Analysis. The virus killed 261 people a day on average, nearly 8,000 a month. But the figure leaves out many untested victims. By comparison, the flu directly kills about 500 people every year.

Italy surpasses 100,000 dead, but the toll is much higher

With the 318 deaths recorded Tuesday, Italy has crossed the threshold of 100,000 victims of Covid-19 since the beginning of the pandemic. It is equivalent to 261 victims per day on average—almost 8,000 per month.

To assess the extent of the data, it is useful to know that the flu directly kills about 500 people every year. Even including the people who die from complications related to the flu, the estimated deaths are 5,000-10,000. Italy is the sixth country in the world to cross this threshold, after the USA, Brazil, Mexico, India and the United Kingdom.

But the round figure is a symbol and little more. The death toll from Covid-19 actually exceeded 100,000 many weeks ago. The official numbers do not take into account the fact that many people have fallen ill with Covid-19 without having access to a diagnostic testing.

Experts now give more importance to the so-called “excess mortality,” i.e. the number of more victims registered in 2020 than in the last five years. To evaluate it, the epidemiologists of the Istituto Superiore di Sanità and the demographers of Istat have set up a joint working group to analyze the impact of the epidemic beyond the incomplete data of regional health surveillance.

The fifth report of the ISS / Istat working group was published four days ago and reveals many interesting numbers. In the 25 pages of the study, it turns out that between March and December 2020 there were 108,000 more deaths than last year, mostly attributable to Covid-19. It is therefore likely that the symbolic figure of 100,000 victims was already reached in mid-December.

The discrepancy between the official numbers and the real victims refers almost entirely to the first wave, the one that hit a limited area of ​​the country—especially the northwest— and hit the health systems of a few regions in a very violent way. The crash sent ASL and hospitals into a tailspin, making even the numerical monitoring of the epidemic impossible, which was held back only by one of the most rigid lockdowns in the world.

According to Istat, one-third of the 51,000 more deaths recorded overall compared to the same period of previous years is missing from the official toll of 34,000 victims of Covid-19 in the period between March and May 2020. In Lombardy, more than twice as many people died in that period of time compared to a year earlier. In some municipalities of the Bergamo area now known internationally, such as Nembro or Alzano Lombardo, from one year to the next the mortality in the months of March and April 2020 was 10 times higher than that of a year earlier. In the rest of Italy, the first wave caused much smaller increases in mortality: + 8.1% in the center, + 5.1% in the south.

In the October to December period in which the second wave was concentrated, health monitoring produced a more faithful image of the real impact of Covid-19: the official number of victims (40,000) is closer to excess mortality overall in the same period (+52,000 deaths). Even in the second wave, the impact of the epidemic was more violent in northern Italy, where deaths increased by 40%. But also in the center (+ 24%) and in the south (+ 26%) the toll of human lives was very heavy.

The excess of mortality offers a more realistic picture of the effect of the epidemic, but it would be wrong to directly attribute every additional death recorded in 2020 to Covid-19. The indirect impact of the pandemic on other diseases is still largely unexplored. Hospitals and local health authorities burdened by Covid-19 cases have had to postpone less urgent therapies and prevention activities. The health consequences of these delays will be spread over the years, becoming less visible but no less substantial. Furthermore, its psychological impact also weighed on the Covid-19 record. Several random searches on hospital emergency rooms have revealed how many people have delayed access to emergency facilities for fear of becoming infected.

On the other hand, social distancing and lockdowns have diminished the impact of other causes of death, such as flu and accidents. Already in Jan. 2021, these beneficial effects partially offset the increase in deaths due to the pandemic. Notwithstanding the 12,000 official deaths from Covid-19, there were 8,500 more deaths than in the same month of 2020. Compared to the 2015-2019 period, however, the excess mortality is estimated at only 2,000 more deaths.

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