An ongoing worldwide pandemic of coronavirus disease 2019 (COVID-19), a novel infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first confirmed to have spread to the Republic of Italy on 31 January 2020, when two Chinese tourists in Rome tested positive for the virus.[2] One week later an Italian man repatriated back to Italy from the city of Wuhan, China, was hospitalised and confirmed as the third case in Italy.[3] A cluster of cases was later detected, starting with 16 confirmed cases in Lombardy on 21 February,[4] and 60 additional cases and the first deaths on 22 February.[5] By the beginning of March, the virus had spread to all regions of Italy.[6]
On 31 January, the Italian government suspended all flights to and from China and declared a state of emergency. In February, eleven municipalities in northern Italy were identified as the centres of the two main Italian clusters and placed under quarantine. The majority of positive cases in other regions traced back to these two clusters.[7] On 8 March 2020, Prime Minister Giuseppe Conte expanded the quarantine to all of Lombardy and 14 other northern provinces, and on the following day to all of Italy, placing more than 60 million people in quarantine.[8][9][10] On 11 March 2020, Conte prohibited nearly all commercial activity except for supermarkets and pharmacies.[11][12] On 21 March, the Italian government closed all non-essential businesses and industries, with additional restrictions to movement of people.[13]
On 6 March 2020, the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) published medical ethicsrecommendations regarding triage protocols that might be employed.[14][15][16]
As of 8 April 2020, Italy is one of the world’s centres of active coronavirus cases with 95,262 active cases.[17] The total of confirmed cases is 139,422, with 17,669 deaths, and 26,491 recoveries or dismissals.[1] By 8 April, Italy had conducted about 807,100 tests for the virus.[18] Due to the finite number of tests performed, the real number of infected people in Italy, as in other countries, is estimated to be higher than the official count.[19][20][21]On 19 March, Italy became the country with the highest number of confirmed coronavirus deaths in the world.[22]
Background
On 31 December 2019, the Health Commission of Wuhan, Hubei, China, informed the WHO about a cluster of acute pneumonia cases with unknown origin in its province. On 9 January 2020, the Chinese Center for Disease Control and Prevention (CCDC) reported the identification of a novel coronavirus (later identified as the SARS-CoV-2) as the cause.[23] In late January 2020, following the developments of COVID-19 outbreak in mainland China, on 3 February, Italy set up enhanced screening measures, including thermal cameras and medical staff at airports.[24]
| COVID-19 cases in Italy (vte) Deaths Recoveries Active casesJan Feb Mar Apr Last 15 days | |||
|---|---|---|---|
| Date | # of cases | # of deaths | |
| 2020-03-26 | | 80,539(+8.3%[vi]) | 8,215(+9.5%) |
| 2020-03-27 | | 86,498(+7.4%) | 9,134(+11%) |
| 2020-03-28 | | 92,472(+6.8%) | 10,023(+9.7%) |
| 2020-03-29 | | 97,689(+5.6%) | 10,779(+7.5%) |
| 2020-03-30 | | 101,739(+4.1%) | 11,591(+7.5%) |
| 2020-03-31 | | 105,792(+4.0%) | 12,428(+7.2%) |
| 2020-04-01 | | 110,574(+4.5%) | 13,155(+5.8%) |
| 2020-04-02 | | 115,242(+4.2%) | 13,915(+5.7%) |
| 2020-04-03 | | 119,827(+4.0%) | 14,681(+5.5%) |
| 2020-04-04 | | 124,632(+4.0%) | 15,362(+4.6%) |
| 2020-04-05 | | 128,948(+3.5%) | 15,887(+3.4%) |
| 2020-04-06 | | 132,547(+2.8%) | 16,523(+4.0%) |
| 2020-04-07 | | 135,586(+2.3%) | 17,127(+3.7%) |
| 2020-04-08 | | 139,422(+2.8%) | 17,669(+3.2%) |
