Italy has developed into a hotbed for the deadly respiratory virus COVID-19, with 14,681 deaths as of 3 April. A soaring death rate overshadows their attempts to ‘flatten the curve.’ But with lockdown restrictions being enforced until at least mid-April, why is the death toll so high?

Distorted Figures

CNN reports distorted statistics of the disease’s impact in Italy are the result of inaccurate testing procedures. Head of the infectious disease unit at Sacco Hospital in Milan, Dr Massimo Galli, confirmed that the number of positive cases for the virus in Italy is “not representative of the entire infected population.” The correct number is actually “much much more.” The fatality rate is increased when only the most severe symptoms in highly susceptible areas are the ones being tested. The totality of asymptomatic patients is in turn neglected.

Limited Protective Gear

The limited availability of protective gear to health workers creates an additional issue to effective patient testing. Many doctors working on the front line are being infected. The Guardian reports the deaths of 77 health workers succeeding the virus outset in Italy. Areas most intensely infected, such as the region of the Lombardy, hold hope that a new wave of cases does not ensue. Galli compares the situation to “a man submerged into the sea with the tip of his nose still being able to reach the surface. He is still breathing, but also hoping that a new wave doesn’t come.”

Elderly Population

Italy’s high elderly population is second largest in the world, behind Japan. Al Jazeera reports the average age of deceased positive-testing patients to be 78. The social matrix of Italian society sees many elderly living and interacting with family members on a daily basis. An entirely new construction of cultural norms is being enforced by preventative measures within these communities. Spending time with loved ones is being punished rather than celebrated. The Istituto Superiore di Sanità (ISS) concluded that 48% of the deceased had an average of three pre-existing conditions, demonstrating how the virus truly attacks the old and vulnerable. For this, the imperative to protect them is clear.

Executive Approach

Lastly, the Italian government’s hesitant approach towards imposing this imperative has been scrutinized. The identity of the initial contagions in Italy posed a mystery for a long period of time. Patients testing positive in regions with no announced COVID-19 cases confused the authorities. This may have influenced late decisions by the Italian Executive to enforce restrictions leveling those of China.

Dr. Giorgio Palu, former president of the European and Italian Society for Virology, points out that this may root from Italy’s democratic government framework. Palu suggests that less severe implementation and more acknowledgment of constitutional rights could be behind Italy’s slower response to COVID-19.

A significant fraction of the international community is already in lockdown. Yet many are still hesitant to enforce aggressive containment measures over fears of economic downfall. Economic security should be of secondary concern in the face of a threatening epidemic. Prioritising the former is risky. Italy did not implement lockdown regulations quickly and is now facing the consequences of inaction.

Italy’s death rate may be reflective of slow preventative measures or a large elderly population. However, what proves most crucial for the near future is abiding by temporary health and safety measures, and providing mutual support. Without these, it is difficult to envision halting the sweeping force that is the Coronavirus pandemic.