Specific claim
In Italy the new virus caused so many deaths that corpses pile up and must be transported out of
the city by the army trucks [34, 47, 38].
Let’s start with a side note that it is an example of our selective attention. The above caption
makes such a good news story and the topic for water-cooler gossips, that a few days before it
actually happened, a fake news with a similar headline appeared in social media. It was showing
the footage of army trucks allegedly transporting the bodies. The news was quickly debunked and
refuted by finding that the video of army trucks had been recorded in a different part of the world.
Nevertheless, the fact is that on March 18th, 2020, there was an isolated incident of using 15
military trucks and 50 soldiers to transport about 60 coffins from Bergamo to remote cremation
sites.
The demand for cremation increased. What was the cause? It’s so easy to come to the
immediate conclusion that some disastrous plague produced extraordinary death toll. It’s not
supported by data, though. As we checked using the z-score data from Euromomo [11], the all-
cause mortality in Italy increased in the middle of March, but the increase was comparable to the
seasonal flu mortality upsurge in previous years [30, 36, 7]. The caveat is that these are country-
wise statistics that may flatten out regional anomalies. Nevertheless, it is fair to compare, because
the previous years seasonal flu outbreaks also had regional character. For example, in January
2017 the z-ratio increased to 12, the same as in the middle of March 2020. If we assume the
most unfavorable delay in reporting we get z-score equal 18 for late weeks of March 2020. For
Italy mortality data, z-score 12 corresponds to about 40% increase relative to the yearly average
of 12500 deaths / week; z-score 18 corresponds to about 60% increase. It means that in January
2017, Italy had to handle about 17,500 dead per week, and in March 2020 they had to handle
20,000 dead per week [17, 16].
The raw mortality increase does not explain why the crematoria are overwhelmed in 2020 and
why they were not three years earlier.
We need to understand the background first and look for the mediator variable then. Cremation
in Italy became fully legal and made equal to the burial only in 1987. Such late adoption was the
result of the Catholic Church influence that was in strong opposition. Cremation popularity reached
15% in 2012 nationwide, but it is still one of the lowest ratios in Europe.
The numerous reports reveal the following:
1. The government has put a stop to funerals and religious ceremonies. There is no ban on
burials, but often there is no such possibility, because many funeral homes have closed for
fear of catching the virus by staff. The ones that remain open are no longer able to manage
the high demand for the service.
2. Since February 2020 Italian authorities increasingly recommend cremation over burial [6]
3. During the coronavirus crisis, more families are choosing cremation over burial, for fear of
catching the virus from the dead.
The initially low cremation popularity in Italy explains the lack of proper infrastructure. There
were not enough crematoria to handle the sudden increase in cremation needs. This increase was
caused by the government decisions and overall state of fear that changed the behavior of the
relatives.
This example of mediator variable is not all-or-nothing. It does not invalidate the fact that
the actual mortality in Italy increased in March 2020 however the increase was not sufficient
enough by itself to cause the discussed incident. We had to identify a set of mediator variables
to explain why crematoria are overwhelmed and why it required using military to transport coffins.
Specific claim
The new virus caused hospitals overload.
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