To what extent Covid causes people’s deaths is one of the most debated (and objectively complex) questions by experts. The Higher Institute of Health has recently tried to take stock on the basis of available data by measuring how much the lethality rate has dropped from the beginning of the pandemic until today. In June of this year, the indicator that allows us to quantify it – that is the Case fatality rate (Cfr), relating to the deaths of the population of diagnosed and notified cases – shows the point of arrival of this downward trend.
19.6% to 0.2%
The crude CFR went from 19.6% detected at the beginning of the pandemic to 0.1% in June 2022, writes the ISS in the extended weekly report on the epidemiological surveillance of SARS-CoV-2 in Italy. In the latest update of this report it is explained that in January 2021 the raw Cfr “was equal to 2.4%, while in January 2022 it was equal to 0.2%. The same decreasing trend was observed in correspondence with both the standardized CFR with respect to the European population and with respect to the Italian population ”, explains the ISS.
The age structure of the Italian population
The high values observed in the first pandemic phase «are probably also due to the reduced diagnostic capacity. As is now well known, the average daily number of tampons carried out went from 3,110 in February 2020 to 175,970 in August 2022 (with a maximum value of 983,681 average daily tampons in January 2022) “. However, the ISS also notes that the values of the standardized CFR using as reference “the European population, on average younger than the Italian population, are always lower than the values of the standardized CFR which has the Italian population as a reference”. In other words, the lethality rate calculated at the European level is lower than the data referring to the Italian population. “This – concludes the ISS – suggests that the differences with other European countries, in terms of lethality, are partly due to the age structure of the relatively older Italian population”.
Ciccozzi: weighs the way in which deaths are counted
“It may seem that in Italy there is an excess of mortality compared to other European countries but by analyzing the data well for the same period of time and standardizing them by population, we see that Italy is certainly not worse than others, indeed sometimes it is better”, clarifies Massimo Ciccozzi, full professor of medical statistics and molecular epidemiology at the Campus Bio-Medico University of Rome. An important weight is the way in which deaths are counted. “The registration rules may also have been standardized, they are the same for everyone. Unfortunately, the way in which deaths are recorded are not the same for all doctors. If in the many causes of deaths, perhaps due to road accidents or otherwise, there is Covid in the death certificate, this is recovered as a Covid death, unless the doctor specifies the true cause of death despite having Covid “. Probably, according to Ciccozzi, “it is this different clarification in registering the main cause that varies from country to country that can explain a difference of up to 20% or perhaps more”.