The next day, Italy was the first European state to block all flights to and from China and Prime Minister Giuseppe Conte declared his country's emergency response "the most rigorous in Europe". But a local outbreak was already taking hold.
Two weeks after Conte's bold words, a 38-year-old man known only as Mattia — who in the days prior had socialised with friends and competed in a fun run — saw his GP in Codogno complaining of a flu.
On February 16 and then again on February 18, he visited the 24-hour casualty department of the local hospital and was turned away both times with instructions for bed rest. On neither occasion was he tested for the virus.
It was only after he returned at 3:00am the following day, now experiencing difficulty breathing, that alarm bells began to ring. He was tested 24 hours later and on February 21 a positive diagnosis was returned. Italy now had its first known local transmission. In the press, the man was dubbed Patient One.
When he learned of the sequence of events, Conte fumed. In a television interview, the Prime Minister said: "We know that the way one hospital facility was managed was not entirely appropriate … [and] that certainly contributed to the spread."
Now, the death toll has spiked to more than 2,500, with almost 28,000 people diagnosed with the disease. On Sunday alone, 368 people died from coronavirus in Italy. On Monday that figure was 349. On Tuesday it was 345.
Bergamo anaesthetist Christian Salaroli told daily newspaper Corriere della Sera that the hospitals were so overwhelmed, and the supply of respirators so inadequate, doctors were having to choose who receives treatment.
"We decide depending on their age and the condition of their health," he said. Watching in horror, many around the world are now wondering how Italy got it so spectacularly wrong?
Italy
is one of the nations worst hit by the global coronavirus pandemic, with more
than 90,000 confirmed cases as of Sunday and more than 10,000 deaths. As a
scholar in the field of security and emergency management who has studied and
worked in Italy, I have determined that there are at least five major reasons
why the country is suffering so much.
1. Lots of old people
Italians
have the sixth-longest life expectancy in the world – 84-years. That means lots
of Italians are elderly: In 2018, 22.6 per cent of its population was 65 or
over, among the highest proportions in Europe.
Medical
researchers have said the coronavirus poses a more serious threat to older people
than to younger ones. Older people are more likely to contract the COVID-19
disease and, mostly, to have a more severe case of it. That can also increase
the demand for hospitals’ intensive-care units.
Many
older Italians may have been also exposed to the virus in the workplace; in
2019 the average Italian retirement age was expected to be 67, at least two
years later than average retirees in other Western developed nations.
2. Close proximity
Italians
aren’t used to social distancing. They are very physically affectionate people:
Hugs and cheek-kisses are common not just among family members but also friends
and even work colleagues.
Even
when they’re just chatting, Italians are closer together than many other
people, because their culture’s psychological perception of personal space is
smaller than in other countries. Large social gatherings, formerly common in
public areas, were banned by Italian Prime Minister Giuseppe Conte at the
beginning of March.
3. Dense population
There
isn’t a lot of space in Italy for people to spread out in. Italy is a densely
populated country, with an average density of 205 people per square kilometre.
In comparison, the United States has an average density of 33 people per square
kilometre. Two-thirds of Italians live in urban areas that are even more dense.
Rome has 2,232 people per square kilometre, and Milan packs about 7,550 people
into every square kilometre.
4. Northern Italy is a business hub
Milan,
in northern Italy, is the country’s financial capital, and has close trade and
educational connections with China. The whole region of northern Italy is home
to offices for many multinational corporations.
Workers
travel from all over the world to attend meetings and conventions in northern
Italy. An infected person not only could infect others, but those people could
rapidly spread out across the entire country.
5. Massive number of cases
As of
March 25, China was the only country registering more COVID-19 cases than
Italy. With far fewer people, Italy’s infection rate is much higher than
China’s. No other country has a truly comparable set of circumstances.
A key
factor in emergency management is learning lessons from others in similar
circumstances – but there is no one for Italy to learn from at this stage of
the crisis. Chinese experts have travelled to Italy to help – but many of the
lessons they are bringing only became clear after Italy’s outbreak began, so
the Italians are behind where other countries, with more recent outbreaks, may
be.
The
Italian government has progressively worked to contain the disease, including
declaring a total national lockdown on March 10. Italy has struggled – and is
continuing to fight – against an unprecedented crisis that found dangerously
fertile ground in elements of the country’s demographics, business, geography
and culture.
But
its people haven’t lost their social habits – just adapted them, and created
perhaps a temporary new national motto: “Distanti ma uniti.” Distant, but
united.