Deaths in Italy ‘could be underestimated’

OFFICIAL reports of Covid-19 deaths in some Italian regions could be a “substantial underestimation” of the actual number of people to die from the disease, a study has suggested.

Researchers examined the change over time in the total number of deaths – known as all cause mortality – in Nembro, a city of around 11,500 people in Lombardy.

The region in northern Italy has been one of the areas most severely affected by the coronavirus pandemic.

Researchers found more Nembro residents died in March 2020 than in the entire previous year or in any single year since 2012.

But they also discovered that only about half of the deaths occurring during the recent coronavirus outbreak were reported as confirmed Covid-19 deaths.

Between February 21 and April 11 this year, a total of 166 deaths were recorded among residents of the city.

From samples taken during the same period, 218 people later tested positive for Covid-19 – of which 85 died.

The peer-reviewed study by experts at the Institute of Public Health and Charite-Universitatsmedizin Berlin, and published in the

BMJ medical journal, based its findings on the monthly all cause mortality data from Nembro between January 2012 and April 2020.

It also took into account the number of confirmed deaths from Covid19 up to April 11 and the weekly absolute number of deaths between January 1 and April 4 across recent years by age group and sex.

The study found monthly all cause mortality between January 2012 and February 2020 fluctuated around 10 per 1,000 person years, with a maximum of 21.5 per 1,000 person years.

In March 2020, monthly all cause mortality reached a peak of 154.4 per 1,000 person years.

By comparison, the rate for the same month in the previous year was only 14.3 per 1,000 person years.

For the first 11 days of April this year, the rate fell to 23 per 1,000 person years.

Researchers found that of the 161 people who died between February 23 and April 4 this year, none were aged 14 years or younger and 14 (8.7%) were aged between 15 and 64.

The study said the increase in all cause deaths was largely drive by a rise in deaths among older people, especially men, aged 65 or above.

The study’s authors said: “Across Italian cities, all cause mortality has notably increased because of the Covid-19 pandemic but this increase is not being completely captured by officially reported statistics on confirmed Covid-19 deaths.”

They said the discrepancies could be due to shortages of tests to confirm Covid-19 or patients dying from causes indirectly related to the disease, such as limitations on healthcare capacity due to the pandemic.

The authors added: “Our findings imply that the reporting of confirmed Covid-19 specific deaths represents – at least for some Italian regions – a substantial underestimation of the actual number of deaths from the disease.”

They concluded: “The results suggest that the full implications of the Covid-19 pandemic can only be completely understood if, in addition to confirmed deaths related to Covid-19, consideration is also given to all cause mortality in a given region and time frame.”