In Italy, official deaths are attributed to COVID-19 only for patients who test positive in hospitals or a limited number of nursing homes that provide testing. This means that the Italian National Health Authority could have potentially excluded thousands of deaths could have been excluded from the reported data. If you compare average death rates with death rates reported in the period of the COVID-19, there is a spike in some regions of over 100% increase. Although it is believed that many national governments have reported inaccurate data, it is believed that official Italian data suffers some major discrepancies.