| Sources:Until 2020-02-22: various news sourcesFrom 2020-02-23: Protezione Civile bulletins at 18:00 CETNotes:^ The data on 2020-03-10 does not include cases from the Lombardy region (approx. 600 cases). This brings the geometric average growth for 2020-03-10 and 2020-03-11 to +17%.^ The data on 2020-03-11 does not include cases from Abruzzo.^ The data on 2020-03-16 does not include cases from Apulia and the autonomous province of Trento (approx. 150 cases).^ The data on 2020-03-17 does not include cases from the province of Rimini.^ The data on 2020-03-18 does not include cases from Campania and the province of Parma.^ The data on 2020-03-26 on the number of deaths in Piedmont was transcribed with a typo, and afterwards corrected by Piedmont authorities.[25] |
First confirmed cases
On 31 January, the first two cases of COVID-19 were confirmed in Rome. A Chinese couple, originally from Wuhan, who had arrived in Italy on 23 January via Milan Malpensa Airport, travelled from the airport to Verona, then to Parma, arriving in Rome on 28 January. The next afternoon, they developed a cough, and by evening the man had a fever; the couple were taken to the Lazzaro Spallanzani National Institute for Infectious Diseases where they tested positive for SARS-CoV-2 and were hospitalised.[26][2] On 2 February, a team from the same institute composed of scientists Maria Rosaria Capobianchi, Francesca Colavita, and Concetta Castilletti isolated the genomic sequence of the virus and uploaded it to GenBank.[27][28]
On 31 January, the Italian government suspended all flights to and from China and declared a state of emergency with the duration of six months. Prime Minister Giuseppe Conte said Italy was the first EU country to take this kind of precautionary measure.[29] The government also introduced thermal scanners and temperature checks on international passengers arriving at Italian airports.[24]
On 6 February, an Italian repatriated from Wuhan tested positive for COVID-19, bringing the total number of cases in Italy to three.[30]
On 22 February, the repatriated Italian recovered and was discharged from the hospital.[31]On 22 and 26 February, the two previously infected Chinese tourists tested negative for COVID-19 at Lazzaro Spallanzani National Institute in Rome.[32]
Clusters in northern Italy
Lombardy
The Lombardy outbreak came to light when a 38-year-old Italian tested positive in Codogno, a comune in the province of Lodi. On 14 February, he felt unwell and went to a doctor in Castiglione d’Adda. He was prescribed treatments for influenza.[33] On 16 February, as the man’s condition worsened, he went to Codogno Hospital, reporting respiratory problems.[33] Initially there was no suspicion of COVID-19, so no additional precautionary measures were taken, and the virus was able to infect other patients and health workers.[34] On 19 February, the wife of the patient revealed he had met an Italian friend who had returned from China on 21 January, who subsequently tested negative.[33] Later, the patient, his pregnant wife and a friend tested positive.[33] On 20 February, three more cases were confirmed after the patients reported symptoms of pneumonia.[35] Thereafter, extensive screenings and checks were performed on everyone that had possibly been in contact with or near the infected subjects.[36] It has been subsequently reported that the origin of these cases has a possible connection to the first European local transmission that occurred in Munich, Germany, on 19 January 2020, consistent with phylogenetic analysis of viral genome.[37][38][39] The 38-year-old man was asymptomatic for weeks, reportedly led an active social life and potentially interacted with dozens of people before spreading the virus at Codogno Hospital.[33][34] Afterward, he was transferred to Policlinico San Matteo in Pavia,[40] and his wife to Sacco Hospital in Milan.[41][42]Civil Protection volunteers carrying out health checks at Guglielmo Marconi Airport
