So Many Deaths In Italy, Despite Lesser Number of Infection As Compared To China. Where Does India Stands?

Italy had one of the largest number of deaths as compared to any country due to the Global Epidemic Coronavirus also known as Covid 19.

Lets Look at the stats first

Countries most affected by infection

The country’s high death toll is due to an ageing population, overstretched health system and the way fatalities are reported

The coronavirus pandemic is exacting a heavy toll on Italy, with hospitals overwhelmed and a nationwide lockdown imposed. But experts are also concerned about a seemingly high death rate, with the number of fatalities outstripping the total reported in China.

Of the 63,927 people confirmed coronavirus patients in Italy, 6,077 so far have died. By contrast China has many more cases, 81,496, but 3,274 fatalities.

In very crude terms, this means that around nine per cent of confirmed coronavirus patients have died in Italy, compared to four per cent in China. By this measure Germany, which has so far identified 28,865 cases and 118 deaths, has a fatality rate of just 0.4 per cent.

So why the disparity?

According to Prof Walter Ricciardi, scientific adviser to Italy’s minister of health, the country’s mortality rate is far higher due to demographics – the nation has the second oldest population worldwide – and the manner in which hospitals record deaths.

“The age of our patients in hospitals is substantially older – the median is 67, while in China it was 46,” Prof Ricciardi says. “So essentially the age distribution of our patients is squeezed to an older age and this is substantial in increasing the lethality.”

A study in JAMA this week found that almost 40 per cent of infections and 87 per cent of deaths in the country have been in patients over 70 years old.

And according to modelling by Imperial College, London the majority of this age group are likely to need critical hospital care – including 80 per cent of 80-somethings – putting immense pressure on the health system.

But Prof Ricciardi added that Italy’s death rate may also appear high because of how doctors record fatalities.

“The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus.

“On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three,” he says.

What Is Morbidity and What It Means for Your Lifespan

Morbidity is any physical or psychological state considered to be outside the realm of normal well-being. The term morbidity is often used to describe illness, impairment, or degradation of health, especially when discussing chronic and age-related diseases which can worsen over time. The higher your morbidity, the shorter your lifespan may be that if you were healthy.

Morbidity vs. Mortality
While morbidity refers to your level of health and well-being, mortality is related to your risk of death. They are not the same thing. Morbidity doesn’t necessarily mean that your ill-health is immediately life-threatening. Over time, however, if an illness continues it may increase your risk of mortality (death). Current research shows people are now living longer with diseases than they once were.

Co-morbidity refers to multiple disorders occurring in the same person. While co-morbid conditions are not linked to the same cause, they may frequently occur together. For example, insomnia and anxiety are often co-morbid, though they are unlikely to have the same cause.

Compression of Morbidity Efforts
James Fries Ph.D., a professor of medicine at Stanford University, introduced the “compression of morbidity” theory, which focuses on preventing the onset of chronic illness later in life to increase life expectancy. The goal is to have shorter illnesses, later in life. Preventive measures like regular check-ups, adequate exercise, a healthy diet and the like are all measures meant to create a compression of morbidity. Medical and lifestyle interventions are aimed at preserving health and wellness for as long as possible before mortality (death) occurs.

Most Common Forms of Morbidity
Heart disease, cancer, chronic lower respiratory diseases, stroke, Alzheimer’s disease, diabetes mellitus, pneumonia and influenza, kidney disease and suicide accounted for almost 75% of deaths in the U.S. in 2013. Seven of the 10 leading causes of death are chronic diseases. Two, heart disease and cancer, account for nearly half of US deaths each year.

The prevalence of chronic disease remains steady, but the infectious disease has had an uptick in recent years thereby increasing morbidity. In addition to infectious diseases, food borne illness, associated infections and sexually transmitted diseases also contribute to higher morbidity among Americans.

This does not mean that Covid-19 did not contribute to a patient’s death, rather it demonstrates that Italy’s fatality toll has surged as a large proportion of patients have underlying health conditions. Experts have also warned against making direct comparisons between countries due to discrepancies in testing.

Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, says that countries do not yet have a good indication of how many mild infections they have.

If further testing finds more asymptomatic cases spreading undetected, the mortality rate will drop.

“It’s too early to make a comparison across Europe,” he says. “We do not have detailed sero-surveillance of the population and we do not know how many asymptomatic people are spreading it.”

Prof McKee adds that testing is not currently consistent across the continent, or world.

“In Germany, epidemiological surveillance is more challenging – simply because of the complexity of working in a federal state and because public health is organised very much at the local level.”

But there are other factors that may have contributed to Italy’s fatality rates, experts say. This includes a high rate of smoking and pollution – the majority of deaths have been in the northern region Lombardy region, which is notorious for poor air quality.

