We should not compare ourselves to Italy

[Mumlove5]

A lot of people are in fear because of what is happening in Italy and it is devastating.

However, Italy is a different country. Every winter and flu season they have a high mortality rate because of their demographics and because of high pollution in the Lombardy region.

A short clip to help:

“ Italy showed a higher influenza attributable excess mortality compared to other European countries. especially in the elderly”

In recent years, Italy has been registering peaks in death rates, particularly among the elderly during the winter season. Influenza epidemics have been indicated as one of the potential determinants of such an excess. The objective of our study was to estimate the influenza-attributable contribution to excess mortality during the influenza seasons from 2013/14 to 2016/17 in Italy.

Methods
We used the EuroMomo and the FluMomo methods to estimate the annual trend of influenza-attributable excess death rate by age group. Population data were provided by the National Institute of Statistics, data on influenza like illness and confirmed influenza cases were provided by the National Institutes of Health. As an indicator of weekly influenza activity (IA) we adopted the Goldstein index, which is the product of the percentage of patients seen with influenza-like illness (ILI) and percentage of influenza-positive specimens, in a given week.

Results
We estimated excess deaths of 7,027, 20,259, 15,801 and 24,981 attributable to influenza epidemics in the 2013/14, 2014/15, 2015/16 and 2016/17, respectively, using the Goldstein index. The average annual mortality excess rate per 100,000 ranged from 11.6 to 41.2 with most of the influenza-associated deaths per year registered among the elderly. However children less than 5 years old also reported a relevant influenza attributable excess death rate in the 2014/15 and 2016/17 seasons (1.05/100,000 and 1.54/100,000 respectively).

Conclusions
Over 68,000 deaths were attributable to influenza epidemics in the study period. The observed excess of deaths is not completely unexpected, given the high number of fragile very old subjects living in Italy. In conclusion, the unpredictability of the influenza virus continues to present a major challenge to health professionals and policy makers. Nonetheless, vaccination remains the most effective means for reducing the burden of influenza, and efforts to increase vaccine coverage and the introduction of new vaccine strategies (such as vaccinating healthy children) should be considered to reduce the influenza attributable excess mortality experienced in Italy and in Europe in the last seasons.

www.sciencedirect.com/science/article/pii/S1201971219303285

Piers Morgan has been intimating we are, every morning for over a week

Piers Morgan has been saying every country, not just the UK, is on the same path as Italy?

If that's the case then he's an idiot. However, I suspect although without watching I can't confirm that he has been saying the UK is following a similar path.

But there are some people who cling to that first graph

The only way plotting the death rate side by side could be accurate is if the uk population was hit much harder than Italy, with the older and vulnerable population being more widely infected, bringing the death toll back to the same number,

It’s not really analysis or any form of forecast, because analysis would be to plot rate of infection, demographics, death rates and then compare the two countries.

SO if the Uk sould not compare themselves to Italy why are they building new hospitals and actully doing similar things to what Italy has been doing

Because it will still be bad and we need to prepare for reasonable worst case, as many countries are.

Of course we should compare to Italy. Italy is our crystal ball to understand this and what we need to do wrt ventilators and ICU beds etc

Poor Italy didn't have that luxury

And Italy may have other problems but we also have fewer ICU beds per head of population than them (which thankfully seems to be being recognised and rectified now)

It has helped me to adjust and get my head around this, seeing what is happening there means I know what is coming and understood what lockdown meant before it happened. It meant I could explain to my DD that her best friend who is an ICU nurse is about to have possibly the worst time of her life.

Even if our numbers are slightly netter than Italy, whichever data model you use, it's going to be fairly close and still bloody awful. I don't like having false hope. I prefer to realistically know what's happening .

@cornishdreams1
I didn’t mean it that way. We’re on this site so was referring to only this site.

@LivinLaVidaLoki

Exactly. Thank you. Dr. John Ioannidis from Stanford University made very reassuring points.

We’re on this site so was referring to only this site.

But this site doesn't solely comprise of mums.

It’s called MUMsnet. Fine, I’ll change it to “parents on here seem”

Of course we should compare to Italy

But we do need to do so accurately to be able to project .

Basic and fundamentally flawed methodology tells us nothing, you can’t say simply just comparing two death numbers is in any way analytical or gives us the ability to forecast. .

As said, we need to factor in speed of acceleration through the population, demographics, death rates across those demographics (they differ hugely) etc, and then map the two countries, to have any idea of the trajectory and comparisons.

If any analyst simply put the two numbers side by side then projected we were following Italy they’d likely be fired on the spot. And mocked in the media.

Comparing our selves to other countries is worth it I think, but only if it’s done correctly, some basic table showing deaths per day is not something that is meaningful in any way shape nor form.

I'm neither a Mum nor am I anxious but the growth rate in deaths is tracking to exactly the same curve as Italy's growth rate.

In a sense these posts are a little pointless as we only need to wait seven days and we'll know one way or the other.