On 21 February 16 more cases were confirmed – 14 in Lombardy, including the doctor who prescribed treatments to the 38-year-old Codogno man,[33]and two in Veneto. On 22 February, a 77-year-old woman from Casalpusterlengo, who suffered from pneumonia and visited the same emergency room as the 38-year-old from Codogno, died in Lombardy.[43] Including the 78-year-old man who died in Veneto, the number of cases in Italy rose to 79.[5][44]Of the 76 newly discovered cases, 54 were found in Lombardy, including one patient in San Raffaele Hospital in Milan[45] and eight patients in Policlinico San Matteo in Pavia,[46] 17 in Veneto, two in Emilia-Romagna, two in Lazio and one in Piedmont.[47]
On 23 February, a 68-year-old woman with cancer from Trescore Cremasco died in Crema. The number of cases in Italy rose to 152, including fourteen patients being treated at Policlinico San Matteo in Pavia.[48][49] On 24 February, an 84-year-old man with pre-existing medical conditions from Villa di Serio died in Bergamo while hospitalised in the Papa Giovanni XXIII Hospital.[50] An 88-year-old man from Caselle Landi, who resided in Codogno, died on the same day.[51][52] An 80-year-old man from Castiglione d’Adda died at the Luigi Sacco Hospital in Milan. He was previously hospitalised in Lodi because of a heart attack, and then transferred to Milan when confirmed as positive.[52][53][54] A 62-year-old man with pre-existing medical conditions from Castiglione d’Adda died in Sant’Anna Hospital in Como.[55] Lombardy governor Attilio Fontana announced that the number of cases in Lombardy had risen to 172, with a total of 229 confirmed in Italy.[56][57][58] On 25 February, an 84-year-old man from Nembro, a 91-year-old man from San Fiorano and an 83-year-old woman from Codogno died from complications caused by the infections.[59][60][61]
The number of cases in Emilia-Romagna rose to 23, spreading through the provinces of Piacenza, Parma, Modena and Rimini. These were all linked to the Lombardy cluster.[62][63][64][65][66] A new case linked to the outbreak in Lombardy appeared in Palermo, Sicily, when a 60-year-old woman from Bergamo tested positive and was admitted to Cervello Hospital.[67][68] A 49-year-old man who previously visited Codogno tested positive in Pescia, Tuscany.[69] Officials in Liguria confirmed that a 72-year-old female tourist from Castiglione d’Adda tested positive in Alassio while she was staying in a hotel. The woman was treated at a hospital in Genoa.[70] Later in the day, a second case in Liguria was confirmed, a 54-year-old man who had visited Codogno for work and tested positive in La Spezia.[71][72][73] On 26 February, a 69-year-old man from Lodi with pre-existing medical conditions died in Emilia-Romagna.[74] The mayor of Borgonovo Val Tidone, Pietro Mazzocchi, tested positive for SARS-CoV-2 and underwent a voluntary isolation at home.[75]
Additional cases involving six minors were identified in Lombardy. A 4-year-old girl from Castiglione d’Adda was admitted to Policlinico San Matteo in Pavia, and a 15-year-old was hospitalised in Seriate Hospital in Bergamo. Two 10-year-olds from Cremona and Lodi tested positive and were discharged. A 17-year-old from Valtellina who attended a school in Codogno, and a school friend from Sondrio, also tested positive.[32][74][76] Officials in Apulia confirmed that a 33-year-old man from Taranto, who returned from Codogno on 24 February, tested positive and was admitted to San Giuseppe Moscati Hospital.[77] A close advisor to Lombardy governor Attilio Fontana tested positive for SARS-CoV-2. Although Fontana tested negative, he decided to put himself in preventive isolation as well.[78] Officials in Campania confirmed two new cases. A 24-year-old woman from Caserta, who had visited Milan, tested positive. A 25-year-old Ukrainian woman from Cremona, who previously visited Lombardy, tested positive at a hospital in Vallo della Lucania. Both were transferred to Hospital Domenico Cotugno in Naples, where they underwent isolation.[79]
