Loads of people have been wondering why the beautiful Mediterranean country has become the new epicentre of the coronavirus pandemic.
Experts list a range of reasons – from Italy’s relatively high age to its strained healthcare system to some old fashioned bad luck – that add up to a disaster not seen in generations.
None of the answers alone explain why the nation of 60 million accounts for over a third of the nearly 11 500 deaths officially reported across the 7.7 billion strong world.
But other countries will want to examine each of these factors and address them through various preventive measures in their bids to avoid becoming the next Italy.
One of the first factors almost everyone who looks at the figures points to is Italians’ average age.
It is high.
The median age of the overall population was 45.4 last year – greater than anywhere else in Europe.
It is also seven years higher than the median age in China and slightly above that of South Korea.
Figures released Friday showed the age of Italians dying of Covid-19 averaging out at 78.5.
Almost 99% of them were also suffering from at least one pre-existing condition or ailment.
Italy’s mortality rate among those infected with the virus is thus a relatively high 8.6%.
“Covid-19 fatalities are hitting older age groups hard,” University of Oxford professor Jennifer Dowd noted on Twitter.
“Countries with older populations will need to take more aggressive protective measures to stay below the threshold of critical cases that outstrip health system capacities,” Dowd said.
Yet Japan’s median age of 47.3 makes it an even older nation than Italy – and it has just 35 officially registered deaths.
So age is clearly not the only factor.
Some scientists think that it could really have been almost any other country after China.
“I think the question of ‘Why Italy?’ is the most important question and it has a simple answer: No reason at all,” Yascha Mounk of Johns Hopkins University told Canada’s CBC television.
“The only thing that makes Italy different is that the first couple of (locally-transmitted) cases arrived in Italy about 10 days before they arrived in Germany, the United States or Canada.”
More than 4 000 people have died in Italy in the month since a 78-year-old builder from the Lombardy region of Milan became the first known European fatality of Covid-19.
European nations such as Spain and France are now following Italy’s trajectory and could theoretically have as many deaths and infections in a few weeks.
“If other countries are not going to react in exactly the right way, they are going to become Italy,” said Mounk.
The grim reality learned across Italy’s devastated north is that diseases start spreading much faster once the healthcare system reaches its saturation point.
Doctors have to start making life and death decisions about whom they help first – and why – when they run out of equipment such as respirators and even beds.
“Sometimes you have to weigh the chances of success against the patient’s condition,” Brescia hospital’s emergency unit head Paolo Terragnoli told AFP this week.
“We try to do our best for everyone, while doing an extra something for those who have better chances.”
Old and frail patients who are turned away are extremely contagious and – tragically but realistically – fated to die.
One of the Italian government’s gravest fears is that the virus will start spreading to Italy’s much poorer and far less equipped south.
Screening and counting
The world has suddenly realised that it does not have enough test kits to screen for Covid-19.
Nations such as Italy dealt with this problem by only testing those who already exhibited symptoms such as a fever and a dry cough.
South Korea had the kits and the means to conduct more than 10 000 tests a day.
Germany followed a similar model and its death rate began to drop once even the mild Covid-19 infections began being counted.
This partially explains both why Italy’s mortality rate is so high and why Covid-19 was contained faster in some other countries.
Harvard University professor Michael Mina said that 100 000 tests per day “might be optimal” for a country such as the United States.