And there’s also no question that parts of Italy’s health system have been overwhelmed with a surge of coronavirus patients and are struggling to cope.

“Doctors in Italy haven’t been dealing with one or two patients in care… but up to 1,200,” says Dr Mike Ryan, health emergencies programme executive director at the World Health Organization. “The fact they’re saving so many is a small miracle in itself.”

This pressure is likely to get worse as more healthcare workers are infected and have to isolate – already, 2,000 have contracted the virus in Italy.

“There are three factors involved in Italy: one is that it is a much older population, two the health system was overwhelmed, and three there has been a significant loss of health workers because of a high coronavirus infection rate among them,” says Prof McKee.

Lets Talk About India.

India has a population of 135 crores, out of which 30% lives below the poverty line.

India has improved its ranking on a global healthcare access and quality (HAQ) index from 153 in 1990 to 145 in 2016, yet ranks lower than neighboring Bangladesh and even sub-Saharan Sudan and Equatorial Guinea.

India is worse than Bhutan, Bangladesh in healthcare, ranks 145th globally which Prime Minister Narendra Modi already accepted in his second address to the nation on 24th March 2020. Modi Clearly & Openly accepted that countries like USA, Italy are much advance and higher in terms of healthcare than India, he is the first prime minister to say so and accept this scary fact, he should be applauded once again by Taali-Thaali-Ghanti that atleast he accepted it, but the question stands, what has been done in last 6 years to improve this?

How ready India was to tackle this situation? why in the last 6 years no reforms in healthcare has been observed, rather than focusing on temples & mosque and hindu and muslims?

According to latest stats, at 8 PM, 26th March 2020, India has approx 649 number of coronavirus positive cases in India and the number is exponentially increasing despite the total lockdown in the entire nation for the last 2 days.

The Ironical part is that, cases registered for violation of rules during the lockdown has also increased at the same rate of spreading of coronavirus positive cases. More surprising was the evening of 22nd March 2020 when modi requested everyone to clap from their home and our learned citizens came on roads as if India has won the world cup. 

Lets Have A Look At The Violations Happened In India During The Lockdown

1. 3,000 cases registered for violation of. rules.

2. The Tamil Nadu police has booked over 1200 people for violations

3. On the first day of lockdown in Kerala on Tuesday, the police have registered 402 cases across the state for violating guidelines. Kerala arrests 2,535 people on first day of lockdown, The police also seized 1636 vehicles and registered cases against 3612

4. 100 Cases Filed In Delhi For Lockdown Violation

5. 149 Cases Filed In Odisha For COVID-19 Lockdown Violations

6. 50 booked for lockdown violation in UP’s Muzaffarnagar

7. Gujarat police detained 426 people in the last 24 hours for violating lockdown rules, files 238 cases for violations of lockdown.

8. 46 Criminal Cases Registered For Violating Lockdown In Jajpur

9. Over 180 cases registered, 5,103 people detained for violating lockdown in Delhi.

Almost every major city & state in the country has observed people violating the rules of lockdown. 

Will it be easy or lets say possible to control spread of coronavirus with such people in India? Not just common public even many leaders from ruling and other parties have also broken the rules of the lockdown.

Amid social distancing protocols and a nationwide lockdown, Uttar Pradesh Chief Minister Yogi Adityanath early on Wednesday participated in an event to shift the idol of an infant Lord Ram to a temporary structure in the Ram Janmabhoomi compound in Ayodhya till the construction, Now you realize why supreme court calls Uttar Pradesh a jungle raj?

Think of a nation where the leaders, that too leaders of ruling parties are breaking the protocols of the lockdown and are worried about statues, temples even during the global epidemic crisis that too when the top leaders of their own political parties are requesting the common public with folded hands not to come out of their homes and strictly follow the lockdown.

Well at this crisis time, it is really not right to talk about politics and everyone should stand united to fight against this global issue, but at the same time, only situation like these test intelligence, preparation, unity, leadership, understanding and maturity of the Future Global Leaders.

We really once again wish Our Honorable Prime Minister Narendra Modi, a very best of luck for fighting this tough situation, but also insist him to be well prepared in advance, these situations are to be dealt with advance preparation and not to dig wells just before the fire, Just imagine and plan well for the situation if this disease spreads among the BPL living in India who do not even know the meaning of sanitization and social distancing.

The Article is written by the editorial team of Inventiva based on the relevant facts & data collected from several recognized & top media houses of India, Italy, UK, France, Australia, Japan,, Spain, Iran, China. The writer in the article is only giving an opinion based assumption dependent on the data and stats available with media houses around the world. The writer do not want to hurt anyone’s emotions, religious sentiments but is only trying to put the facts.