On 26 February, a woman who had returned from Milan in the days before the emergency in Lombardy had started tested positive for the virus in Catania, Sicily.[80] On 27 February, two 88-year-olds and an 80-year-old died in Lombardy.[81] Officials in Abruzzo confirmed that a 50-year-old man from Brianza, Lombardy tested positive and was admitted to the intensive-care unit at Giuseppe Mazzini Hospital at Teramo. He and his family were staying in his holiday home at Roseto degli Abruzzi.[71][82] On 28 February, four people died, including an 85-year-old Lombardy resident in one of the quarantine zones at a hospital in Piacenza, a 77-year-old and two others over the age of 80.[71] As of 1 March 2020, there were 984 confirmed cases and 73 recoveries in Lombardy.[71][83]On 4 March, Emilia-Romagna’s regional minister of health, Raffaele Donini, and minister for territories, Barbara Lori, were declared positive for COVID-19.[84] Governor Stefano Bonaccini and the other members of the regional government tested negative.[85]
On 8 March, Prime Minister Giuseppe Conte extended the quarantine lockdown to cover all the region of Lombardy and 14 other northern provinces.[86] On 10 March, Prime Minister Conte increased the quarantine lockdown to cover all of Italy, including travel restrictions and a ban on public gatherings.[87]
On 25 March, the Associated Press dubbed the UEFA Champions League match between Bergamo club Atalanta B.C. and Spanish club Valencia at the San Siro in Milan on 19 February as “Game Zero”. The match was the first time Atalanta has progressed to a Champions League round of 16 match, and had an attendance of over 40,000 people – about one third of Bergamo’s population. By 24 March, almost 7,000 people in the province of Bergamo had tested positive for COVID-19, and more than 1,000 people had died from the virus – making Bergamo the most hard-hit province in all of Italy during the pandemic.[88]
Veneto
Civil Protection‘s first aid spot in Padua
A secondary cluster of infections occurred in the region of Veneto, initially thought to be the result of a farmer being infected when visiting the primary source in Codogno.[34] The farmer was tested, and the following day, the test was confirmed negative.[89]
On 21 February 2020, two people tested positive in Veneto. The next day, one of them, a 78-year-old man, died at the Schiavonia Hospital in Monselice, making him the first fatality in Italy. The man lived in the municipality of Vò, which was put under quarantine.[90]
On 25 February, a 76-year-old woman with pre-existing medical conditions died in Treviso.[91]
On 26 February, an additional case involving a minor was identified. An 8-year-old girl who lived in Codevigo tested positive.[32][76][92]
On 28 February, Veneto governor Luca Zaia mentioned that after the first two cases, he ordered all 3,300 Vò residents to be tested. Of 6,800 swabs, 1.7% were confirmed positive. This epidemiological study would be used for outbreak investigation by the University of Padua.[93]
As of 28 February, there were 151 confirmed cases in Veneto, with 70 cases in the municipality of Vò, including the two fatalities.[71][93]
By 14 March, no new cases were detected in the municipality of Vò.[94]
Spread to other regions
Paramedics carrying a patient under biocontainment, in Cervia
A number of cases have emerged in multiple regions that might be isolated and not associated with the Northern Italy clusters.
