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Covid-19: a puzzle with many missing pieces

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m627 (Published 19 February 2020) Cite this as: BMJ 2020;368:m627

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The Italian Conundrum

Dear Editor

The average age of those dying in Italy (mostly men) is 81 [1] while the average life expectancy of Italian men is 81[2].

So, on the face of it nothing is happening except for shortages of staff, beds and respirators, and a virus spreading like wildfire - but mortality measured against the norm seems to be zero. Perhaps, the difference is in how people are dying, and as Richard Smith was recently pointing out the ultimate fear is not of dying, since everyone does, but of dying before your time on a hospital trolley in an emergency department [3]. The failure lies in not having kept the infrastructure for an emergency [4].

[1] https://blogs.bmj.com/bmj/2020/03/11/carl-heneghan-assessing-mortality-d...

[2] https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

[3] https://blogs.bmj.com/bmj/2020/03/09/richard-smith-my-worry-about-my-mot...

[4] https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/hospital-beds

Competing interests: No competing interests

13 March 2020
John Stone
UK Editor
AgeofAutism.com
London N22