THE ITALIAN COMPARISON
Chris Mitchell and Sara Belligoni explore why Italy has a far higher rate of dying from the coronavirus than Australia. Factors: more sociable, more smokers, older, more antibiotic resistance, higher retirement age, more density of living. And the old are more likely to live with their children. Read on: we're not about to become another Italy.
Chris Mitchell and Sara Belligoni explore why Italy has a far greater rate of dying than does Australia. Factors: more sociable, more smokers, older, more antibiotic resistance, higher retirement age, more density of living. Bottom line: we must not think we're about to become another Italy.
Back to Italian comparisons. A study from the Centre for Evidence-Based Medicine at Oxford University, updated on March 26, shows Australia’s case fatality rate (CFR) is at the low end internationally. With 13 deaths by last Friday morning from a total of almost 3000 cases Australia had a case fatality rate of 0.44 per cent. The CFR in Italy on March 26 was 10.09 per cent, in Iran 7.60 and in Spain 7.38. Case fatality rates are skewed upwards since the testing bias is towards those who are prime candidates for infection. The CEBM study says the CFR was higher in China earlier in the virus but three months on has now reduced to 0.7 per cent.
The study, like others in the past fortnight, gets interesting when discussing reasons for Italy’s high CFR: “The age structure of the Italian population (second-oldest population in the world); highest rates of antibiotic-resistance deaths in Europe, which might contribute to increased pneumonia deaths … with nearly one-third of the (antibiotic-resistance) deaths in the EU.” Smoking was a high risk factor given 28 per cent of Italian men smoke.
Most important of all was the high rate of “comorbidities” among victims. Professor Walter Ricciardi, scientific adviser to Italy’s Health Minister, says, “On re-evaluation … only 12 per cent of death certificates have shown direct causality from coronavirus, while 88 per cent of patients who died had at least one pre-morbidity — many had two or three.” Recording deaths WITH coronavirus rather than FROM coronavirus inflated the case fatality rate.
In a separate study, the Italian National Institute of Health, analysing 355 deaths, on March 17 said only three (0.8 per cent) had no prior medical conditions, while 49 per cent had three or more, 26 per cent two and 25 per cent one.
High blood pressure was a factor in 76 per cent of deaths, diabetes in 36 per cent and heart disease in 33 per cent.
Dr Giorgio Palu, professor of virology at the University of Padua, says politics played a huge part in the early spread of the virus in northern Italy. He told CNN, “There was a proposal to isolate people coming from the epicentre, coming from China. Then that became seen as racist …”
In early February, in response to such concerns, the mayor of Florence Dario Nardella launched a “hug a Chinese” campaign to fight this supposed racism. Unsurprisingly, the campaign received huge media support in Chinese state media.
None of this is to suggest Australia does not face its most serious health crisis since the Spanish flu 100 years ago, but it does suggest media claims we are directly following Italy may prove misleading. Journalists should not sugar-coat their reporting and undoubtedly many Australians will die in this pandemic as our hospital intensive care units face unprecedented pressure. Yet nor should journalists run with overblown international comparisons.
Sara Bellagoni has more:
There isn’t a lot of space in Italy for people to spread out in. Italy is a densely populated country, with an average density of 533 people per square mile. In comparison, Germany has a population density of 235 people per square mile while the U.S. has 94.
Two-thirds of Italians live in urban areas that are even more dense. Rome has 5,800 people per square mile, and Milan packs more than 19,000 people into every square mile. That’s almost twice the density of Berlin and Washington, D.C.
The percentage of young Italians living with their parents is also among the highest in the EU, with 66 per cent aged between 18 and 34 doing so in 2018, according to Eurostat, compared to an EU average of 48 per cent.
43% of 20–24 year-olds were living in the family home in 2016, up from 36% in 1981.
The ranks of 25-29 year-olds still at home had also grown from 10% in 1981 to 17% in 2016.