Why is coronavirus killing so many people in Italy?

Coronavirus is hitting all around the world, but there’s no doubt that one country has been hit more harshly that any other: Italy. While the death tool has passed the 12.500 mark, about four times China’s, outside the country videos of Italian mayors freaking out at people walking in the street with their dogs or jogging become viral. “Italians can’t follow rules”, “Italians drink dirty water”, “Italians have a public – and therefore third-world – healthcare system”: you can read this kind of statements all around social media.

It’s not just a matter of racism: Italian medias and politicians are also spreading the idea that one person walking alone in a park is responsible for the contagion and the death of many, resulting in a progressive militarization of society and incredibly hard measures taken against anyone that isn’t behaving as the police likes. We are talking about people threatened by soldiers and reported to the police because they were walking alone 500 mt from home or surrounded and beaten because they were jogging (again, alone) on an empty road. The government has recently raised the fine for “not following the directives” to the astonishing amount of 3000 €.

Reality, though, tells a different story. A story about a country in ruins after decades of cuts to social spending and emigration, and governed by puppets that are completely prone to the desires of businesses.

We’ll examine the five reasons why so many people in Italy are dying, in the hope that this will help you readers from all around the world act so that your government doesn’t make the same mistake and lives can be saved.

- The demographic issue
- Austerity, the grim reaper
- Privatization, privatization, privatization
- The responsibility of businesses
- The role of pollution

The demographic issue

Italy is the second oldest country in the world, with 35% of our population over 65 years old. Is this because we eat well and live a nice life drinking aperitif with friends in a beautiful piazza everyday? No, actually it’s because there are no children. At the beginning of 2020, for every 100 deaths in Italy, there were only 67 newborn. Ten years ago the newborn were 96 for every 100 deaths. It’s the lowest rate since the foundation of the Italian state in 1861, when they started collecting data. The Italian population is decreasing by 116,000 people a year.

Are Italians not willing to have babies because they are “choosy” who prefer to stay at home with mamma rather than starting their own family? Again, no. There are no babies because young couples can’t afford them anymore. As reported by Istat, half of Italian workers earn less than 11€ per hour, and 6% make less than 7,50 € per hour. Most of the underpaid workers are young, and young workers also have to carry the burden of short-term contracts with no protections and a record low welfare spending.

As a result, 120.000 Italians have left the country in 2019, 3.000 more than 2018. 5.3 million Italians are registered as living abroad, one million more than just 8 years ago, and the real data is probably a lot higher because many migrants simply don’t register. Most migrants are young and many are doctors. 52% of European doctors leaving their country are Italian.

All of this means a higher prevalence of the elderly within the general population, affecting the economy and the healthcare system, which are unable to support the most fragile ones in case of an epidemic that is more dangerous to them than to anyone else. Old doctors, factory workers, truck drivers, salespersons and so on, must keep on working, and therefore get sick. It’s important to note that the minimum retirement age in Italy has been raised to 67 years old.

Austerity, the grim reaper

Many think that austerity in Italy is a product of the 2008 crisis, but actually our country started to severely cut social spending back in the early 1990s. In the 1980s Italy had 500,000 hospital beds, while today they are only 200.000. We have 3.2 hospital beds every 1000 people, while France has 6 and Germany 8. In 1980 there were 922 ICU beds for 100,000 people, in 2015 they were only 275. The number of hospitals in 1998 was 1381, while now they’re just 1000. 200 were cut over the last 10 years. In the meanwhile, the population has got older and sicker.

Between 2009 and 2018, 37 billion euros were cut from healthcare spending, resulting in a lack of doctors, nurses, social health workers, structures. Between 2009 and 2017, 6,2% of doctors and nurses jobs were cut (46.500 people). Measures that have reduced our healthcare system to a flicker. A shortage of staff – that the government is now, in the middle of the pandemic, hastily trying to repair by hiring thousands of volunteers among newly graduated and even retired doctors and nurses. In the meanwhile, the population got older and sicker.

Per capita expenditure in healthcare in different countries. Source: Eurostat

The madness of throwing old doctors into hospitals full of people affected by a sickness that specifically kills the elderly is self-evident, but many still are responding to the call, with the obvious yet tragic consequences. A 73 years old doctor died of coronavirus a few days ago, after he volunteered to help.

Privatization, privatization, privatization

As if the social spending cuts weren’t enough, the Italian healthcare system was largely privatized over the last decades. The Italian healthcare system is made of 51.80% of public hospitals and 48.20% of private ones, which provide public services and are then reimbursed by the state. In 1998 the ratio was 61.3 to 38.7%.

Lombardy, the region where there’s the vast majority of Covid-19 cases and deaths, has long been considered as the Eldorado of private healthcare businesses. Mostly thanks to Roberto Formigoni, governor of the region between 1995 and 2013, and currently serving a 5 year sentence of house arrest for corruption, indeed in the healthcare sector. With his link with the church-related healthcare businesses, he transformed Lombardy healthcare system into a market funded by public money in the order of billions. And his successors Roberto Maroni and Attilio Fontana the (current governor) have seamlessly followed his path.

