On Thursday morning, Italians across the country woke up to their first day of complete lockdown in a bid to slow the spread of Coronavirus in Italy. The previous evening, the Italian Prime Minister Giuseppe Conte announced even tighter restrictions on movement and on which services could remain open in the country. People are now only permitted to leave their houses for work (if they are unable to work from home), for buying necessities like food, or for emergency reasons. Most commercial activities have been suspended, apart from food shops, pharmacies, and big industries, who must abide by strict safety rules.
But how did Italy go from having two cases of the virus a little over a month ago, to complete quarantine for the entire country? And what can other European countries learn from the spread of the virus in Italy?
At the end of January, Italy confirmed that two Chinese tourists who had arrived in the country 10 days previously from Wuhan, had tested positive for the Coronavirus. In a press conference, Conte announced there was no reason to “create social alarm or panic,” and reassured the public that, “We have already prepared all the precautionary measures to isolate these two cases.” The country was, in effect, fully confident it could contain the virus at this point.
But despite these being the first confirmed cases of the virus in the country, experts tracking the spread of the disease now say it’s likely it had been circulating in Italy, and in other parts of Europe, from as early as mid-January. The incubation period, however, meant cases only began to emerge at the beginning of February.
It was on the 21st of February that the pivotal moment came for Italy. A 38-year-old manager at Unilever, identified only as Mattia, became the first person to test positive in the north of Italy that had no apparent link to China. This meant that, although he had presented himself at the hospital days earlier with flu-like symptoms, doctors rejected the possibility of Coronavirus because they were still looking for links with China. It emerged later that Mattia had met with another man who had been to China in early February.
With doctors concentrating on patients with direct links to China, it is likely many cases of Coronavirus managed to slip through the net during the first weeks of February. These cases, like Mattia, thus managed to spread the virus to both hospital workers and friends and family during this period.
The Guardian reports another sombre example, “In the small southern Italian town of San Marco in Lamis, a man who died before it was known that he was carrying the virus infected his wife and daughter, who then came into contact with dozens of relatives and friends at his funeral – 70 of whom are now in quarantine.”
From the 21st of February, the number of cases in Italy began to rise steadily, particularly in the ‘cluster’ areas in Lombardy and the Veneto. At this point, the first decisive government action was taken to limit the spread. Towns where the virus had been detected were put into lockdown for a fortnight.
However, it’s clear that many cases were still being missed at this time, either because doctors were continuing to look for links to China, or because patients’ symptoms were being attributed to flu. Trevor Bedford, a researcher at the Fred Hutchinson Cancer Research Center, noted the gravity of this error in a post on Twitter: “An extremely important take home message here is that just because a cluster has been identified and ‘contained’ doesn’t actually mean this case did not seed a transmission chain that went undetected until it grew to be [a] sizable outbreak.”
By the 1st of March, there were almost 1600 Coronavirus cases recorded in the country. By the 3rd, the number had risen to nearly 2500. The 4th of March then recorded the highest jump in deaths, reporting 28 more in a 24 hour period.
At this point, the government began to step up containment measures, beginning with locking down the region of Lombardy and 14 other provinces in the north. Unfortunately, this move backfired as the draft proposal for the Lombardy lockdown was leaked on social media the night before, causing many people to scramble to get trains down to the south and join their families. Many of those people abandoning the northern region may unwittingly have spread the virus to friends and family in the south.
It took till 11th March for the government to impose quarantine measures as strict as those that had been enforced in China. Peter Beaumont, Global Development reporter for the Guardian, talks in a podcast for the paper about the difficulty of imposing stringent measures in the country. Compared to China, Italy has “a different social and political system and a different media,” he says, and as such, “people have been unhappy about the measures that have been introduced.” The draconian measures now imposed which are akin to those decreed in China would have been met with much resentment if the statistics hadn’t suggested that the situation was critical.
As former Prime Minister Matteo Renzi told Italian newspaper La Repubblica, Italy is now a “guinea pig” for other European countries, which are highly likely to reach a similar situation in the coming weeks. While China may have seemed too removed from Western society to use as an example of the future, other countries in Europe can now look to Italy and ask, “How does a new virus affect a modern European country, with a democratic government and lively public opinion?” as Beppe Severgnini wrote in the New York Times.
As Beaumont comments, one of the biggest problems that other European countries will now have to face is the “balance between individual rights and politicians making decisions that they think are for all our good, that infringe on those rights.”
The new measures have been deemed essential in Italy, as its health system is now under extreme pressure, and it’s essential to reduce the speed at which the Coronavirus is spreading. As leading public health expert Nino Cartabellotta said in an interview with the Local, “these measures, by reducing the transmission of the virus, delay the peak of the epidemic, and distribute the cases over a longer period of time, which allows the health system to prepare properly and better manage symptomatic cases.”
Experts are warning that other European countries should already be thinking along these lines so that their health care systems can cope with the numbers of patients.