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Regional and temporal patterns of Italian COVID-19 mortality

BACKGROUND: Italy responded to COVID-19 with stringent lockdowns and a mass vaccination campaign. We describe the temporal and regional impact of these measures on mortality, along with social-behavioral correlates. METHODS: The analysis uses National Ministry of Health data on COVID-19 mortality (C...

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Autores principales: Sanmarchi, F, Golinelli, D, De Girolamo, G, Rucci, P, Stoto, M A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10595618/
http://dx.doi.org/10.1093/eurpub/ckad160.976
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author Sanmarchi, F
Golinelli, D
De Girolamo, G
Rucci, P
Stoto, M A
author_facet Sanmarchi, F
Golinelli, D
De Girolamo, G
Rucci, P
Stoto, M A
author_sort Sanmarchi, F
collection PubMed
description BACKGROUND: Italy responded to COVID-19 with stringent lockdowns and a mass vaccination campaign. We describe the temporal and regional impact of these measures on mortality, along with social-behavioral correlates. METHODS: The analysis uses National Ministry of Health data on COVID-19 mortality (CM), excess mortality (EM), and vaccine uptake, along with survey data. We calculate avoidable mortality (AM) as observed mortality minus the lowest regional EM rate in each period. RESULTS: In 2020-21 EM was 180,169, of which 76% were counted as COVID-19. This fraction varied from 13% in the South in Jun-Oct 2020 to 140% in the Northeast in Mar-Jul 2021. Impact varied across Italy, with EM and AM highest in the North during the first and second waves (Feb-Jun 2020 & Nov 2020-Feb 2021) and in the South afterwards (Mar-Dec 2021). After the first wave, there were 33,587 avoidable deaths, 41% of which were in the South. Higher rates in the North in Nov 2020-Feb 2021 were possibly due to less social distancing (e.g. avoiding social events and staying home from work/school), perhaps because residents of the North are more likely to be employed in private industry, which were more likely than public agencies to remain open. Higher rates in the South after Mar 2021 were possibly due to lower trust in hospitals and reduced vaccine uptake, particularly among those aged 80+. CONCLUSIONS: Official CM was differentially under-reported, so EM estimates provide a more robust picture of regional and temporal patterns of COVID-19 deaths. Mortality was high in the North in the second as well as first wave. It was high in the South afterwards (Mar-Dec 2021), accounting for 41% of avoidable mortality. KEY MESSAGES: • Excess mortality estimates provide a more robust understanding of regional and temporal patterns of COVID-19 deaths than reported COVID-19 deaths. • Heterogeneous impact of COVID-19 was associated with differences in preventive habits, trust levels, and vaccine uptake.
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spelling pubmed-105956182023-10-25 Regional and temporal patterns of Italian COVID-19 mortality Sanmarchi, F Golinelli, D De Girolamo, G Rucci, P Stoto, M A Eur J Public Health Poster Walks BACKGROUND: Italy responded to COVID-19 with stringent lockdowns and a mass vaccination campaign. We describe the temporal and regional impact of these measures on mortality, along with social-behavioral correlates. METHODS: The analysis uses National Ministry of Health data on COVID-19 mortality (CM), excess mortality (EM), and vaccine uptake, along with survey data. We calculate avoidable mortality (AM) as observed mortality minus the lowest regional EM rate in each period. RESULTS: In 2020-21 EM was 180,169, of which 76% were counted as COVID-19. This fraction varied from 13% in the South in Jun-Oct 2020 to 140% in the Northeast in Mar-Jul 2021. Impact varied across Italy, with EM and AM highest in the North during the first and second waves (Feb-Jun 2020 & Nov 2020-Feb 2021) and in the South afterwards (Mar-Dec 2021). After the first wave, there were 33,587 avoidable deaths, 41% of which were in the South. Higher rates in the North in Nov 2020-Feb 2021 were possibly due to less social distancing (e.g. avoiding social events and staying home from work/school), perhaps because residents of the North are more likely to be employed in private industry, which were more likely than public agencies to remain open. Higher rates in the South after Mar 2021 were possibly due to lower trust in hospitals and reduced vaccine uptake, particularly among those aged 80+. CONCLUSIONS: Official CM was differentially under-reported, so EM estimates provide a more robust picture of regional and temporal patterns of COVID-19 deaths. Mortality was high in the North in the second as well as first wave. It was high in the South afterwards (Mar-Dec 2021), accounting for 41% of avoidable mortality. KEY MESSAGES: • Excess mortality estimates provide a more robust understanding of regional and temporal patterns of COVID-19 deaths than reported COVID-19 deaths. • Heterogeneous impact of COVID-19 was associated with differences in preventive habits, trust levels, and vaccine uptake. Oxford University Press 2023-10-24 /pmc/articles/PMC10595618/ http://dx.doi.org/10.1093/eurpub/ckad160.976 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Public Health Association. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Walks
Sanmarchi, F
Golinelli, D
De Girolamo, G
Rucci, P
Stoto, M A
Regional and temporal patterns of Italian COVID-19 mortality
title Regional and temporal patterns of Italian COVID-19 mortality
title_full Regional and temporal patterns of Italian COVID-19 mortality
title_fullStr Regional and temporal patterns of Italian COVID-19 mortality
title_full_unstemmed Regional and temporal patterns of Italian COVID-19 mortality
title_short Regional and temporal patterns of Italian COVID-19 mortality
title_sort regional and temporal patterns of italian covid-19 mortality
topic Poster Walks
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10595618/
http://dx.doi.org/10.1093/eurpub/ckad160.976
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