Italy is doubling down on its lockdown strategy to stop the spread of the new coronavirus, halting all non-essential economic activities for two weeks. There are early signs that these draconian steps are paying off, but the human and economic costs will be steep.
The government made mistakes, ones that the rest of the Western world should have learned from but didn’t. Italy has surpassed China as the country with the most deaths from Covid-19, according to the official data. Nearly 5,500 Italians have lost their lives to the disease, compared with less than 3,300 Chinese — even though Italy’s population is barely 4% that of China’s. Almost 60,000 individuals have tested positive for the virus, more than double the number in Spain and Germany.
Italy was the first European country to discover a serious domestic outbreak, which helps in part to explain why it is now so widespread now. Other countries — including the France, the U.K. and even the U.S. — appear to be merely tracking Italy with just a few weeks of delay. Italy may have also been unlucky: Because it faced the beginning of the epidemic before others, it was caught off guard.
There are several plausible reasons for the severity of Italy’s outbreak. The country has a very old population, with a median age of around 45 years. The new coronavirus hits the elderly particularly hard, while it tends to spare younger people and especially children. The median age of those who have died from the virus in Italy is just short of 80 years old, according to the country’s Superior Health Council. Cultural factors may have also played a role: In Italy, different generations tend to spend more time together, often under the same roof, which may have helped facilitate contagion to the elderly. Japan also has an ageing population, but people engage routinely in forms of social distancing, a possible reason for that country’s successful containment of the epidemic.
In Italy, the northern region of Lombardy has been the hardest hit. Nearly half of all registered cases and two thirds of official deaths come from this area, which accounts for a sixth of Italy’s population. The region is the country’s economic powerhouse and has strong commercial links with other countries, including China. This may help to explain why Italy’s outbreak originated here, spreading uncontained for some time. A few smaller hospitals may have mishandled some of the first cases, contributing to hospital outbreaks. These are particularly damaging, since they spread quickly across the most vulnerable part of the population. Higher levels of air pollution may have put citizens at greater risk of suffering from the deadliest consequences of the virus — though this is just a hypothesis that needs to be proven scientifically.
The government and political leaders were initially very complacent about the problem. Prime Minister Giuseppe Conte said on TV at the end of January that the country was fully prepared to deal with the epidemic in that it was taking the most severe containment measures in Europe. As the first cases emerged in southern Lombardy, several politicians rushed to say that people should get on with their normal lives. Milan, the main city in Lombardy and the country’s financial capital, was at the center of a lively motivational video widely spread by the political class with the slogan “Milan does not stop.”
Some tough actions followed quickly, however. The government first forced a full lockdown for 50,000 people in eleven towns in southern Lombardy and in one in the neighboring region of Veneto. Then came more restrictions: Schools were shut down, and public gatherings were banned. On March 10, the country was placed under a national lockdown. Bars, restaurants and shops were closed, and people were told not to leave their homes unless they have to go to work or for other essential reasons (such as buying food). The government has now gone a step further, shutting down all non-essential economic activities, such as many factories, until April 3.
Italy deserves credit for being the first Western country to enforce such tough measures. These measures appear to be working: On Sunday, the daily growth rate of the number of people tested positive to the virus slowed to just above 10%, and the number of new deaths fell. This trend needs to be confirmed in the future, but these figures bring hope.
However, the government has often acted erratically. At first, it failed to enforce a full lockdown in another area of Lombardy, the province of Bergamo, which now has the most cases in Italy. A decision to close several areas of northern Italy was leaked to the press before its approval, sparking a rush to escape to the south, which may have helped spread the virus. Just this weekend, after Conte announced his plans to halt factories on Saturday evening, the government spent most of Sunday struggling to define which factories it would consider essential.
More than 4,000 health care workers have tested positive for the virus — a sign that doctors and nurses are overly exposed and may act as transmission channels themselves. While Italy has performed more than 230,000 tests, it has failed to put together a comprehensive strategy of testing, tracking and self isolation, which has helped save lives in countries such as South Korea or Singapore.
Unfortunately, these failings have been matched elsewhere in Europe. France and Spain have waited far too long before enforcing a lockdown. The U.K. has made a dramatic U-turn on an initial plan to pursue a soft containment strategy, but is still struggling to take draconian measures to enforce social distancing. In Spain too, a sizeable number of healthcare workers have been infected. The U.S. has only recently ramped up testing, and is struggling to catch up with growing demand for it.
Italy deserves credit for taking tough measures, such as limiting the freedom of movement of its citizens, which seemed impossible for a Western country. These steps have been used as a model elsewhere. However, they offer no guidance over how to handle the epidemic in the long run, since it is impossible to keep the economy shut for months. Many countries in Asia seem to have done a better job at combining these different priorities. That’s where the West should look for long-term answers — and do it soon.
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