Italian health officials reported on Wednesday that 110,574 people have been infected by COVID-19 and 13,155 people have died.

However, these tallies are not entirely accurate–a Wall Street Journal analysis shows–as many people who have died from the disease either never made it to the hospital, or they were never tested.

Plus, the burden that the pandemic puts on health-care systems can cause so many casualties that it’s hard to accurately gauge the full human cost.

Italy’s hidden death toll shows what could occur in the worst-hit areas of the U.S., Europe and elsewhere, if the coronavirus curve isn’t flattened.

As it stands, more than 210,000 people have been infected in the U.S., and 4,669 people have died.

However, Italian health officials are hopeful that the nationwide lockdown will begin to significantly cut into the steep infection and mortality rate in the coming weeks.

For more details on the WSJ analysis, click here.

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