There are lots of articles showing how the death rate is tracking to Italy, this is just one that happens to be around this morning...

news.sky.com/story/coronavirus-the-data-suggests-the-uk-is-on-course-for-many-thousands-of-deaths-11966517

I'll be anxious about a pandemic without being called an 'over anxious mum' thanks.

I'll listen to WHO who are saying most countries need to take it more seriously than they are already.

Of course we shouldn't. We have the privilege of learning best practice from observing the horror the country is going through, but it's not the same here. The constant arbitrary rejigging of the tables is ridiculous, going from tracking first death to second to tenth and now fiftieth (soon to be hundredth no doubt) with seemingly the only aim being to frighten and catastrophise every time we appear to be falling behind Italy in numbers by their own measures therefore undermining the fear-mongering. It's like 'ooh, my numbers are showing a significant gap - I know, I'm going to move us on, let's see, 3 days because it'll look worse'. Isn't it bad enough without these pathetic games that have no basis in logic?

This article says otherwise:

news.sky.com/story/coronavirus-the-data-suggests-the-uk-is-on-course-for-many-thousands-of-deaths-11966517

'But each day the death number has been depressingly predictable. Britain is simply following Italy's path, but we are about 15 days behind them.'

SO if the Uk sould not compare themselves to Italy why are they building new hospitals and actully doing similar things to what Italy has been doing ? Sorry genuine question

One of the reasons for the new hospitals is so that COVID-19 patients can be isolated. Mark Porter, a GP who also writes for the Times, explained this a few weeks ago. He said that his GP surgery had taken over a local dentists and were using that for suspected COVID-19 patients and keeping the surgery "clean". Effectively you have "red" settings for suspected COVID-19 patients and "green" settings for everyone else.

There are also many other articles it in detail. The bbc have a decent one for example.

www.bbc.co.uk/news/health-52056111

If you try and post anything that’s not totally negative you get shouted down and told that can’t possibly be true. It’s such weird behaviour.

@NemophilistRebel .. in fact, the peaks of death rates in the previous winters were very much higher than we have experienced in the winter 19/20 and so far, even with estimates made for delays in reporting deaths, Italy hasn't come close to the death rates at the peaks of the winter 2016/17 or 2017 / 18.

www.euromomo.eu Caveats and warnings about the data all noted on this site.

Here is a graph of deaths in Italy against deaths in the UK, made myself from raw figures gained using the daily statistics. I have not adjusted for date. The graph is exponential, meaning that each vertical separating line represents a tenfold increase. You can see that both lines have a very similar gradient at the start, but that Italy's curve has begun to level out. Ours has not yet.

I see no reason to believe that our graph is likely to level out any sooner than their's did.

I'm sorry I can't get the dates to format properly, but these graphs start at the beginning, and go up to yesterday.

I see no reason to believe that our graph is likely to level out any sooner than their's did

Do you think that’s because you’re just comparing two death rates and failing to take into account, acceleration across the population, case load by demographic Ie age ranges and under lying conditions, , the death rate for those demographics, icu care available etc and are just comparing two death rates, so are unable to project?

ChateauMargaux

I am anxiously awaiting more data from Euro Momo, as from analysis to date, I believe we are being mislead and more and more evidence is supporting that.

@rrg1 I am intrigued. .. what is your take on things... PM me if you don't fancy a pile on!!

@Bluntness100 No, I think it's because you would need to see a very abrupt and unnatural plateau to our curve in order for us to not reach Italy's figures.

The only reliable figure we have is the death rate. Case load by demographics, acceleration, all this is built in to a raw death rate comparison. I am making no prediction about the age ranges of the deceased, only that in terms of sheer numbers, we are likely to be at least on par with Italy.

You can come up with all kinds of verbal reasons why you think the projection is wrong, but I think it's worth considering the phrase "There are no straight lines in nature."

I mean, you could create a smoothing off curve that will end lower than Italy's, but I think you would need to place the burden of evidence on the people choosing to believe it would be different, rather than the people believing it is more likely to be the same.

Nello I think it’s not as simple as comparing death rates, in fact I know it’s not, to enable a projection or forecast.

All two death rates tell us is the now and the past. It does not tell us the future.

And we do have reliable data, we know hospitalisations, serious v critical cases, case load by demographics, rate of infection through the population, icu beds etc. It’s simply no one has mapped it on here. The info is there and the scientists use it to project.

With death rates as a forecast then it’s just wait and see, because there is no intelligence or analytics behind it. It’s just two numbers plotted. It can’t possibly predict the future.

That’s why you can’t see a reason it would deviate, because there is no data to allow you to do so, or project it confidently, because all you’re doing is looking at current and historical death rates, no more no less.

To have any form of accurate forecast much more data comparison is required.

I’m not super anxious. Thanks. I’m a person. A human being. Lots of people on this site are not parents. Some are even male and childless.

Many Mumsnet posters have brilliant minds and it is a hive of information. Perhaps you have some relevant input into the conversation. However your style is patronising as hell.

This is not flu. We understand this country will not track Italy for a large number of environmental reasons. It can still be a benchmark.

People can’t say if the graph posted below won’t hold. So it’s not really worth speculating atm.