On 25 February, the first case in Florence, Tuscany involved a 63-year-old entrepreneur with companies in Asia who had returned from the Philippines and Singapore on 6 January. He tested positive and was admitted to Santa Maria Annunziata Hospital.[32][95]
The first case in Rimini involved a 71-year-old man from Cattolica who returned from Romania on 22 February. He tested positive and was admitted to Infermi Hospital.[96][97] A 51-year-old man from Piandimeleto who went to Romania with the man also tested positive and underwent self-quarantine at home.[98] On 26 February, one of people with whom he had interacted in Romania tested positive.[99]
On 26 February, the Norwegian Institute of Public Health confirmed that a 26-year-old Norwegian man living in Florence tested positive and was admitted to Santa Maria Annunziata Hospital. He had stayed in Norway for 14 days and returned to Florence five days before.[100][101]
The passenger ferry GNV Rhapsody was placed under isolation in the port of Genoa with 58 crew members on board after a passenger tested positive for the virus after having sailed to Tunisia on the ship.[102]
On 7 March, President of Lazio and leader of the Democratic Party, Nicola Zingaretti, tested positive for COVID-19.[103] Ten days before, he was in Milan attending public events.[104][105] The following day, President of Piedmont Alberto Cirio also tested positive.[106]
A US Navy sailor stationed in Naples tested positive on 6 March. Health officials in the US military began “a thorough contact investigation” to determine if any other personnel may have been exposed to the virus.[107]
On 11 March, it was announced that Juventus and national team footballer Daniele Rugani had tested positive for COVID-19.[108]
GIMBE (Italy’s Group for Evidence-based Medicine), in a report from 18 March, analysed data from the Istituto Superiore di Sanità and found that healthcare workers represented over 8% of all detected coronavirus cases.[109]
On 26 March 2020, Italica Grondona became the world’s oldest person to recover successfully from the coronavirus at the age of 102.[110][111] She was successfully recovered from the coronavirus after being tested positive with mild symptoms and was hospitalised in Genoa on 9 March for 20 days.[112]
On 22 March, it was announced that Juventus forward Paulo Dybala and former Italy national team captain Paolo Maldini had tested positive for COVID-19.[113]
Under national lockdown
Starting on 8 March, the region of Lombardy together with 14 additional northern and central provinces in Piedmont, Emilia-Romagna, Veneto, and Marche, were put under lockdown.[114] Two days later, the government extended the lockdown measures to the whole country.[115]
Two weeks later, the number of new cases per day started to show signs of slowing down, while the number of new deaths rose slightly.[116] On 31 March, the president of the Italian National Institute of Health, Silvio Brusaferro, announced that the pandemic had reached its peak in the country.[117] The news was confirmed also by the head of the Civil Protection, Angelo Borrelli.[118]
Three weeks into the lockdown, its effects began to show. Italy reported declines in the number of new cases and of new deaths per day. The country also saw a steady decrease in the occupancy of intensive care units.[119] On 5 April, Italy had the lowest number of new daily deaths in two and a half weeks,[120] and one day later the lowest number of new daily cases in three weeks.[121]
Management
First measures
On 31 January 2020, the Italian Council of Ministers appointed Angelo Borrelli, head of the Civil Protection, as Special Commissioner for the COVID-19 emergency.[122][123]Italian government task force to face the COVID-19 outbreak in the Civil Protectionsituation room on 23 February. Prime Minister Giuseppe Conte and Health Minister Roberto Speranza are in the foreground, from behind.
On 22 February, the government announced a new decree imposing the quarantine of more than 50,000 people from 11 different municipalities in Northern Italy. The quarantine zones are called the Red Zones and the areas in Lombardy and Veneto outside of them are called the Yellow Zones.[124]Penalties for violations range from a €206 fine to three months of imprisonment.[125] The Italian military and law enforcement agencies were instructed to secure and implement the lockdown.[126]
Schools were closed in ten municipalities in Lombardy, one in Veneto and one in Emilia Romagna. All public events were cancelled and some commercial activities[which?] were halted or were allowed to resume only until 6 pm.[127][128] All religious services were cancelled.[129] Regional train services to the most affected areas were suspended, with trains skipping stops at Codogno, Maleo and Casalpusterlengo stations.[130][131]
