Version 1
: Received: 4 April 2020 / Approved: 6 April 2020 / Online: 6 April 2020 (15:17:12 CEST)
Version 2
: Received: 3 May 2020 / Approved: 4 May 2020 / Online: 4 May 2020 (18:38:16 CEST)
How to cite:
Pasquariello, P.; Stranges, S. Excess Mortality from COVID-19: Lessons Learned from the Italian Experience. Preprints2020, 2020040065. https://doi.org/10.20944/preprints202004.0065.v2
Pasquariello, P.; Stranges, S. Excess Mortality from COVID-19: Lessons Learned from the Italian Experience. Preprints 2020, 2020040065. https://doi.org/10.20944/preprints202004.0065.v2
Pasquariello, P.; Stranges, S. Excess Mortality from COVID-19: Lessons Learned from the Italian Experience. Preprints2020, 2020040065. https://doi.org/10.20944/preprints202004.0065.v2
APA Style
Pasquariello, P., & Stranges, S. (2020). Excess Mortality from COVID-19: Lessons Learned from the Italian Experience. Preprints. https://doi.org/10.20944/preprints202004.0065.v2
Chicago/Turabian Style
Pasquariello, P. and Saverio Stranges. 2020 "Excess Mortality from COVID-19: Lessons Learned from the Italian Experience" Preprints. https://doi.org/10.20944/preprints202004.0065.v2
Abstract
There is much discussion among clinicians, epidemiologists, and public health experts about why case fatality rate from COVID-19 in Italy (at 13.3% as of April 20, 2020, versus a global case fatality rate of 6.9%) is considerably higher than estimates from other countries (especially China, South Korea, and Germany). In this article, we propose several potential explanations for these differences. We suggest that Italy’s overall and relative case fatality rate, as reported by public health authorities, is likely to be inflated by such factors as heterogeneous reporting of coronavirus-related fatalities across countries and the iceberg effect of under-testing, yielding a distorted view of the global severity of the COVID-19 pandemic. We also acknowledge that deaths from COVID-19 in Italy are still likely to be higher than in other equally affected nations due to its unique demographic and socio-economic profile. Lastly, we discuss the important role of the stress imparted by the epidemic on the Italian healthcare system, which weakened its capacity to adequately respond to the sudden influx of COVID-19 patients in the most affected areas of the country, especially in the Lombardy region.
Keywords
COVID-19; case fatality rate; Italy; testing; health care system; demographics; comorbidites; epidemiological trends
Subject
Medicine and Pharmacology, Epidemiology and Infectious Diseases
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Comment:
Version v2 also includes a new version of the iceberg model, one based on newly available epidemic understanding and outcomes, which supersedes the one reported in version v1.
Commenter: Saverio Stranges
Commenter's Conflict of Interests: Author
Commenter:
Commenter's Conflict of Interests: Author