Human Costs of the First Wave of the COVID-19 Pandemic in the Major Epicenters in Italy

Background: Relying on national official reports to assess the impact of COVID-19 pandemic on human life faces problems of miscounting due to under-reporting of COVID-19 deaths, inaccurate death registration and inconsistency in classification. The reported mortality is often provided at the national level whilst the outbreaks are localised, resulting in underestimation of the true scale of the impact. Methods: This study uses all-cause daily death registrations data provided by the Italian Statistical Office (ISTAT) focusing on the five most severely hit provinces in Italy (Bergamo, Brescia, Cremona, Lodi and Piacenza) and Lombardy region. We calculate excess mortality in 2020 compared to the average of the years 2015-2019 and estimate life expectancy for the first wave of the epidemic and for the rest of the year 2020. Findings: The estimated excess deaths show significantly higher mortality than official statistics, particularly during the peak of the epidemic and amongst people aged ≥70 years. For the first wave of the epidemic (1 January to 30 April 2020), life expectancy in the five provinces reduced by 6.2 to 8 and 3.6 to 5.8 years for men and women, respectively. For annual life expectancy in 2020, with regular after-COVID mortality patterns, the years of life lost is equivalent to 2.5 to 4.1 years for men and 1.7. to 2.6 years for women, respectively. Interpretation: The COVID-19 pandemic posed a substantial impact on population health in Italy as it represents the largest decline in life expectancy after the 1918 influenza pandemic and WWII.Funding Statement: No funding to declare.Declaration of Interests: All authors declare no conflict of interest. Ethics Approval Statement: No ethical approval required.