Higher excess mortality in March. But in April, 82% of the additional deaths were due to Covid
In total, from February 20 to April 30, the deaths due to Covid, according to the Istat-Iss analysis, were 28,561, of which the 53% in March and the 47% in April. This despite the sharp drop in numbers on excess mortality: it went from 26,350 in March to 16,283 in April, but with 14,420 victims from Covid in the third month and 13,426 in the fourth.
The reduction in the share of excess mortality not explained by Covid-19 “is a very important result documented in the report – we read – With the data available today we can only hypothesize two possible causes. IS increased diagnostic capacity of healthcare facilities and therefore Covid-19 cases have been more accurately diagnosed, or is indirect mortality decreased, not related to the virus but caused by the crisis in the hospital system in the most affected areas. The latter component, in fact, improves as the pressure on health systems“.
However, the figure remains high in some of the areas most affected by the pandemic: “The excess of mortality still remains high in April 2020, on levels similar to those of March, in the provinces of Pavia (135% more deaths than the 2015-2019 average), of Monza and Brianza (+ 101%) and of Milan (+ 98%) “, they add. Despite this, also due to the clearly higher absolute numbers and the peak reached at the end of the third month, from March to April the “most important decrease in terms of deaths and percentage variation is observed in Lombardy. The deaths for the total number of cases decreased from 24,893 to 16,190 and the excess of deaths compared to the average for the same months of the 2015-2019 period fell from 188.1% to 107.5% “.
“This positive result – continues the report – is due to the decrease in April mortality in many of the provinces that were first hit hardest by the increase in deaths in March. Bergamo is Lodi these are the areas where the decrease in mortality has been more pronounced, the excess mortality drops from 571% in March to 123% in April in Bergamo and from 377% to 79.8% in Lodi “.
However, it should be noted that in some of the provinces with a high and medium spread of the virus, there was an increase in mortality in April that was more consistent than that of the month of March, compared to the average for the same months of the period 2015-2019. This is the case, for example, of Sondrio (93% more deaths in April than 78% in March) or Trento (83% in April compared to 69% in March).
And to be most affected are the men in the two age groups between 70 and 79 years old is between 80 and 89 years old, “For which the cumulative deaths from 1 January to 30 April 2020 increase by more than 52 percentage points compared to the same period of the 2015-2019 average. Age class follows +90, with an increase of 48% “. On the other hand, the increase in mortality in the women, in all age groups: “At the end of April it reached 42% more than the average of the years 2015-2019 for the age group +90, which is the most affected by excess mortality. 80-89 class follows with an increase of 35% and 70-79 (31%) ”.
Italy divided into three: “Majority of cases in the North. Diffusion limited to the South and the islands “
In Italy, from the beginning of the epidemic (February 20) until May 25 (date of updating the database for the report), they were reported to the integrated surveillance system 227,719 positive cases Covid-19 diagnosed by regional reference laboratories, of which 209,013 until April 30. The peak of reported cases occurs in March, with 113,011 official infections, and decreases from April (94,257) and even more markedly in May (18,706).
“There geographic spread of the Covid-19 epidemic is heterogenous – explains the report – and for this reason the Italian provinces have been divided into three classes based on the distribution of standardized incidence rates to April 30: the first, defined a ‘low’ spread, includes the provinces with a rate of less than 60 cases per 100 thousand residents (34 provinces, mainly South is Islands), the second, defined a ‘media’ diffusion, includes the provinces with values of the rate between 60 and 150 cases per 100 thousand residents (32 provinces, largely Central Italy), the third class, a ‘high’ spread, includes the provinces with values above 150 cases per 100 thousand residents (41, in large part of theNorthern Italy) “.
Considering Covid-19 cases and deaths, 75% of the reported cases and 82% of the deaths are in the provinces defined as high-spread, 17% of the cases and 13% of the deaths in the medium-spread ones and respectively the ‘8% and 5% in low diffusion provinces “.