Covid-19 update: over 5 Million Italians infected in March 2020

In March 2020, the number of people infected by Covid-19 in Italy might be 5 million, 1 million of them only in the Northern-Italian region Lombardia. Even if we assume that only half of the symptoms are attributable to Covid-19, the number of contagions remains significant. And even if we avoid counting those who are asymptomatic, the virus might have infected a significant part of the Italian population before the end of March: the share of the population infected would be definitely higher than the officially registered cases.

This is what the latest research carried out by BVA Doxa and coordinated by Carlo La Vecchia from Milano State University highlights. The research was conducted in Italy between the 27th and 30th of March, on a total sample of 1000 individuals, representative of the Italian population between 18 and 85 years old, in terms of gender, geographical area and socio-economic status.

Italy, and specifically Norther-Italian region Lombardia is one of the most affected countries by Covid-19: according to the official data, by the end of March Italy registered 105.792 cases and 12.442 deaths on a national level, and 43.208 cases and 7.199 deaths on a regional level. However, what is really difficult to understand is the real impact the virus is having on the country and the more realistic data which still remain uncertain: the registered cases in Italy mainly include people who were admitted to hospitals, plus a limited number of individuals who turned out to be positive to Covid-19 from swabs performed in a non-systematic way.

In order to estimate a more accurate number of positive cases in Italy, BVA Doxa research, coordinated by Carlo La Vecchia from Milano State University, included a set of questions on symptoms that might be related to Covid-19 (such as fever, headache, cold, cough, and gastrointestinal disorders).

In the last 3 weeks in Italy, 14.4% of the subjects reported Covid-19 symptoms, and 1.5% fever above 38.5 degrees. In Lombardia, the percentages reach respectively 18.3% and 3%. In both Italy and Lombardia,  the percentage of subjects who reported Covid-19 symptoms is higher among women, young people, smokers and people with higher education.

Of course, part of the symptoms described is unrelated to Covid-19. Although the annual flu period ended by March 7, some of the reported symptoms could be related to other non-specific (viral) conditions. However, it is possible that most of the symptoms – and the majority of people with a fever above 38.5 degrees – are due to Covid-19. Even assuming that only half of the reported symptoms are attributable to Covid-19, approximately 8% of the population in Italy and 10% in Lombardia would have been affected by Covid-19 during the three weeks prior to the data collection.

This would mean that the number of infected people in Italy would be at least 5 million, and 1 million in Lombardia alone, a figure that can be doubled if we assume that most of the symptoms similar to those of Covid-19 are actually related to Covid-19. The data are limited to a period of 3 weeks; other subjects had similar symptoms before March 7. In addition to this data, subjects who contracted Covid-19 but didn’t show any symptoms should be counted as well.

Despite the limitation of the study in terms of reliability of the answers given, due to the subjectivity of the replies, the survey presents important data, considering the whole study is part of a validated periodical survey conducted on a reasonably large and representative sample of the Italian and Lombard general population. Results indicate that – even ignoring asymptomatic cases – the Covid-19 epidemic could have affected a substantial part of the Italian population by the end of March, certainly a higher part compared to the officially registered cases.

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