QED

Italians, Statistics, the Virus and Us

For the modern-day statistician, there are lies, damned lies and Covid-19. The morbid fascination with numbers of the infected, the recovered and the dead is distorting an understanding of the novel coronavirus. Newspapers are keeping score — by totals, by country, by state — with all the enthusiasm of cricket fans (although the runs are coming faster).

A dangerous extension of this tendency is to make comparisons – unfavourable for Australia with Singapore, for example, and increasingly with Italy, to serve as a threat for non-compliance with new rules. Italy, I understand well, having lived there from 1990 to 2001, so I set out to determine just how analogous that country’s situation is for us. The result: not at all.

The gross figures so happily quoted to instill fear are a total of 50,418 infected cases and 6,077 deaths (Deceduti). That is a mortality rate of 11.7%, compared with the reported 4% for China. So let’s look a little further into Italy. We immediately find that there is no “Italian situation”, but a crisis for the north. Of the 21 regions there is as much variation in infection rates as there is in dialect or criminality. Campanilismo, the “my belltower is better than yours” syndrome may also be applied to disease!

Here is the table of the incidence of Covid-19 in a sample nine of the regions, from north to south:

            Lombardy               17885 cases   3456 deaths   19%

            Emilia-Romagna  6390            816                 12.7%

            Piemonte                 4127               283                 6.9%

            Tuscany                    2144               91                    4.2%

            Umbria                       500                 16                  3.2%

            Lazio (Rome)          1272               53                    4.2%

            Calabria                      260                 8                    3.1%

                                                Sicily                            596                  8                    1.3%

The situation is already turning around. For the last two days the number of new cases in Lombardy has declined; in Bergamo and Brescia it has halved. The total new deaths is down from 651 to 602 a day. Here is the graph of the daily trend of positive cases:

The north is a special case. It has a high population density, is the centre of manufacturing industry and has a large Chinese workforce, employed in the factories which China bought out. When the virus first hit and Australia prohibited entry from China, political opposition to offending China prevented similar action. Workers returning after the New Year celebrations spread the virus.

But why was the death rate so high? The native Italians were sitting ducks. Italy has the second-oldest population in the world after Japan. The median age is 47 years, compared with 37 in China and 38 in the U.S. The median age in Italian hospitals is 67 years. Some 87 per cent of the virus deaths were of people older than 70 years. And 88 per cent had one or more pre-existing illnesses.

And here’s a surprising fact. Professor Walter Riccardi, scientific advisor to the Ministry of Health, says everyone dying in hospital, from whatever cause, is coded as a victim of the virus. In a re-evaluation by the National Institute of Health, only 12 per cent of the deaths showed a direct causality.

“The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus,”  the UK Telegraph reported. “… Eighty-eight per cent of patients who have died have at least one pre-morbidity – many had two or three.”

These rubbery figures show how misleading and, indeed, useless it can be to extrapolate from another country’s experience. There is no equivalence between Italians and Australians in age distribution, lifestyle or nutrition levels. Italians overwhelmingly live in apartments and, due to high youth unemployment, often with three generations in the one home. The old towns and villages with their narrow streets and close living are natural incubators, yet as the above figures show, the risk of death is not high, except for the elderly.

The lesson is that we should keep our eye on the death rate, not the case total.

In passing, it is worth observing that the Keynesians of the Treasury have lost none of their influence. Doubling welfare payments, especially for pensioners, to boost aggregate demand is a wilful waste of the nation’s resources. Where is the money coming from?

11 comments
  • Peter OBrien

    Geoffrey, thank you. A very timely article, in my view. The glib comparisons with Italy have disturbed me for some time. I touch on this point briefly in a piece which will shortly appear on this august site.

  • Stephen Due

    “Where’s the money coming from”? Good question! What about the horrendous economic destruction Australian governments are unleashing on our society? Scott Morrison has successfully adopted a pleasing pastoral demeanor – the advantage no doubt of years of church experience – but as usual he is not showing much imagination. Doctors have advice to offer. Enough is enough, however. Australian governments must stop acting as if we have unlimited wealth that can just be turned on like a fire hose.

