Italy’s virus toll poses uncomfortable questions

“If you can act sooner, even a bit lighter in the measures, they work better than acting harshly a bit later or too late.”

– MATTEO VILLA, RESEARCH FELLOW AT THE INSTITUTE FOR INTERNATIONAL POLITICAL STUDIES

ROME — Italy is reclaiming a record nobody wants — the most coronavirus deaths in Europe — after the health care system again failed to protect the elderly and government authorities delayed imposing new restrictions.

This wasn’t supposed to happen. Italy was the first country in the West to be slammed by COVID-19 and, after suffering a huge wave of death in spring, brought infections under control.

Italy then had the benefit of time and experience heading into the fall resurgence because it trailed Spain, France and Germany in recording big new clusters of infections. Yet the virus spread fast and wide, and Italy has added nearly 29,000 dead since Sept. 1.

“Obviously there needs to be some reflection,” Guido Rasi, former executive director of the European Pharmaceutical Agency, told state TV after Italy reported a pandemic-high record of 993 deaths in one day. “This number of nearly 1,000 dead in 24 hours is much higher than the European average.”

Italy added 649 more victims Saturday, bringing its official total to 64,036. According to the official British government total of 64,024, Italy did overtake Britain, though the Johns Hopkins University tally late Saturday still showed Britain leading Europe with 64,123 dead. Both numbers are believed to greatly underestimate the real toll, due to missed infections, limited testing and different counting criteria.

Italy is taking over the dishonorable ranking despite having 6 million people fewer than the U.K.’s 66 million, to trail only the much larger U.S., Brazil, India and Mexico. According to the Hopkins tally, Italy has the most deaths per 100,000 population among the most affected countries.

Public health officials argue that Italy has the world’s second-oldest population after Japan, and the elderly are the most vulnerable to the virus.

The average age of Italian victims has hovered around 80. In addition, 65% of Italy’s COVID-19 dead had three or more other health problems before they tested positive, such as hypertension or diabetes, according to Italy’s Superior Institute of Health.

But that doesn’t explain the whole picture. Germany has a similarly old demographic and yet its death toll is one-third of Italy’s despite its larger population of 83 million. Germany recorded its highest daily number of coronavirus victims Friday — 598 — but has 21,500 dead overall.

Analysts point to Germany’s long-term higher per-capita spending on health care, which has resulted in greater ICU capacity, better testing and tracing capabilities and higher ratios of doctors and nurses to the population. But Germany also imposed an earlier, lighter lockdown this fall and is now poised to tighten it.

“If you can act sooner, even a bit lighter in the measures, they work better than acting harshly a bit later or too late,” said Matteo Villa, research fellow at the Institute for International Political Studies, a Milan-based think tank.

Italy, he said, waited too long after infections started ticking up in September and October to impose restrictions and didn’t reinforce its medical system sufficiently during the summertime lull.

With another wave of infections feared to be just around the corner with Christmas visits and the winter flu season, many are wondering how many more will die.