Corona strategies on the test bench – Italy: course of caution after a traumatic first wave

Covid-19 deaths in the Ponte San Pietro Bergamo hospital in the province of Bergamo at the beginning of the corona pandemic in March 2020 (imago / FOTOGRAMMA / Carlo Cozzoli)

Fighting the corona pandemic is not a sprint, but a marathon. It is not yet possible to say which countries will do particularly well in the end, especially since new virus variants such as Omicron are constantly changing the situation. As a result, countries whose strategy initially seemed successful can suddenly fall behind.

How the corona strategies of selected countries have proven themselves so far is the focus of research this week in a five-part series. How strict were the measures? How effectively did they succeed in slowing down the spread of the virus and reducing the number of Covid deaths? In the first part of the series we look at Italy.

The corona virus arrived in northern Italy comparatively early and spread quickly there. The country had no chance to prepare. The effects were correspondingly dramatic. A football match, the Champions League game between Atalanta Bergamo and FC Valencia on February 19, 2020 in Milan, is considered a starting point for the outbreak in Italy. The game is called a superspreading event. The details are disputed, but mass infections have repeatedly turned out to be the drivers of the pandemic.

Bergamo fans probably brought the virus to a region where the medical infrastructure was deficient. There were not enough intensive care beds, and the clinics were quickly overwhelmed by the number of Covid 19 patients. The result: Italy quickly counted more Covid deaths than China, the country where the pandemic started. The images of body bags that had to be transported from Bergamo to other places because the city’s crematoria were no longer sufficient went around the world.

Italy at the beginning of the Corona pandemic in March 2020: deserted square in the city of Naples

After the devastating start of the corona pandemic, the Italian government imposed curfews (imago/ZUMA Wire/Fabio Sasso)

The events have opened the eyes of people and governments in other European countries to what the pandemic means in concrete terms. The effects of the first Corona wave in Italy were terrible, but not across the country, but especially in the north. More than 30,000 people died in this first wave of infection in Italy from and with Corona. But the authorities also reacted quickly and sealed off the entire region in March 2020.

In general, Italy took comparatively particularly strict measures very early on in the fight against the pandemic. This is shown by a look at the COVID-19 Stringency Index compiled by the University of Oxford. The measures included the cessation of school operations, closures of shops and companies, and curfews. Italy stuck to this path as the pandemic progressed, and the government and authorities reacted more sharply to each new wave than other countries.

The terrible experiences in the first wave have established a culture of caution in government dealings with Corona. Basically similar to Spain and Portugal, which were also very badly affected by the pandemic early on, were confronted with overburdened clinics and high death rates and also reacted to this situation with strict lockdowns.

Cumulative confirmed COVID-19 deaths per million people

Graphic shows number of Covid-19 deaths in Germany, Italy, India, South Africa, USA and Australia

For some countries, the number of confirmed deaths is much lower than the actual number of deaths. This is due to limited testing and difficulties in assigning the cause of death. (Deutschlandradio / Andrea Kampmann)

When the number of infections rose sharply again in Italy in autumn 2020, this time not only in the north but throughout the country, the effect of the strict measures was clearly evident: the number of deaths also rose sharply again, but compared to the high number of infections but significantly less than in other countries.

After the first corona vaccines were approved in the European Union at the end of 2020, there were initially only a few vaccine doses available in Italy, as in Germany. Accordingly, the vaccination rate increased only slowly. In mid-2021, around half of the population was fully vaccinated – as in Germany. After that things went faster in Italy. Possibly because there, as in Portugal, a general organized the vaccination program.

Certainly, however, because politics increased the pressure to be vaccinated. In October, Italy became the first western country to enact 3G regulation for public and private companies. This means that every employee who has not been vaccinated or has recovered must present a negative corona test every day. A little later, a job-related vaccination requirement for doctors, nurses, teachers, police officers and other professional groups came into force. Currently, more than three quarters of the Italian population has been vaccinated twice, around 40 percent have been boosted (as of January 17th, 2022).

After the devastating first wave of Corona, Italy followed a very strict course during the pandemic – with clear consequences for the economy and, above all, for national debt. Despite drastic measures, however, there were a comparatively large number of corona infections in the country. So far, around 13 percent of the population has already been infected. For comparison: In Germany it was only nine percent at the same time (as of January 17, 2022).

More Italians also died from and with Corona than in this country: According to statistics, there were around 140,000 Corona deaths, that is more than 2,300 per million inhabitants. This value is two thirds higher than the corresponding value for Germany. A difference that is also reflected in the excess mortality: Experts put this for the pandemic period for Italy at 13 percent, in Germany the excess mortality is only four percent.

Despite stricter restrictions, the corona pandemic has left more serious marks in Italy than in Germany, for example. The reasons for this cannot yet be conclusively named. One could be the poorly positioned Italian healthcare system. In Italy, for example, there are less than half the number of intensive care beds per capita as in Germany.

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