  • Peter Smith

    I was airing my views, as I do, yesterday morning, on the last day my regular cafe was open. Well, we don’t want to get like Italy a lady remarked. One problem is that very few people look into things for themselves so they simply accept that what governments do is right. And the information we get is meaningless, like being told about the number of new cases. We need to know how many new cases there are requiring critical care in hospitals. That is why, as Geoffrey says, we need to focus on deaths, assuming that information is a little more reliable than is apparently coming out of Italy . I am not sure about the “death rate” because we simply have no idea how many cases there are which are mild or asymptomatic. And, finally, good news. Trump indicated this morning our time that he would soon open up the US economy. Saying something like: We have the sytems in place and the information to allow us to do two things at once. To continue to fight the virus and protect the vulnerable and also to get the economy going again. The cost of not getting the economy going would produce worse effects than the virus ever could. America to save the world again methinks. Trump is the man for the times, as Churchill was in 1940.

  • Biggles

    Whence cometh the money? As Uncle Roger would say, “They’re printing it, Brian”.

  • pgang

    Fake news in other words. Exactly what I’ve been advising people. It is this Italian lie that has people spooked the most. It is utterly shameful that it hasn’t been corrected for the public. I am still utterly gobsmacked by the massive over-reaction (an understatement) to this non crisis.
    Geoffrey the money will be stolen from the future, as always.

  • Tezza

    All very true, Geoffrey. But when all is said and done, Lombardy shows us how easily exponential growth in a new infection with serious consequences for some can overwhelm a shaky health care system. It’s just a matter of counting the surge in dead bodies of those who needed intensive care, regardless of the proximate cause of any particular death.

    Adding up your totals for the rest of Italy suggest they have serious problems too, though the national policies might succeed given the relatively earlier scale of the disease in the south and fewer Chinese worker carriers.

    For all the differences between Australia and Lombardy, I can easily envisage Australia replicating Lombardy’s experience, not least because of our universities’ amazing policies of free holidays in third countries for incoming Chinese students to circumvent our belated and selective border closures. Our surplus health capacity is not that great, and although our mortality rates are presently much better than Lombardy’s for reasons you mention, with infections doubling every 4 or so days, we’re only about 2 or 3 weeks of compound growth behind overwhelming our health system. Two or three weeks is not much time for very porous ‘social distancing’ and self-isolation policies to have effect.

    Since so many Australians now find compound growth a mystery (witness credit card debt and pay day lending) and since common sense and a sense of mutual obligation with one’s fellow citizens have obviously been destroyed by identity politics (witness Bondi Beach), I favour supporting the Government’s belated and messy policies, rather than undermining them.

    There’s some interesting investigative journalism awaiting anyone to track the Chinese student element of Australia’s infections. I notice the proportion of ‘foreign source’ infections in Australia’s daily data remains fairly high given belated and selective border closures, and the proportion of cases still ‘under investigation’ is high and rising. Some States seem to be releasing less compositional data by the week on the rising number of infections.

  • Wayne

    Agree with Peter. The WA site with virus stats does not have any information on how many of the positive cases rely hospitalization and how many of those require ICU treatment.

    Also the deaths in W.A to date as far as I can see are all related to cruise ships or overseas travel not from local transmission.

    I agree with those in the UK querying the actions being taken there which we are aping. They are calling it a panic pandemic. I fear we have massively over reacted and millions of people are unnecessarily being put in economic jeopardy.

  • Stephen Due

    The Australian tonight says: China has under-reported its confirmed COVID-19 cases by one third, or more than 40,000 infections, according to the South China Morning Post.
    The 40,000 infections were – wait for it – asymptomatic. The 80,000 they have officially reported include only the symptomatic ones. The full news report is on the SCMP website.

  • pgang

    Stephen Due, this whole thing has been nothing but a media beat-up. Electronic media now totally controls us. We can see that from the ongoing comments from those who still think that this is some sort of a global, world-ending crisis. From the empty schools, which are down to about 20% attendance. The news moguls have fulfilled their destiny.

  • DG

    Old people are vulnerable, as are those already unwell. So, isolate them, let the rest of us develop herd immunity. Apart from its parlous effects, the current other herd phenomena: mentality, is hilarious to watch. But I was excited to see the death rate at around 10%: a real example of decimation! I’m sure other Latinists would be similarly thrilled.

  • rod.stuart

    Why does Italy have a giant mortality rate, apart from the fact that the health system is overloaded?
    You manage what you measure, but just be sure you are aware of what you are measuring.
    https://wattsupwiththat.com/2020/03/24/the-italian-connection/

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