Coronavirus: for all its blunders, Italy offers hope for other democracies

Hard-hit Italy turns corner on coronavirus despite rule-defying populace, dysfunctional bureaucracy.

A man walks past St Peter’s Square at the Vatican during the country's lockdown aimed at curbing the spread of the COVID-19 infection. Picture: AFP

Rapper Federico Lucia’s music is filled with scathing lyrics about Italian society.

But when the novel coronavirus struck his hometown of Milan in March, he and his wife, fashion entrepreneur Chiara Ferragni, used their celebrity to solicit donations. The $5 million they collected quickly turned into a new 20-bed intensive-care unit for coronavirus patients at the city’s San Raffaele Hospital.

“This virus emergency has made us discover a sense of belonging,” said Mr Lucia, who performs under the stage name Fedez. “We are united like we have never been for at least 30 years.”

Italy has long had a reputation as a nation with a rule-defying populace, comical politics and a dysfunctional bureaucracy. But its national lockdown since early March is showing that an unruly, freedom-loving Western society can come together at a critical time to contain the pandemic.

The country appears to be turning the corner in its battle against the virus. New infections are declining, the number of people needing intensive therapy and other hospital care is stabilising, and even the daily death toll is finally trending down.

“We have begun to see the light at the end of the tunnel. We can touch it,” said immunologist Alberto Mantovani, scientific director of the Humanitas hospitals in Milan and Bergamo. “We feel it in the hospital. The number of admissions is down and people are leaving the ICU.”

The way out of the crisis came at a great cost. An early refusal to abandon the nation’s way of life was followed by a frazzled lockdown that induced its economy into a coma. It has the highest death toll of any nation so far, with at least 17,669 dead, or 0.03 per cent of the population. The real toll is almost certainly significantly higher, because thousands of virus-related deaths outside of hospitals in the hard-hit north haven’t been counted.

Italy’s increased restrictions—and its people’s eventual willingness to follow them—might have saved its central and southern regions, which so far have avoided the devastation wrought on the country’s north. But with the restrictions in their fifth week, some Italians are also showing signs of lockdown fatigue—prompting concerns that more social interaction and looser observance of the rules could undermine recent achievements and lead to new outbreaks.

With the US and other Western nations believed to be lagging one to four weeks behind Italy on the epidemiological curve, the country’s experience offers a tentative hope that democracies can defeat the coronavirus without compromising their fundamental freedoms or adopting the kind of repressive measures employed by China.

A nurse wearing a protective mask walks between the transportable beds next to the intensive care unit at a hospital in Rome. Picture: AFP

“Italy shows that democracies can be just as efficient as dictatorships,” said Roberto Burioni, professor of virology at San Raffaele Hospital. “Italians have demonstrated that, when it’s necessary, they can work, they can be committed, they can move ahead at the same speed as the Chinese.”

Italy was the first democracy to impose a lockdown. It will also be among the first to grapple with how to begin easing the restrictions, which are taking a severe economic toll.

A series of early mistakes allowed the virus to spread. Northern Italy’s Lombardy region, the epicentre of Europe’s virus outbreak, adopted restrictions as early as February 23, closing down cinemas, churches, schools, museums, stadiums and bars. It also imposed a quarantine on a cluster of virus-stricken small towns south of Milan.

But many Italians, sceptical about the danger, scoffed at appeals for social distancing. Opposition leader Matteo Salvini released a video on February 27 urging the country to “reopen everything” because the situation was supposedly under control, saying he wanted to see packed stadiums. The same day, Nicola Zingaretti, leader of the Democratic Party, part of Italy’s governing coalition, posted an image of himself having a drink with several other people in Milan. It was captioned: “Our economy is stronger than fear—Let’s go out for an aperitivo, a coffee or a pizza.”

A street cleaner truck sprays disinfectant on a street to avoid the spread of COVID-19 virus in central Rome. Picture: AP

Amid political pressure to loosen the restrictions, museums were reopened. The Rome Opera announced performances to show “resistance” to the virus. Tens of thousands of Italians packed ski resorts. The central government in Rome pushed back against Lombardy’s pressure for more radical steps.

“At the beginning, people were a little confused because the message wasn’t clear. Were you supposed to stay in or could you go out?” said Lombardy Governor Attilio Fontana. “People started to move about and social contacts increased, giving oxygen to the virus to start spreading again.”

The mood changed almost overnight as the body count mounted. On March 7, Mr Zingaretti tested positive for the virus. The next morning, Prime Minister Giuseppe Conte’s government imposed a lockdown on Lombardy and nearby northern Italian provinces—the first democratic country to implement such restrictions on people’s movement in decades. This time, the measures were backed across the political spectrum. The opposition now clamoured for even harsher controls.

Mr Conte extended the lockdown to all of Italy on March 10, and has since tightened the rules by closing down nearly all offices and factories in the country—steps all widely approved by Italy’s traditionally bickering politicians. An obscure law professor who became prime minister in 2018 through Byzantine political deal-making, Mr Conte has become one of Italy’s most popular leaders ever, with approval ratings as high as 72%.

Italians, not normally known for their patience at queuing, have been lining up diligently in front of supermarkets, bakeries and pharmacies, keeping a safe distance. Italian supermarkets have stayed well stocked, with nearly no sign of panic-buying—in contrast to the empty shelves in the UK and many American cities.

