Experts say having one of the oldest populations in the world, a large number of cases concentrated in a small area and inaccurate statistics are contributing to the deadly impact the virus is having there.
At least 16, 327 People have now been diagnosed with the virus, making it the worst hit country outside of China , and are confirmed to have died.
Its death rate is 6. 27 per cent, according to the most recent data – the highest in the world.
In China the death rate is 3. per cent and scientists have suggested if that is higher than the true figure because many cases are likely to be going unreported.
Only Wuhan and the Hubei province around it have more cases of the coronavirus than Lombardy, the worst hit area in Italy, which is putting immense pressure on local health systems.
Milan’s Duomo cathedral is pictured almost deserted today as Italy is in complete lockdown as it grapples with the worst coronavirus outbreak outside of China
A municipal worker is seen spraying disinfectant in Piazza San Marco in Venice today. Tourism has all but stopped in Italy and citizens are banned from traveling
Italy has become the unlikely center of Europe’s – and the world’s – coronavirus crisis. It is the worst hit area outside of the Hubei province in China
Italy has become the unlikely epicenter of the world’s coronavirus crisis .
It yesterday recorded a massive 327 deaths in a single day and, on Monday, had at least 1, 720 new infections confirmed.
Even in the peak of its own epidemic, China – with a population times the size of Italy’s – never recorded more than 3, 2019 in a day.
Government complacency has been blamed for the speed at which the outbreak has gripped the country, but the age of its citizens may be what is causing the deaths.
Italy has the largest population of elderly people in Europe, with almost a quarter of people ( (per cent) aged
And the median age – the middle of the age range – is . 5 years old, according to the CIA – the fifth highest in the world.
For comparison, the UK’s median age is . 6 ( (per cent aged over) ) and the US’s is 5 5) (per cent over) ).
The older person is, the more deadly catching the coronavirus can be.
Age is known to be one of the biggest risk factors because the immune system and lungs are naturally weaker so the body is less able to fend off pneumonia, Which the virus causes in severe cases.
Research has found that aged people 80 or over have a 17. 8 per cent risk (one in seven) of dying if they develop COVID – , the disease caused by the coronavirus.
The local president of Lombardy, Attilio Fontana, confirmed: ‘All the deaths we’ve had are either very old people or very sick people,’ the New York Times reported.
Figures from the World Health Organization and Chinese scientists reveal that as the age of the patient increases, the greater their risk of dying
People queue up outside a supermarket in Rome today. People have been urged to keep their distance from others and to avoid forming crowds
Top-tier football teams Juventus and Inter Milan are pictured playing a match behind closed doors earlier this week – the Serie A league has since been put on hold as the government battles the outbreak
Experts say the UK – where the number of coronavirus cases started to take off last week – is just two weeks away from being in a situation as bad as Italy’s
A roadblock is shown at the Austrian border – Austria is now turning away Italian citizens who try to cross onto its soil without a certificate proving they’re coronavirus-free
People who have tested positive for coronavirus must not leave their homes for any reason.
Anyone with a fever or respiratory symptoms is urged to stay at home and limit social contact, including with their doctor.
NO TRAVEL ACROSS ITALY
Travel is only allowed for ‘urgent, verifiable work situations and emergencies or health reasons’. Grocery shopping is considered a ‘necessity’ and still allowed.
To avoid work-related travel, public and private companies have been urged to put their staff on leave.
Flights, trains and public transport will continue but Prime Minister Giuseppe Conte says he wants as many people as possible to stay at home.
People who do want to travel will need to fill in a document explaining their reasons for doing so and carry it with them.
NO PUBLIC GATHERINGS
‘All forms of gatherings in public places or sites open to the public’ are banned, the decree says.
Cinemas, museums, theaters, pubs, dance schools, betting shops and discos are all closed. Weddings and funerals are banned. Schools and universities will remain shut until April 3.
Bars and restaurants were only allowed to open between 8am and 6pm, the decree said, and only if a distance of at least 3ft could be kept between customers.
Sporting events of all levels and disciplines were cancelled – stopping play in the Serie A football league. Fixtures in international competitions can go ahead but will be played behind closed doors.
Gyms, sports centers, swimming pools, spas and leisure centers must close.
SHOPS MUST KEEP 3FT DISTANCE
Shops can remain open but only if they can guarantee the 3ft safety distance for customers.
Big and mid-sized shopping centers have to close at the weekend. Food stores are allowed to remain open at all hours.
NO LEAVE FOR HEALTH WORKERS
Leave for health workers is cancelled. People accompanying their friends or relatives to emergency units are not allowed to stay with them in the waiting rooms without express permission.
ALL OF ITALY IS COVERED
The entire country, including the islands of Sicily and Sardinia, is covered by the decree – covering a total population of some million people.
As patient ages decline, so do their chances of dying.
Between 74 and 74 years old the death rate is around 3.6 per cent, while it is more like 1.3 per cent for those aged 59 to .
For people in their s this drops to 0.4 per cent, and it’s just 0.2 per cent for those in their s.
People who have other long-term health problems , such as diabetes, heart disease or cancer are also at a greater risk because they have weaker immune systems than usual.
The vague symptoms of COVID – 23 infection also contributed to a delayed reaction to the outbreak, because it came during flu season.
A researcher at the Italian National Insitute of Health told
Time magazine: ‘The virus had probably been circulating for quite some time.
‘ This happened right when we were having our peak of influenza and people were presenting with influenza symptoms. ‘
Italians caught up in the country coronavirus outbreak may also be at particularly high risk because most of the cases are concentrated in a small area.
The northern regions of Lombardy and Veneto are the ones that have been hardest hit by the infection.
Lombardy is an area smaller than England with Milan as its only major city, but is host to more than 5, coronavirus cases, while the surrounding regions of Emilia-Romagna, Veneto and Piedmont contain the majority of the remainder.
