What’s the problem with Italy’s official coronavirus numbers?

There is growing evidence that the death toll and infection rate figures being reported daily by Italian officials may be much lower than the reality.

What's the problem with Italy's official coronavirus numbers?
More testing is needed in Italy for accurate figures, Italian experts have said. Photo: Tiziana Fabi/AFP

Since the coronavirus outbreak began in Italy in late February, the public has been relying on official government data for a picture of how many deaths, cases, and recoveries there have been in each part of the country, and how things are changing.

READ ALSO: How Italy has changed the way it reports the daily coronavirus figures

Italy's Department for Civil Protection releases these statistics daily at around 6pm. The data is then pored over by experts worldwide, looking for evidence that Italy's quarantine measures are containing the spread as hoped – and that other countries can confidently follow its example.

But a growing number of Italian experts have now said these numbers may not be completely reliable.

“For sure, the figures are wrong,” said Matteo Villa, a researcher at the Italian Institute for Political Studies and author of a new study (in Italian) titled ”Coronavirus: Lethality in Italy, between appearance and reality”

He that the death toll may have been underestimated by up to 6,000, or a third of the official total.

In total, Italian authorities have recorded 115,242 cases and 13,915 deaths as of Thursday, April 2nd.

Authorities acknowledge that the data are incomplete, as the death toll doesn't include people who died at home, or in nursing homes, or those who were infected by the virus but not tested.


“It is plausible that deaths are underestimated,” Higher Health Institute president Silvio Brusaferro stated. “We report deaths that are signalled with a positive swab. Many other deaths are not tested with a swab.”

The possible scale of the disparity showed up this week when death records for the month of March from different years were compared.

The data showed a very large difference between the number of Covid-19 deaths reported by authorites, and the total death toll in different Italian regions.

Experts have said the only explanation is that coronavirus deaths have been under-reported.

The deaths were “mostly attributable to the virus”, said Villa.

“Some of the increase will be people who die of other illnesses, because they cannot find a hospital bed due to the crisis,” Villa explained, “but that will be partly offset by the decline in road fatalities due to Italy’s lockdown.”

“For every two sufferers in Italy there is another one you can’t see,” he added.

Even higher numbers in Bergamo

Records released by town halls in Bergamo, at the heart of the outbreak in the worst-affected Lombardy region, show a number of uncounted virus deaths which may be even higher than Villa’s estimate.

Bergamo Mayor Giorgio Gori said on Wednesday he does not trust the official figures and thinks the real toll may be twice as high.

The mayor tweeted a newspaper analysis suggesting that the COVID-19 toll in the Bergamo province was “between 4,500 and 5,000, and not the 2,060” officially reported.

The explanation may be that Italy’s count of 115,242 cases is also incomplete, with estimates of the real number ranging from 400,000 to six million.

The mayor also cited analysis showing that 26 percent of Bergamo province's population may have contracted the virus.

Why is Italy's fatality rate so high?

From the offical figures, it appears that the fatalty rate in Italy is around 12 percent.

“That's a nearly impossible number;” Villa told Al Jazeera in a television interview on Thursday.

“We know from other research that the number of people who die are about one percent of those infected,” he said. “So there's something strange going on. Everyone's asking if Italy is special in any way, in terms of why people are dying so much.”

“The simple answer is, clearly not,” he said. “We are not testing enough people.”

These figures have been overestimated throughout the crisis, according to Nino Cartabellotta, a leading Italian public health expert, professor, and president of the Gruppo Italiano per la Medicina Basata sulle Evidenze (GIMBE), Italy's Group for Evidence-based Medicine.

Analysis by GIMBE of the official data appears to show that the mortality rate in Italy has long been well above average. 

Cartabellotta told The Local this rough figure is “undoubtedly overestimated” as “we're only seeing the tip of the iceberg”.

He calculates that, with further testing, the figure would eventually be found to be closer to 2.2 percent, in line with the rate in China.

The head of Italy's Civil Protection Department, Angelo Borrelli, has meanwhile said it's “credible” to believe there up to ten times more cases in reality than officially recorded.

Villa tweeted on Friday that “the difference between the official and plausible total cases is getting deeper.”

The data on official cases is getting “less and less reliable”, he wrote.

Member comments

  1. It is important that the way the figures are collected is not changed, what we need to know is the trend, although the figures are important, at this time we need to be able to see if the measures being taken are working or not. If suddenly the way the reporting is done we will have no idea what is happening.

  2. If this were handled like a real public health issue, we might have more confidence in the numbers being reported. However, every single country has politicized the pandemic because every single government failed to act on years of warnings to prepare for a pandemic and no government wants to admit how badly it has failed. It will be at least a decade before the dust settles and governments are willing/able to allow people to know the extent of the devastation of this pandemic.

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Covid face mask rule on flights in Europe set to be eased

The mandatory EU-wide mask requirement for air travel is set to be dropped from Monday, May 16th, but airlines may still require passengers to wear masks on some or all flights

Covid face mask rule on flights in Europe set to be eased

Europe-wide facemask rules on flights are set to be ditched as early as next week in light of new recommendations from health and air safety experts.

The European Union Aviation Safety Agency (EASA) and European Centre for Disease Prevention and Control (ECDC) dropped recommendations for mandatory mask-wearing in airports and during flights in updated Covid-19 safety measures for travel issued on Wednesday, May 11th.

The new rules are expected to be rolled out from Monday, May 16th, but airlines may still continue to require the wearing of masks on some or all of flights. And the updated health safety measures still say that wearing a face mask remains one of the best ways to protect against the transmission of the virus.

The joint EASA/ECDC statement reminded travellers that masks may still be required on flights to destinations in certain countries that still require the wearing of masks on public transport and in transport hubs.

It also recommends that vulnerable passengers should continue to wear a face mask regardless of the rules, ideally an FFP2/N95/KN95 type mask which offers a higher level of protection than a standard surgical mask.

“From next week, face masks will no longer need to be mandatory in air travel in all cases, broadly aligning with the changing requirements of national authorities across Europe for public transport,” EASA executive director Patrick Ky said in the statement. 

“For passengers and air crews, this is a big step forward in the normalisation of air travel. Passengers should however behave responsibly and respect the choices of others around them. And a passenger who is coughing and sneezing should strongly consider wearing a face mask, for the reassurance of those seated nearby.”  

ECDC director Andrea Ammon added: “The development and continuous updates to the Aviation Health Safety Protocol in light of the ongoing Covid-19 pandemic have given travellers and aviation personnel better knowledge of the risks of transmission of SARS-CoV-2 and its variants. 

“While risks do remain, we have seen that non-pharmaceutical interventions and vaccines have allowed our lives to begin to return to normal. 

“While mandatory mask-wearing in all situations is no longer recommended, it is important to be mindful that together with physical distancing and good hand hygiene it is one of the best methods of reducing transmission. 

“The rules and requirements of departure and destination states should be respected and applied consistently, and travel operators should take care to inform passengers of any required measures in a timely manner.”