No excess mortality among working-age Italians during the Omicron wave of Covid-19

Main Article Content

Gianfranco Alicandro
Giuseppe Remuzzi
Stefano Centanni
Alberto Gerli
Carlo La Vecchia


Covid-19, SARS-CoV-2, Pandemic, Working age, excess deaths


Background: This study provides updated estimates of the excess deaths in Italy with a focus on the working-age population. Methods: Over-dispersed Poisson regression models, fitted on 2011-2019 mortality data, and including terms for age, calendar year and a smooth function of the week of the year, were used to estimate the expected number of deaths during the Covid-19 pandemic. The excess deaths were then obtained by the difference between observed and expected deaths and reported according to the pandemic periods defined by the predominant circulating variant of SARS-CoV-2. Results: Around 170,700 excess deaths at all ages were estimated between March 2020 and March 2022 in Italy with most of the excess occurring during the pre-Delta and Delta period, and 2930 excess deaths (+2.5%) during the Omicron wave. The excesses among the working age population were: 10,425 deaths (+11.8%) during the pre-Delta period, 2460 (+9.4%) during the Delta wave, 283 (+2.2%) during the transition period to Delta. Mortality was lower than expected during the Omicron wave (-6.1%).

Conclusions: Over the periods preceding the Omicron wave, Covid-19 caused around 12,800 excess deaths among individuals of working age, accounting for over 10% excess death. This excess was no longer observed during the Omicron wave.

Abstract 551 | PDF Downloads 350


1. World Health Organization (WHO). WHO Coronavirus (COVID-19) Dashboard. 2022. Accessed June 13, 2022.
2. Islam N, Shkolnikov VM, Acosta RJ, et al. Excess deaths associated with covid-19 pandemic in 2020: Age and sex disaggregated time series analysis in 29 high income countries. BMJ. 2021;373. doi:10.1136/bmj.n1137
3. Alicandro G, Remuzzi G, Centanni S, Gerli A, La Vecchia C. Excess total mortality during the Covid-19 pandemic in Italy: updated estimates indicate persistent excess in recent months. Med Lav. 2022;113(2):e2022021. doi:10.23749/mdl.v113i2.13108
4. Istituto Nazioale di Statistica. Decessi e cause di morte: cosa produce l’Istat. Published 2022. Accessed June 2, 2022.
5. Istituto Nazioale di Statistica. Popolazione residente e ricostruzione intercensuaria della popolazione. Published 2022. Accessed June 2, 2022.
6. Istituto Superiore di Sanità. Monitoraggio delle varianti del virus SARS-CoV-2 di interesse in sanità pubblica in Italia. Published 2022. Accessed June 2, 2022.
7. Borri N, Drago F, Santantonio C, Sobbrio F. The “Great Lockdown”: Inactive workers and mortality by Covid-19. Health Econ. 2021;30(10):2367-2382. doi:10.1002/hec.4383
8. Rao A, Ma H, Moloney G, et al. A disproportionate epidemic: COVID-19 cases and deaths among essential workers in Toronto, Canada. Ann Epidemiol. 2021;63:63-67. doi:10.1016/j.annepidem.2021.07.010
9. Commissario straordinario per l’emergenza Covid-19 - Presidenza del Consiglio dei Ministri. Covid-19 Opendata Vaccini. Published 2022. Accessed June 2, 2022.
10. La Vecchia C, Negri E, Alicandro G, Scarpino V. Attitudes towards influenza vaccine and a potential COVID-19 vaccine in Italy and differences across occupational groups, September 2020. Med Lav. 2020;111(6):445-448. doi:10.23749/MDL.V111I6.10813
11. Van Noorden R. Major Study Errs on Covid deaths. Nature. Published June 9, 2022. Accessed June 13, 2022.
12. Adam D. COVID’s true death toll: much higher than official records. Nature. 2022;603(7902):562. doi:10.1038/D41586-022-00708-0
13. Whitaker M, Elliott J, Chadeau-Hyam M, et al. Persistent COVID-19 symptoms in a community study of 606,434 people in England. Nat Commun. 2022;13(1). doi:10.1038/S41467-022-29521-Z
14. Katsoularis I, Fonseca-Rodríguez O, Farrington P, et al. Risks of deep vein thrombosis, pulmonary embolism, and bleeding after covid-19: nationwide self-controlled cases series and matched cohort study. BMJ. 2022;377:e069590. doi:10.1136/BMJ-2021-069590
15. Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nat Med. 2022;28(3):583-590. doi:10.1038/S41591-022-01689-3
16. Morrow AJ, Sykes R, McIntosh A, et al. A multisystem, cardio-renal investigation of post-COVID-19 illness. Nat Med. Published online May 23, 2022. doi:10.1038/S41591-022-01837-9