People with symptoms were advised to call the 112 emergency number, instead of going directly to hospitals, in an effort to limit the disease’s spread.[132] The Ministry of Health provided a website and a direct line (1500) from which people could obtain the latest updates and information, as well as report suspected cases.[133]
Educational trips to destinations in Italy and abroad were suspended. Universities in Lombardy, Veneto, Trentino Alto-Adige, Piedmont and Emilia-Romagna suspended all activities from 23 February until 1 March.[134][135][136][137][138][139]
On 22 February 2020, Prime Minister Giuseppe Conte suspended all sporting events in the regions of Lombardy and Veneto, which included three Serie A football matches in those regions, as well as one in Piedmont, that were to be played the following day.[140][141][142] The following week, six Serie A matches were initially to be played behind closed doors, but all were later suspended,[143][144][145] as were two Coppa Italia matches.[146][147]
Authorities in Veneto cancelled the last two days of the Carnival of Venice.[148] Authorities in Piedmont cancelled the last three days of the Carnival of Ivrea.[149]
La Scala, Duomo di Milano and Piccolo Teatro in Milan, as well as Basilica Di San Marco in Venice, were closed until further notice.[150][151][152] A Giorgio Armani fashion show, which was scheduled on Sunday, the last day of Milan Fashion Week 2020, went ahead without any media or buyers present; it was instead streamed live online.[153][154]
In addition to the emergency phone numbers 112 and 118, new dedicated numbers were added for the different regions – Lombardy 800894545, Campania 800909699, Veneto 800462340, Piedmont 800333444 and Emilia-Romagna 800033033.[155][156][157][158] The Ocean Viking, a rescue ship operated by MSF and SOS Mediteranee that was carrying almost 300 migrants, was quarantined for 14 days in Pozzallo, Sicily.[159] Trenitalia and Italo, the major providers for Italy’s high-speed trains, ordered the installation of hand-sanitiser dispensers on all trains as well as the distribution of masks, disposable gloves and disinfectants to all onboard staff members.[160]Empty shelves at the Esselungasupermarket in Bergamo, 26 February 2020
Supermarkets in Lombardy and Emilia-Romagna were emptied by customers as residents stockpiled food and supplies.[161][162][163] Streets, parks and train stations in multiple cities in Lombardy were left deserted.[164][165]
On 24 February 500 additional police officers were assigned to patrol the quarantined areas in Lodi and Veneto.[166] Additional toll-free numbers were added for other regions — Valle D’Aosta 800122121, Trentino Alto Adige 800751751, Friuli Venezia Giulia 800500300, Toscana 800556060, Umbria800636363, Marche 800936677 and Lazio 800118800.[158]
The governor of Basilicata, Vito Bardi, instituted a mandatory 14-day quarantine for people arriving from areas in Northern Italy affected by the outbreak.[166] The Ministry of Health announced that it had engaged 31 laboratories in Italy to carry out the analysis of swabs from suspected COVID-19 cases.[167] Minister Roberto Speranza appointed Walter Ricciardi, a member of World Health Organization‘s executive committee and former president of Italian National Institute of Health, as a special adviser for relations between Italy and international health organisations.[168] Filming of Mission: Impossible 7 starring Tom Cruise in Venice was halted.[169]
Major companies such as IBM, Enel, Luxottica, PwC and Vodafone continued to allow employees to work from home. Generali Tower in Milan and Palazzo Madama in Rome installed thermal scanners to measure temperatures of visitors and employees.[170][171] FAO Headquarters in Rome conducted temperature checks on visitors entering the building.[172]
Multiple regions in Italy such as Liguria, Trentino Alto Adige, Friuli Venezia Giulia, Abruzzo and Marche decided to close all schools and universities for two days to a week. Court proceedings were postponed until further notice.[157]Starting from the 9th week of the year, ICU cases related to COVID-19 started to appear in the hospitals. Their spike showed a different behaviour than the cases of seasonal flu.[173][174]
The FTSE MIB Index fell by 6% and other stock market indices across Europe were also affected.[175] Over 300,000 calls per day were logged on Lombardy’s toll-free line as well as the emergency number 112.[176] Some of the residents inside the Red Zone managed to leave the quarantined areas daily, bypassing the checkpoints by going through back roads.[177][178]
