ROME (AP) – Italy could soon restore a record that no one wants – the most corona virus death in Europe – after the healthcare system once again failed to protect the elderly and the government delayed imposing new restrictions.
This was not supposed to happen. Italy was the first country in the West to be severely criticized for COVID-19, and after suffering a major wave of deaths in the spring, it was able to control the infection.
Then Italy used the time and experience before the re-emergence of the fall, as it left Spain, France and Germany with new large groups of injuries. However, the virus has spread rapidly and widely, and Italy has added 28,000 deaths since September 1.
“It is clear that some thinking is needed,” Guido Raci, former executive director of the European Medicines Agency, told state television after Italy reported a record 993 deaths in one day. “This number, which is close to 1,000 dead in 24 hours, is much higher than the European average.”
Italy added another 761 casualties on Friday, taking the official total to 63,387, which is just under 63,603 deaths in Europe, according to Johns Hopkins University. Both numbers are believed to significantly underestimate the number of true casualties, due to missed casualties, limited testing and different count criteria.
However, Italy could overtake Britain despite having 6 million fewer than the UK’s population of 66 million, and would only be left behind by the United States, Brazil, India and Mexico. According to the Hopkins census, Italy also has the highest number of deaths per 100,000 inhabitants among the countries most affected.
Public health officials argue that Italy has the second largest population in the world after Japan, and that the elderly are the most vulnerable to contracting the virus.
The average age of the Italian victims is around 80 years. In addition, 65% of Italian COVID-19 victims had three or more other health problems before they tested positive, such as high blood pressure or diabetes, according to Italy’s High Institute of Health.
But that does not explain the whole picture. Germany has a similarly outdated demographic, yet it is one-third of Italy’s death toll despite its larger population of 83 million. Germany recorded its highest daily number of coronavirus victims on Friday – 598 – but the total death toll did not exceed 21,000.
Analysts point to a rise in long-term healthcare spending per capita in Germany, which has resulted in increased ICU capacity, improved testing and tracking capabilities, and higher ratios of doctors and nurses to the population. But Germany also imposed an earlier and lighter lockdown this fall and is now preparing to tighten it.
“If you can act sooner, or even a little lighter in procedures, it works better than acting harshly a little later or later,” said Matteo Vella, a research fellow at the Institute for International Political Studies, a Milan-based think tank.
He said Italy had waited too long after the contagion began in September and October to impose restrictions and not sufficiently strengthened its medical system during the summer lull.
He said, “If you look at France and the United Kingdom, you can see that Italy has performed much worse.” “And if you look at a similar population with the same demographics, which is Germany, then Italy’s performance was much worse.”
With fears of another wave of infections approaching with the Christmas visits and the winter flu season, many are wondering how many will die.
Doctors blamed systemic problems in Italy’s healthcare system, and especially in the hardest-hit Lombardy region, for failing to respond adequately. They pointed to the growth of private hospitals in Lombardy in recent years at the expense of public hospitals. Mind-draining and bureaucratic obstacles led to fewer physicians entering the practice, while general practitioners complained of a lack of support despite being the backbone of the system.
Nearly 80,000 Italian health care workers have been infected and 255 doctors have died.
“We requested the closure at the beginning of November because the situation inside the hospitals was really difficult,” said Dr. Filippo Agnelli, president of the country’s medical association. “We saw that it worked in the spring and allowed us to get out of under COVID. If it does, then it’s likely that the numbers will drop today.”
But the Italian government has resisted the reimposition of the nationwide lockdown this fall, cognizant of the devastating impact on the economy that is only just beginning to return to life after the lockdown in the spring.
Instead, on November 3, the government divided the country into three risk areas with varying restrictions. But by that time, infections had been doubling every week for about a month and hospitals were already overwhelmed in Milan and Naples.
Italy also entered the pandemic poorly prepared. It had fewer intensive care beds than the average developed country. And in recent weeks, investigative news reports indicated that Italy had not updated its pandemic flu preparedness plan since 2006 – which may help explain the acute shortage of protective gear early on and its chaotic initial response to the pandemic.
A WHO report, published and then immediately removed from the WHO website, indicated that Italy’s 2006 plan had only been “reaffirmed in 2017” without updating it. The report said the plan was “more theoretical than practical” and that when COVID-19 struck, everything exploded.
“Unprepared for such a flood of critically ill patients, the hospitals’ initial reaction was improvised, chaotic and creative,” the report said.
The United Nations health agency said it deleted the report because it contained “inaccuracies and inconsistencies,” and then decided not to republish it because it had developed other methods to assess country responses.
Italy was also ranked 31 – between Indonesia and Poland – in a 2019 survey of 195 countries compiled by the Global Health Security Index to assess capacities to respond to a pandemic or other healthcare crisis. Italy scored particularly poorly in responding to emergencies, preparedness, and communicating with healthcare workers during the crisis.
Government officials admit they were caught unprepared, but have vigorously defended their response to the resurgence of scientifically sound and proportional to prevent the economy from collapsing. Domenico Arcuri, the government commissioner for virus control, said Thursday that the November restrictions are flattening the curve of infection in Italy.
“Daily injuries are decreasing, hospital admissions are decreasing, and unfortunately the number of people admitted to intensive care is decreasing,” Arcuri said.
This is comforting to Marcella Paula, who announced the death of her 90-year-old aunt on Facebook on December 6, saying she contracted the virus in hospital in October after complications after an angioplasty.
“My aunt was tough, made of Trentino fibers,” Paula wrote in explaining the unusual photo she posted of her aunt carrying herself on a set of gymnastics rings this year. “I want to remember it like this, even though the idea of her and many others die alone and then put them in a body bag hurts me.”
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