Why Is Italy Suffering So Much From Covid-19?

Medical personnel at work in the intensive care unit of the hospital of Brescia, Italy, Thursday, March 19, 2020. Italy has become the country with the most coronavirus-related deaths, surpassing China by registering 3,405 dead. Italy reached the gruesome milestone on the same day the epicenter of the pandemic, Wuhan, China, recorded no new infections. For most people, the new coronavirus causes only mild or moderate symptoms. For some it can cause more severe illness. (Claudio Furlan/LaPresse via AP)

ITALY (VINnews) — Italy is fast emerging as the country suffering most from the coronavirus pandemic, with more than 5000 people dead from the virus and hundreds more dying daily. Overwhelmed hospital staffers have had to make devastating decisions about who to treat and who they must allow to perish.

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Epidemiologists have been closely watching the Italian model to try and fathom why it has been so hard-hit in comparison with other countries in an attempt to learn more about the virus and the way it spreads. A new study by Oxford University researchers in the journal Demographic Science claims that the reason may be twofold: The country has the second-oldest population on earth, and its young tend to mingle more often with the elderly, like their grandparents, unwittingly infecting them and causing their deaths.

In Italy, 23 percent of the population is over age 65, compared to the US, where that population numbers 16%. “Extended longevity has played some role in changing the population structure,” University of Oxford demographer and epidemiologist Jennifer Beam Dowd, lead author of the new paper, told Wired.com. “But it actually has most to do with how rapid the decline in fertility has been in a population.” That is, it’s affected more by Italians having having fewer children than it is by them living longer.

At the same time, young Italians tend to interact a lot with their elders. Dowd’s Italian co-authors note that young people tend to live with their parents and grandparents in rural areas but commute to work in cities like Milan. Data on the composition of Italian households bears out this familial arrangement too.
The study’s authors argue that this frequent travel between cities and family homes may have exacerbated the “silent” spread of the novel coronavirus. Young people working and socializing in urban areas interact with large crowds, where they may pick up the disease and take it home. If they have no symptoms, they’ll have no clue that they’re infecting their elders, the most vulnerable population.

“We know now that the mortality is higher in older individuals, but what’s not clear yet is why,” says Carlos Del Rio, executive associate dean of the Emory School of Medicine at Grady Health System, who wasn’t involved in this research. For example, it could be a matter of older people having weaker respiratory systems, which could also lead to a higher mortality rate among seniors for diseases like pneumonia.

Other researchers studying why children don’t seem to get that sick from Covid-19 have pointed out the corollary: Children tend to have “pristine” lungs that have not already been damaged by a lifetime of inflammation caused by allergies, pollutants, and diseases. This might make them more resistant to the virus and they will not suffer symptoms even if they are infected.

Despite a full lockdown in Italy, the virus has already spread far and wide and caused untold harm already. But with this kind of demographic knowledge, public health officials can better confront the threat elsewhere, Dowd says. “One of the points that we were trying to make is that it’s not necessarily just about isolating the older population—we are identifying that they’re the most vulnerable—but the general social distancing that’s being encouraged to flatten the curve,” says Dowd. Flattening the curve means slowing the rate of new infections, buying researchers time to develop treatments and vaccines, and giving hospitals some respite. “I think our point was that’s actually more important when you have a higher fraction of your population that is vulnerable,” she says.

Israeli defense minister Naftali Bennett made this point bluntly when he told Israelis not to go near their grandparents, stating that potentially they could infect those closest to them. Such social distancing may be the key to protecting both the most vulnerable elements of the population and the entire public.


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