo.eu/ It goes back several years and you can clearly see the last influenza pandemics (2017). It also show the mortality for each member country and of course italy. At the moment there is no increase in mortality there. They write on their website: Note concerning COVID-19 related mortality as part of the all-cause mortality figures reported by EuroMOMO Over the past few days, the EuroMOMO hub has received many questions about the weekly all-cause mortality data and the possible contribution of any COVID-19 related mortality. Some wonder why no increased mortality is observed in the reported mortality figures for the COVID-19 affected countries. The answer is that increased mortality that may occur primarily at subnational level or within smaller focal areas, and/or concentrated within smaller age groups, may not be detectable at the national level, even more so not in the pooled analysis at European level, given the large total population denominator. Furthermore, there is always a few weeks of delay in death registration and reporting. Hence, the EuroMOMO mortality figures for the most recent weeks must be interpreted with some caution. Therefore, although increased mortality may not be immediately observable in the EuroMOMO figures, this does not mean that increased mortality does not occur in some areas or in some age groups, including mortality related to COVID-19.

rurban 7y ago

More than 54.000? That was the number of deaths with the last big flu in Italy 2014. It's also still half of the death toll in a typical flu season. The flu IFR is 1% for years in Italy, the COVID-19 IFR in most countries at about 0.6%. But thanksfully pneumonia deaths are so much more media triggery than normal flu deaths. https://www.ijidonline.com/article/S1201-9712(19)30328-5/fulltext https://www.ijidonline.com/article/S1201-9712(19)30328-5/ful...

MagnumOpus 7y ago
Your source says 20,250 excess deaths from 14/15 winter?
- rurban 7y ago
  "A mortality rate of 10.7 per 1,000 inhabitants was observed in the winter season 2014/2015 (more than 375,000 deaths in absolute terms), corresponding to an estimated 54,000 excess deaths (+9.1%) as compared to 2014"