Italy’s coronavirus outbreak may be so devastating because it has such an old population and the elderly come into frequent contact with the young.
A study by the University of Oxford has suggested that multiple generations living under the same roofs ‘accelerated’ the spread of the virus in rural Italy.
More than 31,000 people have been diagnosed with the virus in the crisis-hit country and at least 2,503 people have died – a death rate of almost one in 12.
The country has the world’s second oldest population after Japan – 22 per cent of people are over 65 – and people in that group are known to be more likely to die if infected.
But it could be the movements of young people which triggered the disaster.
It’s common for young adults in rural areas to live with their parents and grandparents but to commute into cities, such as Milan, to work and socialise.
They may have been picking up the virus while travelling and brought it home without realising they were ill, the Oxford researchers said.
Another study published this week suggested that 86 per cent of patients may have no idea they’re ill in the early stages of a country’s epidemic, raising the risk of this deadly spread going unnoticed.
And the UK also has an ageing population – there are 11.9million people over the age of 65 and people are living, on average, three years longer than they did in 2003 – so the way the virus has spread in Italy could be a lesson for the British Government.
Prime Minister Boris Johnson has urged people not to visit sick or elderly relatives as one of his dramatic measures announced this week to protect the UK.
Italy is in the grip of the worst coronavirus epidemic outside of China – 31,000 people have been diagnosed with the illness. Pictured, medical staff collect a patient in an isolation pod at a hospital in Rome
Dead coronavirus patients are pictured alongside coffins at Ponte San Pietro Hospital in Bergamo, Italy. More than 2,500 people there have been killed by the virus
Italy’s devastating outbreak has been centred around Milan and the more rural areas surrounding it in the Lombardy and Veneto provinces.
The whole country is in lockdown and all citizens have been banned from travelling and urged from going outside – all tourists have been sent home.
In their study, published in the journal Demographic Science, the researchers wrote: ‘Even relatively few connections between communities can lead to a stark reduction in average network distances; the so-called small world phenomenon.
‘Such community “connecting” individuals might be those young people around Milan that work in the city but reside in the most hard-hit villages in the surrounding with their parents and grandparents.
‘Thus, intergenerational co-residence may have accelerated the outbreak by creating intercommunity connections that increase the proximity of elderly to the initial cases, an area for further study.’
The coronavirus kills people by triggering pneumonia, an infection which essentially floods the lungs, and organ failure. Pictured are dead patients at an Italian hospital
Two men wheel a coffin through a room filled with dead coronavirus patients at a hospital in Bergamo. Social distancing measures may limit the numbers of people who are allowed to attend funerals
Paramedics are pictured outside a hospital in Rome yesterday, March 17
An intensive care ward is pictured inside one of Italy’s purpose-built coronavirus hospitals in Rome
The legendary canals of Venice now run clear as the entire of Italy is in lockdown and tourists have been ordered to leave by the Government. The city is one of the world’s most visited places and is usually heaving with tourists
WHAT ARE THE RULES OF ITALY’S QUARANTINE?
THE SICK MUST STAY AT HOME
Anyone with a fever or respiratory symptoms is urged to stay at home and limit social contact, including with their doctor.
NO TRAVEL ACROSS ITALY
Travel is only allowed for ‘urgent, verifiable work situations and emergencies or health reasons’. Grocery shopping is considered a ‘necessity’ and still allowed.
To avoid work-related travel, public and private companies have been urged to put their staff on leave.
Flights, trains and public transport will continue but Prime Minister Giuseppe Conte says he wants as many people as possible to stay at home.
People who do want to travel will need to fill in a document explaining their reasons for doing so and carry it with them.
NO PUBLIC GATHERINGS
‘All forms of gatherings in public places or sites open to the public’ are banned, the decree says.
Cinemas, museums, theatres, pubs, dance schools, betting shops and discos are all closed. Weddings and funerals are banned. Schools and universities will remain shut until April 3.
Bars and restaurants were only allowed to open between 8am and 6pm, the decree said, and only if a distance of at least 3ft could be kept between customers.
Sporting events of all levels and disciplines were cancelled – stopping play in the Serie A football league. Fixtures in international competitions can go ahead but will be played behind closed doors.
Gyms, sports centres, swimming pools, spas and leisure centres must close.
SHOPS MUST KEEP 3FT DISTANCE
Shops can remain open but only if they can guarantee the 3ft safety distance for customers.
Big and mid-sized shopping centres have to close at the weekend. Food stores are allowed to remain open at all hours.
NO LEAVE FOR HEALTH WORKERS
Leave for health workers is cancelled. People accompanying their friends or relatives to emergency units are not allowed to stay with them in the waiting rooms without express permission.
The danger of the lifestyle described in the study is that the city-goers interact with a lot of people, visit busy places and work or travel in more cramped conditions.
They risk picking up the virus and spreading it without realising, either because they get such a mild illness, or because it is transmitted before they get sick.
And through this route, the virus could make its way out of a city like Milan – where travellers will have brought it in – into smaller villages in the countryside.
Italy has the biggest population of elderly people in Europe, and the second oldest in the world, with almost a quarter of people (22 per cent) aged 65 or older.
And the median age – the middle of the age range – is 46.5 years old, according to the CIA – the fifth highest in the world.
For comparison, the UK’s median age ranks 50th is 40.6 (18 per cent aged over 65) and the US’s is 38.5 (17 per cent over 65).
The older someone is, the more deadly catching the coronavirus can be.
Age is known to be one of the biggest risk factors because the immune system and lungs are naturally weaker so the body is less able to fend off pneumonia, which the virus causes in severe cases.
Older people are also more likely to have the types of long-term illnesses which raise the risk of coronavirus becoming fatal, such as diabetes or heart disease.
Research has found that people aged 80 or over have a 14.8 per cent risk (one in seven) of dying if they develop COVID-19, the disease caused by the coronavirus.
But one of the authors of the Oxford study, Dr Jennifer Dowd, said simply trying to shut off old people from the rest of the society would not be enough.
The Government in the UK had spoken of trying to protect the elderly with a ‘cocoon’ strategy by keeping them inside care homes and their own homes.
Officials came under fire last week for appearing to suggest they were hoping the virus would spread among healthy, young people, to build up a herd immunity which could protect the vulnerable by making the virus unable to spread through the population.
Now, however, over-70s in Britain are being urged to stay home and avoid contact with other people to reduce their risk of getting infected.
But Dr Dowd said: ‘One of the points that we were trying to make is that it’s not necessarily just about isolating the older population,’ Wired reported.
‘We are identifying that they’re the most vulnerable—but the general social distancing that’s being encouraged to flatten the curve.’
‘Flattening the curve’ is a phrase that refers to trying to prolong and outbreak and spread the cases out over a longer period to reduce the pressure on hospitals.
‘I think our point was that’s actually important when you have a higher fraction of your population that is vulnerable,’ Dr Dowd added.