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  1. Ciminelli G, Garcia-Mandicó S
    J Public Health (Oxf), 2020 11 23;42(4):723-730.
    PMID: 32935849 DOI: 10.1093/pubmed/fdaa165
    BACKGROUND: There are still many unknowns about COVID-19. We do not know its exact mortality rate nor the speed through which it spreads across communities. This lack of evidence complicates the design of appropriate response policies.

    METHODS: We source daily death registry data for 4100 municipalities in Italy's north and match them to Census data. We augment the dataset with municipality-level data on a host of co-factors of COVID-19 mortality, which we exploit in a differences-in-differences regression model to analyze COVID-19-induced mortality.

    RESULTS: We find that COVID-19 killed more than 0.15% of the local population during the first wave of the epidemic. We also show that official statistics vastly underreport this death toll, by about 60%. Next, we uncover the dramatic effects of the epidemic on nursing home residents in the outbreak epicenter: in municipalities with a high share of the elderly living in nursing homes, COVID-19 mortality was about twice as high as in those with no nursing home intown.

    CONCLUSIONS: A pro-active approach in managing the epidemic is key to reduce COVID-19 mortality. Authorities should ramp-up testing capacity and increase contact-tracing abilities. Adequate protective equipment should be provided to nursing home residents and staff.

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