According to Prof Walter Ricciardi, scientific adviser to Italy’s minister of health, the country’s mortality rate is far higher due to demographics – the nation has the second oldest population worldwide – and the manner in which hospitals record deaths.
“The age of our patients in hospitals is substantially older – the median is 67, while in China it was 46,” Prof Ricciardi says. “So essentially the age distribution of our patients is squeezed to an older age and this is substantial in increasing the lethality.”
But Prof Ricciardi added that Italy’s death rate may also appear high because of how doctors record fatalities.
“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.
This does not mean that Covid-19 did not contribute to a patient’s death, rather it demonstrates that Italy’s fatality toll has surged as a large proportion of patients have underlying health conditions. Experts have also warned against making direct comparisons between countries due to discrepancies in testing.