Informing the global COVID-19 response by estimating excess deaths in Italy during the COVID-19 and 1918 influenza pandemics

Coronavirus disease-2019 (COVID-19) is an unprecedented health crisis in modern times, with an estimated 2.89 million deaths worldwide as of April 2021.1 Italy was one of the first countries outside of Asia to experience a wave of COVID-19 cases, and in response instituted national limits regarding movement and closures of schools, recreational activities, and shops.2 To help illustrate the power of a robust and consistent public health response and illustrate the need for a continued robust response worldwide as we face the threat of new COVID-19 variants, we analyzed data from Italy to examine the excess mortality during the COVID-19 pandemic, compared with the 1918 influenza pandemic.