However the impact on hospitals remains minimal.

Italy has "effectively entered the fourth wave" of covid-19, according to a report issued on Thursday by the Gimbe Foundation, a public health think tank.

The indepedent monitoring report found that the number of coronavirus-related deaths has started to increase again after 15 consecutive weeks of decline.

The GIMBE report documented a 46 per cent increase in deaths in the seven days from 21-27 July, rising to 111 from 76 the previous week.

The study also found a 64.8 per cent increase in new covid cases over the previous week, rising to 31,963 from 19,390.

The study recorded a 42.9 per cent increase in people isolating at home (68,510 up from 47,951 the previous week), a 34.9 per cent increase in hospital admissions with symptoms (1,611 up from 1,194), and a 14.5 per cent increase in the number of covid patients in intensive care (189 up from 165).

• Covid-19 news updates from Italy

The virus "is circulating more than documented by the new cases identified" - said GIMBE president Nino Cartabellotta - "due to insufficient testing and the failure to resume contact tracing."

Renata Gili, head of health services research at GIMBE, confirmed a "slight increase in hospitalisations, after the first signs of recovery last week."

However the impact on hospitals is considered minimal, with general admissions accounting for three per cent at a national level and intensive care admissions at two per cent nationally.

The report found an increase in new covid cases in all regions of Italy except Molise, in the week from 21 to 27 July, with 40 provinces exceeding the incidence of 50 cases per 100,000 inhabitants.

For full details of report see GIMBE website. For official information about the covid-19 situation in Italy - in English - see health ministry website. Photo credit: Boumen Japet / Shutterstock.com.