As a result, 40% of hospital beds in Lombardy are private. And needless to say, private hospitals are far beyond the front line in the current epidemic of coronavirus. Unlike other countries (like Spain for example), Italy hasn’t taken any real initiative to seize or nationalize private hospitals, even if public ones are collapsing under the pressure of thousands of new coronavirus patients a day and field hospitals are built everywhere in Lombardy. 65 doctors and nurses were sent by Cuba to help our public hospitals, and the government is still protecting the private ones.

All the government was able to do was timidly asking for their help. A call that, shamelessly, some private hospitals replied to to make some more money, or at least avoid spending a nickel of their own. While public healthcare is facing an unbearable emergency, the San Raffaele hospital, one of the biggest hospitals in Milan, had the nerve to seek donations to build a new ICU in its gym. The San Raffaele is owned by a corporation valued at 1.65 billion Euros.

As a result, the Italian healthcare system is far from being up to the huge challenge it is called to. On social media, hundreds of people are reporting that hospitals refuse to test them and to hospitalize them, unless they aren’t able to breath anymore. But when you start having breathing problems, it’s often too late even to call an ambulance. A 48 years old woman from Brescia has died of coronavirus at home, and people are dying without having ever been examined by a doctor.

Hundreds of people are sharing their experience on social media, which is always the same: they start developing all the typical symptoms – high fever, cough, shortness of breath – call their doctor and the coronavirus national helping line to ask for a mask and for cure, and the answer is often “No mask, stay at home, call an ambulance if you can’t breathe”.

Even healthcare workers (including doctors and nurses) don’t get tested, even if they’ve been in contact with covid-19 patiens, unless they develop symptoms. But research shows that you can transmit a virus even when symptoms haven’t shown up yet, or even if they never show up. Thanks to the complete lack of prevention of contagion in hospitals, Sassari, in Sardinia, is experiencing an outbreak with 90% of covid-19 patients who are doctors and nurses.

The situation is so critical that the head of the Civil Protection Angelo Borrelli admitted that the real numbers of the contagion are probably 10 times higher than reported. Even many high level members of his staff have tested positive.

The responsibility of businesses

In Bergamo the tragedy has assumed the most catastrophic proportions. Coffins carrying coronavirus victims are transported away on military vehicles to be cremated elsewhere, because the local structures are full, and an astonishing video shows the amount of obituaries in the local newspaper.

The nearby Seriana valley has now been recognized as the third outbreak point of the epidemic started in late February and currently killing hundreds of Italians everyday, together with a few municipalities next to Lodi (Codogno among them) and the small village of Vo’ Euganeo, in the Veneto region. But unlike the other two, the Seriana valley wasn’t declared a “red zone” and put under lockdown – even though some of its towns have lost almost as many citizens in less than one month than in the entire 2019. Why?

Number of deaths in Bergamo, by year. Source: Isaia Invernizzi https://twitter.com/EasyInve/status/1243467630721273856/photo/1

Because of businesses. As journalists have reconstructed, both the Region and the Istituto Superiore di Sanità (the highest Italian health institution) wanted to put the area in lockdown at the beginning of March, but the government took time. Confindustria – the General Confederation of Italian Industry – opposed the decision to protect the interest of the many factories of the valley, and it was finally aborted. The factories kept on running and most still are, together with the epidemic.

Under the pressure of numbers and a much weaker pressure of big unions (CGIL, CISL and UIL – forced to act by a series of wildcat strikes), the M5S-PD government has decided to take action against businesses, by apparently ordering the closure of all the non-essential firms. Apparently, because the burden to decide what is essential and what isn’t has been left to companies, which can simply self-certify their importance for the national needs and keep on working. Big unions are timidly threatening to do local, sector-specific strikes, but as for now with no results.

The role of pollution

As many researches show, the risk of contracting viral pneumonia is higher in polluted areas. And the Po Valley, where are most of the covid-19 cases and deaths, has the worst air pollution in Europe. It is likely that air pollution, especially PM10 particles, have a role in transmitting the virus and maybe even in making people, especially the elderly, more vulnerable to coronavirus. And even if pollution has dramatically dropped over the last few weeks due to lockdown, its damages in lungs remain.

Source: https://www.eea.europa.eu/themes/air/interactive/pm10-interpolated-maps/

Environmentalist organizations have long called for measures to reduce the pollution in the Valley, and not only no one has ever listened, but the situation got worse over the last few years.

Conclusions

The reasons why Italy is facing thousands of deaths by coronavirus are mostly man made and could be avoided with decisions that weren’t only guided by profit. How many lives could be saved, if our country were a more equal one? Who’s responsible for the catastrophe we are living?