The Italian job

We’re constantly told that we’re going to be Italy in a few weeks (although that few weeks seems to be rather a moveable feast). But are Italy’s higher figures are in large part due to the way Italy records deaths?

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 was in the Telegraph, but otherwise the media has ignored this extremely important story.

There’s more:

But there are other factors that may have contributed to Italy’s fatality rates, experts say. This includes a high rate of smoking and pollution – the majority of deaths have been in the northern region Lombardy region, which is notorious for poor air quality.

Riccardi also points out that Italy has the second oldest population in the world.

Are we shooting ourselves in the foot over a records keeping issue? Is the the medical and economic equivalent of the Mars Climate Orbiter, which crashed because one team involved used metric measurements and another team used imperial? That cost $125 million. This is probably going to cost hundreds of billions.

The Covid-19 story is looking more farcical by the day. Nothing has been learned from previous health scares.

Update: Should also mention the large-scale Chinese numbers in northern Italy that have been mentioned elsewhere, but I don’t have anything solid on that.

I’ve also been sent some links to weekly death stats which I need to go through when I have a chance.

Update 2: I also note that significant use of Italian statistics in Neil Ferguson’s Imperial College paper (p. 16), that one behind the UK shutdown — he says:

In the UK, this conclusion has only been reached in the last few days, with the refinement of estimates of likely ICU demand due to COVID-19 based on experience in Italy and the UK (previous planning estimates assumed half the demand now estimated).

Update 2: 2018 article here on the Chinese workers in northern Italy. (Thanks to commentator Russtovich for this.

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4 thoughts on “The Italian job

  1. “Italy has the second oldest population in the world” – true, but it’s all pretty marginal. It’s not that different from most European countries, and certainly not enough to account for an apparent order of magnitude difference in death rates. I’ morally certain it’s the statistics, the Italians may be undercounting cases; they’re certainly overcounting deaths.

  2. My pal The Retired Epidemiologist says that (in the long ago) one of his projects was stymied by idiosyncratic data from Italy. He investigated: at that time cause of death in Italy was recorded by either (i) a doctor, or (ii) a nurse, or (ii) the deceased’s family.

    It seems they’ve changed the system?

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