As of the date that I am writing this (23/03/2020), there are many articles around the world, trying to investigate, explain, hypothesis on why Italy has been experiencing such high infection rates, and especially deaths, from the coronavirus pandemic.
The most common theory is that the aged population of Italy is the main factor behind the high deaths. According to I.Stat, Italy has 23.1 % of it’s population over the age of 65, second to Japan. With the majority of deaths in this age group (see statista,com), it makes sense, at first, that this is the main reason for Italy’s high death rate. But then, look at Japan. They only have 2.111 infected and only 57 deaths, and that is including the cases from the Diamond Princess (stats of 26/03/2020) – in comparison Italy had a total of 80.589 infected and 8.215 deaths. Age is clearly not the only factor.
Ironically, the Italian health system is questioned, in a very sweet-sour way. The health care is mostly free of charge for the elderly in Italy, and so, they receive high medical care, and are ‘blessed’ with living a little bit longer. However, this means that many of the elderly are being treated for some illness of sorts. Enter the Covid-19 virus, and these patients with a pre-existing illness quickly find themselves in the over-populated ICU. But, if we look at the virus death-rate from other European countries with similar health care, some even more advanced, this theory doesn’t add up.
There is also the Italian culture. The elderly are known not to be home-bound. They often socialise in the parks, at bars and coffee shops, visiting their grandchildren. Italians have a very personal social culture. They hug and kiss each other on both cheeks. These gestures contribute to the transmission of the virus, possibly explaining the quick spreading of the virus: from the grandchildren to the elderly, and then quickly among the elderly. But I have to argue that this culture cannot be the main cause: it is also a European culture, and many cultures around the world have close social gatherings. This still doesn’t efficiently, or effectively explain the Italian crises.
Maybe air pollution is a factor. The European Public Health Alliance (EPHA) announced that the pre-existing diseases from which the elderly have are also associated with high air pollution, especially pollution from vehicles: hypertension, diabetes, and respiratory illnesses. The areas in Italy which are the hardest hit are indeed also the most polluted. Even Wuhan, the origin of the virus, has high pollution. However, this has been dismissed my several professionals, as, once again, doesn’t quite match the statistics when one views the rest of the world.
The most popular cause of the Italian viral disaster is the delayed response by the Italian government when the pandemic broke out. To add salt into the wound, the Italian government had made many mistakes when creating the lock-down, mainly their lack in coordination, lack in communication, public announcements before taking action which allowed mass panic and mass escapes from the red zones. The virus spread quickly, and quickly to the countries ‘nonni’ (grandparents).
Then, there is also the lack of preparation for pandemic disasters. Italy had not action plan, no supplies, no back-ups. Hospitals quickly became under-stocked with essentials and equipment to fight the disease.
The most interesting theory comes from Norway. The Norwegian journalist, Erik Martiniussen, proposed his theory in the newspaper Aftenposten. Martiniussen had recently published a book called ‘The War on Bacteria’ (Krigen mot bakteriene), and, from this, he developed his idea. Italy has a problem with antibiotic resistant bacteria in its hospitals: one of the highest rates of antibiotic resistant infections in Europe. According to Martiniussen, Italy has nearly 11.000 deaths annually from antibiotic resistant related illnesses. In comparison, Norway has only 69. He states that Italy has a history of over-use of antibiotics, and therefore has a high number of people with antibiotic resistant bacteria. It is known that many patients who arrive in ICU, because their lungs are weakened by the virus, have secondary bacterial infections. In Italy, if many of the secondary infections are antibiotic resistant, what can the hero medical staff honestly do? They are defenceless.
However, in my opinion, Italy has a unique situation. A situation where all the above theories are in-play, and where many more are to blame. A unique situation which is actually universal. This could happen in many other countries, many other cities. If other leaders take a good note, and learn from the causes and mistakes, then, as the virus spread around the world, the Italian virus disaster won’t be repeated.