Measuring Resilience and Fatality Rate During the First Wave of COVID-19 Pandemic in Northern Italy: A Note.

Background: This Policy Brief aims to contribute to the debate on the resilience of the healthcare systems during the pandemic by discussing whether mortality indicators are appropriate for assessing resilience or whether other statistics should be employed. Evidence: During the first wave of the COVID-19, much emphasis was placed on case-fatality rates to offer a preliminary assessment of the resilience of healthcare systems. However, these statistics are often biased and do not consider the real figure of the population that has been infected. Policy Options and Recommendations: Comparing data obtained with different approaches based on statistical inference and large-scale serological survey, the brief highlights, that great care must be taken when using case-fatality data, which in the absence of careful analysis, can lead to erroneous conclusions. Conclusion: Using case-fatality rate gives us no sounding information about the real capability of healthcare systems to save lives during the pandemic. However, even in the absence of detailed epidemiological data new advancements in statistical methods can be useful to provide a more sounding evaluation of the resilience of the healthcare systems.