On 25 February, Aviano Air Base closed all schools until 28 February.[71] General Tod D. Walters issued a travel ban covering the areas of Italy affected by the outbreak for US service members and their families.[179] Driver’s licence exams were suspended in Lombardy and Veneto.[180] The number of checkpoints in the Red Zones was increased from 15 to 35, and army personnel were sent to help staff the checkpoints.[181]
The Italian Basketball Federation suspended all of its championship games, including Lega Basket Serie A.[182]
Istituto Tecnico Economico Enrico Tosi in Varese, Istituto Comprensivo di Pianoro in Bologna and Liceo Attilio Bertolucci in Parma conducted lessons for students online while waiting for the schools to reopen.[183][184][185] The University of Palermo suspended all activities until 9 March.[186]
Morgan Stanley, Barclays, Mediobanca and UniCredit requested their Milan staff to work from home.[187]
Multiple fairs and exhibitions were rescheduled. Salone del Mobile, a furniture fair in Milan, was postponed to 16 to 21 June.[188] Bologna Children’s Book Fair was rescheduled to 4 to 7 May.[189] Cosmoprof Worldwide Bologna, a cosmetic fair, was rescheduled to 11 to 15 June.[190] Expocasa, a furniture fair in Turin, was rescheduled initially to 28 March to 5 April but later to future date to be announced later.[191][192] Roma Motodays was postponed to 17 to 19 April.[193]
Italy opened a probe into skyrocketing online prices for masks and sanitising gels. Police issued warnings that criminals were using false identities and posing as health inspectors to gain access to people’s homes to steal money, jewellery and other valuables.[194]
On 26 February, Director of the Italian National Institute of Health Franco Locatelli announced that swabbing would only be performed on symptomatic patients, as 95% of the swabs previously tested were negative.[195]
The Italian Minister of University and Research, Gaetano Manfredi, announced that online lessons would be delivered to students in areas affected by the outbreak starting on 2 March.[196]Palermo and Naples closed all schools until 29 February.[197][198] The University of Basilicata installed a thermal scanner and continued all teaching activities as per normal.[199] The University of Bari suspended all medical- and health-related internships for medical and healthcare students.[200] Politecnico di Milano conducted thesis mentoring for more than one thousand students graduating the following week using Skype.[201]A sign in Bologna, advising the closure of all museums in the city due to the outbreak
The Italian Winter Sports Federation decided to proceed with the Women’s World Cup alpine skiing races at La Thuile, Aosta Valley on 29 February.[202] The MIDO Milan Eyewear Show was rescheduled to 5 to 7 July.[203]
On 27 February, Taranto, Apulia closed all schools until 29 February.[204] Multiple schools were closed in Roseto degli Abruzzi.[205] D’Annunzio University suspended all activities until 29 February.[206] Cartoocomics Fair in Milan was rescheduled to 2 to 4 October.[207] The Winter Rescue Race in Piedmont was cancelled.[208] University of Bologna planned to set up a remote teaching project in which exams and lessons would be delivered to students online, to be partially completed on 2 March.[209] Messina closed all schools from 29 February to 3 March.[210]
On 28 February, during an interview with Rai News24, Professor Massimo Galli from the Luigi Sacco Hospital in Milan suggested that the majority of newly recorded cases were pre-existing cases that were finally detected during the extensive tests performed on people (and their relatives) who had come in contact with confirmed patients.[211] The rapid increase of positive cases was the result of the blanket testing approach that was deployed following the first confirmed case in Codogno.[212]
The Ministry of Health announced new guidelines for reporting cases. It would no longer report asymptomatic cases (positive swabs taken from patients who were not showing symptoms), which had counted as 40 to 50% of all reported cases at the time. These people would undergo isolation at home and would be followed up with new tests until they were negative.[213][214] Universities in Lombardy extended their closure until 7 March.[71]
Nationwide measures
On 1 March, the Council of Ministers approved a decree to organise the containment of the outbreak. In the decree, the Italian national territory was divided into three areas:[215]
- A red zone (composed of the municipalities of Bertonico, Casalpusterlengo, Castelgerundo, Castiglione D’Adda, Codogno, Fombio, Maleo, San Fiorano, Somaglia and Terranova dei Passerini in Lombardy, and the municipality of Vò in Veneto), where the whole population is in quarantine.
