Please can someone explain why the death toll in Italy is escalating so much?

[Thelowquietsea]

I'm aware that there's a large number of elderly in Italy, they live intergenerationally, in fairly tight cities.

But they've been in lockdown for weeks. Why is the death toll jumping so significantly?

Because people flouted the social distancing and lock down measures.

Never going to happen here. Oh wait...

Because lockdown didnt happen soon enough!

Because coronavirus is extremely contagious and they didn’t contain it quickly enough
We will be the same here in a couple of weeks

Because it spread and then everyone was sent home to their family groups.

Because they never believed it would happen to them and kept on socialising, meeting up with friends, going to the park, visiting their older relatives... Do I need to go on?

I think it takes a long time for measures to make a difference. Say the incubation is 5/6 days (but up to 14) then it may take 4 weeks for someone to die.

They don’t actually know how long it incubates for do they ? They forced isolation earlier in the curve than us I believe and it’s still rising. I honestly believe we will be the worst hit country of all.

Because people with the virus have symptoms 5-14 days after catching it, and deaths happen 10-28 days after symptoms (average in China was 14). Hopefully after 3 weeks of lockdown the death rate will go down, if it doesn't the lockdown hasn't worked.

Because it spreads so fast and they locked down too late! They don't have beds to treat people.
People are watching what is happening there and still flouting the advice here. God help us all.

Don’t you watch the news?

The death toll is because their hospitals are overwhelmed and they can’t save people who, a few weeks ago, would have lived.

Because everyone flouted advice. Now the number of people needing intubation exceeds the number of available ventilation devices. Those on assisted breathing/intubation devices are not recovering fast enough for the number of cases coming in. It’s sobering.

Older population
High incidence of smoking
High levels of pollution in the north
Very tactile culture

Because they left the house to buy toilet roll.

I despair at the photos on social media about the lack of social distancing.

I haven't left my house in days apart from to walk my dogs on a country road.

My children have finished school, one who doesn't have a clue where he stands re: A levels.

But this is a small price to pay compared to having to bury loved ones.

Some people just aren't taking in seriously enough.

They have only been in total countywide lockdown for about 2 weeks, which isn't enough to show significant effects. Previous to that much of the country was, like the UK, on a self-policed "don't go out" ....

The average ICU stay for patients who survive is 21-24 days.
For patients who pass away it's around 18-19 days.
Most patients are ill for around a week before their condition worsens and requires ICU treatment.
We also know that the incubation period is 1-3 weeks.

So the patients dying now first showed symptoms around a month ago and were infected around 6-7 weeks ago!

Lockdown now will slow down the death rate in 6 weeks' time...

Agree. The lockdown really started on 8 March. If it’s effective, the deaths will peak 3-4 weeks later so around end of March. 25% of the population is also over 65 and Italians are really sociable and greet with a kiss. This means that it will spread more and that more will die (as the death rate rises sharply above 70).

The next couple of months will be really frightening both there and here.

Because people didn't understand that "STAY HOME" applies to them.

First, the capacity of the Italian health system
in Northern Italy is completely tapped out. They have run out of ventilators, beds, ambulances, and healthcare workers are getting sick and some are dying. What you see in the death toll is the result of them no longer being able to offer any help to those who need help breathing (and statistically that’s about 1 in 10).

For lockdown to really work, it has to happen before anyone can see much of a problem, because by the time the hospitals start to fill up it has been spreading silently for weeks and is too late. It was too late for Italy by the time they locked it down, and when they did, people still
did not really listen.

The UK is on a trajectory to be even worse off than Italy, I believe, based on current modeling. And bonus, the UK has half the ICU capacity that Italy has.

Incubation period is up to 14 days or possibly beyond. Then it may take a week or two for the illness to progress to the dangerous stage. And then maybe a day or two to die.

And even after lockdown, for any one person who got infected before lockdown and then self isolated with family, there is the incubation period and progressive worsening of family members to take into account.

If my son gets infected now, he may not be ill for another 2 weeks. Supposing he then passes it on to me. That may mean another week or two before I show any symptoms and perhaps an additional week before I'm a stretcher case. Make it a month in all.

So the people we are seeing dying now in Italy are likely to be the victims of infection brought into the house before the lockdown. The hope is that with strict lockdown the tide will start to turn and there will be fewer new infections.

In other words, even if we do lockdown tomorrow, we will still have to ride out the storm. If we do not do lockdown it will just carry on multiplying exponentially. We are, at a guess, 14 days behind Italy.

What is the demographic breakdown of Italian fatalities, does anyone know?

Apart from reasons everyone else has stated, Italy has a LOT of very old people with a lot of underlying/unmanaged health conditions like diabetes. It's famous for its large quantity of centenarians. I think this has been one reason why the healthcare system has been so overwhelmed.

This is a very illuminating article www.bloomberg.com/news/articles/2020-03-18/99-of-those-who-died-from-virus-had-other-illness-italy-says

They have announced nearly 800 deaths today, 550 of which in Lombardy. It’s horrific.

As previous posters have said, I guess they are so overwhelmed in that region that people are dying who shouldn’t through lack of necessary medical care.

And people are asking here if they can turf all the kids out to play on the street together....

It won't work here. Brits are too ignorant.

I live near the lakes, which is fully open. All the cafes are getting around it providing a 'takeaway service' so there are queues and groups all stood together. I'm absolutely disgusted. They're stripping all the local shops of provisions so the people who actually live there can't get anything. And to top it all if they get ill at their oh so safe holiday home they're going to end up taking one of our extremely limited number of ICU beds.

The lakes aren't going anywhere. It's always swamped. We don't really have a low season, those businesses that are doing well will continue to do so when this is over. The business owners have put sheer greed before lives. The people who have come here are selfish, brainless morons.

There was a lot of flouting of the lockdown.
The population is older, with a lot of smoking and other co-morbidities.
Italians tend to live in multigenerational houses - so when they did lockdown it spread round the whole family including granny and granddad.
Plus the dangerous stage kicks in around day 8-9 - lockdown takes a long time to have an effect on deaths.
Finally once you are on a ventilator, you may be on it for 3-6 weeks. Some of the deaths will be people who went on ventilators early who now are deteriorating or can't be weaned from ventilators so won't survive - so these won't show up until 4 weeks or so after they caught it.