This means Lombardy has more cases than any province of China outside of Hubei, of which Wuhan is the capital.
That region alone has more cases than Spain, France, Germany or the US do in total.
As a result local hospitals are under immense pressure, which means patients may not get the high quality care they need and the virus could be more likely t o spread in overloaded hospitals.
Experts also say that the true number of cases is not being recorded in Italy because the infection is spreading so fast and people with mild illness may not be counted.
This means the death rate appears higher than it is because all the deaths will be counted – most patients will have been hospitalized and diagnosed before dying –but not all the infections .
Krys Johnson, a disease expert at Temple University in Philadelphia, admitted: ‘We probably don’t know how many people have actually become infected,’ according to Scientific American .
The situation is so bad in Italy partly because the Government stopped testing people in late January unless they had been to China.
Strict rules had been put in place to test anyone with the symptoms of coronavirus but, after the Government banned all flights from China – it was the first country to do so – the testin g relaxed.
As a result, infected people are believed to have traveled to Italy from other countries.
The first confirmed patient is thought to have passed the virus on to at least five other people, including doctors and patients in the hospital he was taken to, before even being diagnosed.
Officials still don’t know how the man, a 56 – year-old in Milan, was infected, and there are fears the virus circulated for weeks before he was discovered.
Italy is the worst-hit country other than China, with (deaths and 7,) confirmed cases of the virus [subs: please update figures later].
The country has imposed the most restrictive measures since World War Two, with 20 million people now needing permission to travel.
HOW DID IT GET SO BAD?
(On January) stringent protocols were introduced which said anyone should be swabbed coronavirus if they have alarming symptoms.
But apparently these were lifted on January to only include people who had traveled to China.
Critics say this is down to Italy’s false sense of security because it believed it had put up robust border defenses against the virus.
The country had Stopped all direct flights from China – the only EU country to do so.
It had also introduced temperature-screening at airports – despite its highly questionable effectiveness.
While politicians in other countries – including Britain – conceded from the start that it was ‘inevitable’ coronavirus would arrive, and started to put protocols in place to cope with it, Italy had focused on putting up barriers in a bid to stop it entering the country.
WHAT HAPPENED NEXT?
By the time Italian politicians realized the virus had arrived in their country, it was too late to control it.
The first case was a 46 – year-old Italian man who had never been to China – known as ‘paziente uno’ or ‘patient one’.
He arrived at a hospital in Codogno near Milan on February 20 but was not initially tested for coronavirus.
Before he even got to hospital, he had infected his pregnant wife, a friend he went running with, and three elderly people in a bar he frequented.
In hospital he saw doctors four times before he was tested for the virus. He was eventually tested and diagnosed on 23 February – but even then there was a three-hour delay before he was put in isolation.
By then he had infected several staff members and patients.
SO WHO INFECTED PATIENT ONE?
Doctors are still to find out how he was infected. The implication is that the virus had been circulating in the community for weeks before ‘patient one’ was even infected.
WHAT DID THAT MEAN FOR ITALY?
Other) countries adopted an early strategy of ‘containing’ the virus – by identifying symptomatic people arriving from China and other affected countries, isolating them if they had symptoms, treating them in secure units if they tested positive, and tracking down anyone they had been in contact with.
This ‘track and trace’ strategy – which has been effectively used around the world to control the Sars, Ebola and Mers virus outbreaks in recent years – is essential to stop Imported cases from becoming ‘endemic’ within a country.
In Britain that phase of the coronavirus strategy is just coming to an end in Britain as the virus is now being transmitted within the community.
But in Italy the virus had escaped before the y knew it was even in the country.
WHAT OTHER MISTAKES HAVE BEEN MADE? Critics say once the decision was made to ‘lock down’ the virus, the implementation of protocols across the nation was left up to regional governments – and the way it was handled was patchy at best.
For example in San Marco in Lamis, in the Apulia region in south-east Italy, the body of a 74 – year-old man who died was released by health authorities before he was tested for coronavirus.
It later transpired he Had already infected his wife and daughter, who met dozens of relatives and friends at his funeral. Seventy of them are now in quarantine.
The episode has been described as ‘a catastrophic mistake’.
BUT WHY IS THE DEATH TOLL SO HIGH?
The rising number of deaths may in part be explained by Italy’s elderly population.
Around 27 per cent of Italians are aged over 81, making it the second oldest country in the world after Japan.
Initial data suggests the elderly and those with essential health conditions are more likely to die if they contract the virus.
Public health officials in Italy have been keen to stress that the average age of fatalities there is , with the vast majority aged over and already ill.
HAS) IT CR EATED A POLITICAL ROW IN ITALY?
Tensions have threatened to boil over concerning how Lombardy, Italy’s richest region, reacted to the outbreak.
In the early days of the outbreak, authorities there carried out widespread testing, even on those who displayed no symptoms.
The approach was described as ‘exaggerated’ by Italian Prime Minister Giuseppe Conte, who said the measures ‘would end up dramatising the emergency’.
Government officials suggested that the positive results for those with no symptoms could cause panic.
The blame game then saw officials in Lombardy hit back at Mr Conte for his refusal to adopt a proposal in February calling for the mandatory quarantine of students returning from China.
Attilio Fontana, president of the region, said: ‘They told us it was a racist behavior . ‘
On paper, the Italian Government’s draconian decision to place million in quarantine, could curtail the rampant spread of the virus.
But it remains entirely unclear if the measures are adequate given the virus is now in every region of the country.
The rules, which affect a quarter of Italy’s population, are too wide in scope to be strictly enforced by the authorities, leaving people to police themselves.
Though failure to comply with the measures can result in a small fine or three-months in jail, the measures are still being seen as advisory.