Economic hardship is growing among poorer families without savings. But there has been little social disorder so far. Italy is enforcing its lockdown by handing out fines, but without imprisoning people or welding shut the doors of apartment blocks, as China did.

“What has emerged from this is a very high level of civility among our citizens, especially the youth,” said Luca Zaia, the governor of the northeastern Veneto region. “We have managed all this in a very civic and participatory way, and haven’t had to resort to public force.”

A Chinese medical team that arrived in Italy in mid-March wasn’t shy in criticising what they saw as Italian laxity. “Your measures aren’t strict enough. I don’t know what people here are thinking,” said Sun Shuopeng, the head of the delegation and a vice president of the Chinese Red Cross.

But Italy’s democratic system has proved an advantage rather than a hindrance in fighting the virus, because it makes individual citizens feel more responsible for everyone’s wellbeing, argued Naples’ Mayor Luigi de Magistris. “Italy has displayed proof of democratic resilience,” he said. “This is the time when democracies need to demonstrate their authority, which is different from authoritarianism. At such a time, nobody should take advantage of the necessary restrictions of individual liberties to install a police state.”

During the coronavirus outbreak in Wuhan in February, China’s propaganda made great use of the country’s ability to rapidly set up field hospitals—something it touted as proof of the superiority of its party-state. But Italy, too, has been able to take similar measures.

Milan’s Policlinico hospital, which dates back to 1456 and has survived plagues and wars, had 28 intensive-care beds before the coronavirus struck. It operated 76 at the end of last week.

For two weeks, some 400 people toiled around the clock building a new 205-bed ICU facility at Milan’s trade-fair centre. The facility, which opened on Sunday, will eventually be served by 216 doctors, 510 nurses and 180 support staff. The rooms have six beds in a row and double doors to control air pressure. Floors are colour-coded green and red, with red showing the areas where the infected patients are located. A hotel will house all staff who don’t want to return home for fear of infecting their families.

“We’ve never tried anything on this scale,” said Marco Giachetti, Policlinico’s chairman. “Before the virus changed everything, I would have never thought this could be done.”

Many other Italians have responded in similarly innovative ways. Liquor giant Campari has begun making hand sanitiser. Car maker Fiat Chrysler is manufacturing components for ventilators, and Ferrari is mobilising its supply chain to assist. Armani converted all its Italian factories to production of single-use gowns for doctors and nurses. Other fashion companies are making face masks.

“We have the means and the machinery. Not doing anything would have been criminal,” said designer Giorgio Armani, the company’s founder.

In Brescia, one of the Lombard cities most devastated by the pandemic, engineer Cristian Fracassi developed a way to transform a common snorkelling mask into one that could be used for ventilation, designing and making 500 valves with a 3-D printer at his company. He then posted the design online, for anyone to use. It is now copied by hospitals as far away as Brazil.

“We were engineers and we didn’t think we could help doctors. But it turns out we can actually help save lives,” Mr Fracassi said.

Italy is set to continue its national lockdown until Easter, and to unwind it only slowly from mid-April onward. The government is subsidising employers’ payrolls while their workforce is idle, and sending checks to the self-employed. That isn’t enough for many households, particularly in the poorer parts of southern Italy, where many people work off the books in the informal economy and don’t qualify for the government subsidies.

In Palermo, the capital of Sicily, only some 600 families were so destitute that they were registered for food assistance before the pandemic, said Mayor Leoluca Orlando. Now, the number is 15,000 and rising as the city rolls out an electronic version of food stamps that can be redeemed with a mobile phone in Palermo’s groceries and supermarkets.

“We have a new poverty,” Mr Orlando said. “We owe a response to all those used to a comfortable life yesterday and who today, stuck at home, no longer have enough to eat.”

In late March, a group of people in Palermo loaded their shopping carts in a Lidl supermarket and refused to pay for their food at the checkout. Police intervened. Since then, according to Mr Orlando, officers are patrolling all of the city’s main food shopping centres. Despite some social-media calls to protest and not pay for groceries, stores have continued to operate normally. “There has been no uprising and no revolt,” the mayor said.

The question is how long this can last. While some Italian manufacturing plants may be reopened in mid-April, there is little likelihood that the country’s vital tourism industry will rebound in time for summer. The same goes for fashion, retail and restaurants.

Milan hosted nearly 10 million tourists last year. “This year we’ll probably have one million, and next year, three million? How many jobs have we lost,” wondered the city’s mayor, Giuseppe Sala. Whenever the city reopens for business, Mr Sala said, it will be gradual, with new lockdowns if infections flare up again, and with only some people, such as the under-50s, allowed back to work at first.

In the Veneto region, authorities are planning to roll out large-scale antibody testing, to let people who have had the virus and are now likely immune to go back to work. “We are planning Phase Two of the emergency, in which we loosen some measures and learn to live with the virus,” Prime Minister Conte said last week.

Giovanni Rezza, head of infectious diseases at the National Health Institute and one of the architects of Italy’s response, said Italy—and the rest of Europe—won’t be able to cut new infections to zero, something China claims to have done. That means the focus after the lockdown will be on thorough monitoring to rapidly identify cases, trace contacts and contain new clusters.

For Italy and most of the world, all that is uncharted territory. “Coronavirus is like an adventure in a forest, where you are opening a new pathway with a machete,” said Veneto’s Gov. Zaia. “There is no marked route. We are building it day by day.”

The Wall Street Journal