Italy's coronavirus death toll is much higher than reported, statistics bureau ISTAT said on Monday in an analysis pointing to thousands of fatalities that have never been officially attributed to COVID-19. In its first report of the epidemic's impact on Italy's mortality rate, covering 86% of the population, ISTAT said that from Feb. 21, when the first COVID-19 deaths occurred, until March 31, nationwide deaths were up 39% compared with the average of the previous five years. Of the 25,354 "excess deaths", the coronavirus was registered by the Civil Protection Agency as the official cause for 13,710, leaving around 11,600 deaths unaccounted for. These occurred overwhelmingly in the northern part of Italy most heavily hit by the virus. The statistics bureau said it was reasonable to assume these people either died of COVID-19 without being tested or that the extra stress on the health system due to the epidemic meant they died of other causes they were not treated for. Officially, up to May 3, the Civil Protection Agency recorded 28,884 coronavirus deaths, the second highest toll in the world after the United States. The tally only includes people who tested positive. The agency compiles data from the regions on deaths of people who tested positive for the virus and issues them in a bulletin at 6 p.m. every day. The agency normally manages the response to natural disasters such as floods and earthquakes. ISTAT's report, drawn up with Italy's National Health Institute, confirmed the massive concentration of the epidemic in the country's northern regions, where the vast majority of unreported deaths have also taken place. In March, deaths were up 49% nationwide compared with the average of the previous five years, ISTAT said. In the north they rose 95%, compared with an increase of 9% in the centre and an uptick of just 2% in the south. In the northern region of Lombardy, which includes the financial capital Milan and has been most ravaged by the disease, deaths were up 186% in March from 2015-2019. They increased by 47% in neighbouring Piedmont to the west and by 24% in Veneto to the east, a region where the outbreak first surfaced alongside Lombardy but which got it under control thanks to an effective testing and tracing policy. In Lazio, around the capital Rome, deaths in March were down 8% compared with the previous five years. The southern regions of Sicily and Campania, around Naples, also saw a decline in the death rate, though much smaller than Lazio's. Looking at individual cities, the worst-hit was Bergamo, near Milan, where deaths were up 568% in March compared with the 2015-2019 average. The nearby cities of Cremona and Lodi saw increases of 391% and 370% respectively. In Milan they rose 93%. In Rome, Italy's most populous city, which has been relatively lightly hit by COVID-19, overall fatalities were down 9% from the previous five years. The Sicilian capital Palermo also posted a 9% decline.
