The vast majority of people who have died with COVID-19 had other medical conditions that put them at risk of severe disease, or other conditions caused by COVID-19. But internet posts misinterpret data about those conditions to falsely claim that Italy has reduced its count of COVID-19 deaths. It hasn’t.
There have been more than 130,000 COVID-19 deaths in Italy from the beginning of the pandemic through Oct. 5, according to the latest in a series of reports from the Italian National Institute of Health. The reports break down the most common comorbidities, or other medical conditions, for those who died with the disease.
A misrepresentation of that report has now filtered through several websites and was recently shared by America’s Frontline Doctors, a group that formed in the summer of 2020 and has spread falsehoods about COVID-19 treatments, public health precautions and vaccines. We’ve written about some of its claims before.
The group’s Facebook page posted a screenshot of one of the websites that misrepresented the Italian report and added this message: “Italy drastically reduced the country’s official Covid-19 death count by over 97%. This means Covid killed fewer people than … an average seasonal flu. 2020. The Year of the Fraud.”
Here’s how the claim evolved:
In February 2020, as Italy was becoming a COVID-19 hotspot, the Italian Ministry of Health issued a requirement that all deaths attributable to COVID-19 be certified by the Italian National Institute of Health, or ISS by its Italian initials. The ISS then created a working group, called the COVID-19 Surveillance Group, to do that. The working group regularly issues reports that examine data on COVID-19 deaths, including the most common comorbidities present in those who died.
The most recent of those reports covers data through Oct. 5. It included information on comorbidities for a sample of patients who died in the hospital, finding that 2.9% of that sample had no other medical conditions before they contracted COVID-19. That’s not surprising. The more health conditions a person has, the higher the risk for developing severe COVID-19, the Centers for Disease Control and Prevention has explained.
But the Italian report was distorted by others.
The managing director for a conservative Italian publication, Il Tempo, referred to that report in an Oct. 21 article that said: “only 2.9% of the deaths registered since the end of February 2020 would be due to Covid 19. So of the 130,468 deaths registered by official statistics at the time of preparation of the new report only 3,783 would be due to the power of the virus itself.”
A British website we’ve written about before then cited that story in a post that claimed, “Turns out 97.1% of deaths hitherto attributed to Covid were not due directly to Covid. According to its latest report on Covid mortality, the Institute says COVID-19 has killed fewer people than the average bout of seasonal flu.”
That website later ran a correction noting, “The author of the piece is effectively stating his opinion that only those who died of Covid without comorbidities (2.9%) should be counted as a Covid death, and then extrapolates from there to suggest that the ‘real’ Covid death toll over the period in question was only 3,783. This is all contrary to the report itself.”
But another website, which has shared other dubious claims about the pandemic, had already cited the post, adding this headline: “Italy’s ‘From Covid’ Death Count Drastically Reduced By Over 97 Percent.”
A screenshot of that headline is what America’s Frontline Doctors shared with its more than 100,000 followers.
But Italy didn’t reduce its COVID-19 death count by “over 97 percent.” As we said, the report included comorbidity data drawn from medical records of 7,910 patients who died in hospitals, and 2.9% represented the share of those people who died with no other illnesses.
As we’ve explained before, those with certain preexisting conditions, such as diabetes or hypertension, have a heightened risk for severe illness if they are infected with SARS-CoV-2, the virus that causes COVID-19.
“[T]he presence of chronic diseases in the elderly population is very common,” the ISS said in a statement responding to the claim. “In view of the fact that chronic diseases represent a risk factor for death from COVID-19 and that these are very common in the general population, it is not surprising the high frequency of these conditions in the SARS-CoV-2 positive deceased population.”
For example, according to the ISS report, 66% of those who died had hypertension and 29% had type 2 diabetes. Just over 97% had at least one comorbidity.
In the U.S., 19% of those who have died with COVID-19 had hypertension and 16% had diabetes, according to the CDC.
“It’s pretty rare that someone wouldn’t have at least one issue caused by coronavirus prior to their death,” epidemiologist and science writer Gideon Meyerowitz-Katz explained after a similar claim was promoted by then-President Donald Trump last year. That claim alleged that the CDC had reduced the COVID-19 death toll by 94%, but it was based on the same faulty presentation of data as the current claim about Italy.
“[A]ll it means is that in 94% of cases people who had COVID-19 also developed other issues, or had other problems at the same time,” Meyerowitz-Katz wrote.
In the U.S., the vast majority of deaths that mention COVID-19 on the death certificate list that disease as the underlying cause of death, Jeff Lancashire, spokesman for the CDC’s National Center for Health Statistics, told us when we wrote about last year’s similar claim. That means it was the condition that started the chain of events that resulted in death.
Current data from the CDC show that COVID-19 is the underlying cause of death in more than 90% of cases citing the disease on death certificates, with the remaining death certificates listing it as a contributing cause.
In Italy, COVID-19 is the underlying cause of death in 89% of deaths of people who tested positive for the coronavirus, according to the ISS statement.
So, Italy hasn’t reduced the number of deaths attributable to COVID-19. The claims saying that it has are based on the same kind of misrepresentation of data that we wrote about a year ago.
Editor’s note: SciCheck’s COVID-19/Vaccination Project is made possible by a grant from the Robert Wood Johnson Foundation. The foundation has no control over FactCheck.org’s editorial decisions, and the views expressed in our articles do not necessarily reflect the views of the foundation. The goal of the project is to increase exposure to accurate information about COVID-19 and vaccines, while decreasing the impact of misinformation.