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Italy’s staggering virus toll poses uncomfortable questions

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Italy's staggering virus toll poses uncomfortable questions
In this Thursday, March 26, 2020 file photo, military trucks moving coffins of deceased people line up on the highway next to Ponte Oglio, near Bergamo, one of the areas worst hit by the coronavirus infection, on their way from Bergamo cemetery to a crematory in some other location as the local crematory exceeded its maximum capacity. Italy is poised to reclaim the dishonor of reporting the most coronavirus deaths in Europe, as the second surge ravages the country’s disproportionately old population and exposes how public health shortfalls and delayed restrictions compounded a lack of preparedness going into the pandemic. (AP Photo/Luca Bruno, File)
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Italy could soon reclaim a record that nobody wants—the most coronavirus deaths in Europe—after the health care system again failed to protect the elderly and the government 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 28,000 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 another 761 victims Friday, bringing its official total to 63,387, just shy of Britain’s Europe-leading 63,603 dead, according to Johns Hopkins University. Both numbers are believed to greatly underestimate the real toll, due to missed infections, limited testing and different counting criteria.

Italy's staggering virus toll poses uncomfortable questions
In this March 28, 2020 file photo, a coffin is loaded onto a military truck to be taken with several others to crematoriums in Venice and Udine, from the San Giuseppe church in Seriate, near Bergamo, northern Italy. Italy is poised to reclaim the dishonor of reporting the most coronavirus deaths in Europe, as the second surge ravages the country’s disproportionately old population and exposes how public health shortfalls and delayed restrictions compounded a lack of preparedness going into the pandemic. (AP Photo/Antonio Calanni, file)

Still, Italy could overtake Britain despite having 6 million people fewer than the U.K.’s 66 million, and would trail only the much larger U.S., Brazil, India and Mexico. According to the Hopkins tally, Italy also 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 only 21,000 dead overall.

Italy's staggering virus toll poses uncomfortable questions
In this Nov. 7, 2020 file photo, a gurney containing a body of a patient who died overnight is seen in the sub-intensive COVID-19 unit of the Tor Vergata Polyclinic Hospital, in Rome. Italy is poised to reclaim the dishonor of reporting the most coronavirus deaths in Europe, as the second surge ravages the country’s disproportionately old population and exposes how public health shortfalls and delayed restrictions compounded a lack of preparedness going into the pandemic. (AP Photo/Alessandra Tarantino, file)

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.

Nicole Winfield