According to an analysis by Luca Dellanna in Italy, a huge number of Italian deaths have been going unregistered.
Comparing death rates in Corona-afflicted towns in North Italy this March with the statistics from March during previous years, he estimates that the differential could be as high as a factor of 5.
If this can be validly extended to Italy as a whole, the number of deaths there (more than 10,000 as of today) may in fact be approaching 50,000. That’s already almost 10% as many deaths as the 600,000-650,000 experiences in a typical year.
Or, almost every second death in Italy now accrues to COVID-19.
Of course, the “if” is doing a lot of work here. Are these small towns – accounting for 180 deaths out of Italy’s 6,820 as of March 24 – representative?
I didn’t cherrypick the data: I took all data I could find from towns in Bergamo or Brescia province regarding March 2020 data compared to March 2019. Of course, there is some selection bias: the journalists that dug up that data looked for it in the worst-hit towns.
But the effect would still be non-negligible.
Incidentally, I’d be very surprised if things were otherwise in Wuhan. When I was observing its epidemic, there were plenty of reports of dead people being cremated without testing for COVID-19 (a cold, but not unreasonable, decision, considering the shortages of test kits).
In recent days, relatives of the deceased in Wuhan during those two months have been offered to pick up the urns containing the ashes of their loved ones. One estimate, admittedly extrapolated from one crematorium to Wuhan’s other seven – that is, making the assumption that these crematoria all had similar capacities – is that there are 45,500 urns in total. Back of the envelope calculations. China’s death rate is 7/1,000. Wuhan has 11 million people, but let’s count all 19 million in its metro area. That’s 19M * .007 *2/12 = 22,000 expected deaths for China’s hardest hit region. This is obviously considerably higher than the official death toll of 3,295 and suggests an effective doubling of the death rate for Wuhan during January-February. This is not that far off from what Italy as a whole might now be experiencing this March.
One suggestion is that overburdened healthcare systems meant that many people who needed other, non-Corona operations expired instead. This is nonsense. It is very rare that operations are vitally needed within a matter of 1-2 months for survival. And these rare cases would in any case have almost certainly been greatly exceeded by just the numbers of lives saved due to reduced traffic accidents. There have also been recent reports darkly insinuating that the loss of 15-21 million cell phone subscribers in China during the epidemic was associated with the deaths of the contract owners. This is complete nonsense.