- A yellow zone (composed of the regions of Lombardy, Veneto and Emilia-Romagna), where social and sport events are suspended and schools, theatres, clubs and cinemas are closed.
- The rest of the national territory, where safety and prevention measures are advertised in public places and special sanitisations are performed on means of public transport.
Montage of notices on shops in Bologna declaring their temporary closure, or requiring people to stay at least one metre apart
On 4 March, the Italian government imposed the shutdown of all schools and universities nationwide for two weeks as the country reached 100 deaths from the outbreak.[216][217] The same day, the government ruled that all sporting events in Italy would be played behind closed doors until 3 April.[218]
On 5 March, when the newly appointed Emilia-Romagna regional minister of health, Raffale Donini, tested positive for COVID-19, Governor Stefano Bonaccini appointed Sergio Venturi as commissioner for the emergency. Venturi was the regional minister of health until February 2020.[219]
In the night between 7 and 8 March, the government approved a decree to lock down Lombardy and 14 other provinces in Veneto, Emilia-Romagna, Piedmont and Marche, involving more than 16 million people.[114] The decree “absolutely avoided any movement into and out of the areas” and, like the previous one, it provided sanctions of up to three months in prison for those who violated the lockdown.[220] It was possible to move into and out of the areas only for emergencies or “proven working needs”, which must be authorised by the prefect.[221] The decree also established the closure of all gyms, swimming pools, spas and wellness centres. Shopping centres had to be closed on weekends, while other commercial activities could remain open if a distance of one metre between customers could be guaranteed.[222] The decree imposed the closure of museums, cultural centres and ski resorts in the lockdown areas and the closure of cinemas, theatres, pubs, dance schools, game rooms, betting rooms and bingo halls, discos and similar places in the entire country.[223] Civil and religious ceremonies, including funeral ceremonies, were suspended. All organised events were also suspended, as well as events in public or private places, including those of a cultural, recreational, sporting and religious nature, even if held in closed places.[224] This measure was described as the largest lockdown in the history of Europe,[225][226] as well as the most aggressive response taken in any region beyond China, and paralysed the wealthiest parts of the country as Italy attempted to constrain the rapid spread of the disease.[227][228]
Riots broke out in many penitentiaries throughout Italy after restrictions on conjugal visits were imposed by the government in the 8 March decree.[229] Nine prisoners died in Modena and three in Rieti,[230][231] while 76 detainees escaped from Foggia‘s penitentiary.[232][233][234] Two prison agents were assaulted and kidnapped in Pavia.[235] On 9 March in Bologna, detainees took control of the Dozza penitentiary, forcing personnel to exit the building.[236] On 11 March, two prisoners were found dead in Bologna’s penitentiary.[237]
On 9 March, the government announced that all sporting events in Italy would be cancelled until at least 3 April, but the ban does not include Italian clubs or national teams participating in international competitions.[238] In the evening, Conte announced in a press conference that all measures previously applied only in the so-called “red zones” had been extended to the whole country, putting approximately 60 million people in lockdown. Conte later proceeded to officially sign the new executive decree.[115][239]Queue in front of a supermarket after the introduction of social distancing rules
On 11 March, the government allocated 25 billion euros for the emergency.[240] In the evening, Conte announced a tightening of the lockdown, with all commercial and retail businesses except those providing essential services, like grocery shops and pharmacies, closed down.[12][11][241] He also appointed Domenico Arcuri as Delegated Commissioner for the Emergency. Arcuri will cooperate with Commissioner Angelo Borrelli with the aim of strengthening the distribution of intensive care equipment.[242]
On 19 March, the Army was deployed to the city of Bergamo, the worst hit Italian city by the coronavirus, as the local authorities can no longer process the number of dead residents. The city’s mayor Giorgio Gori said the true number of dead could be much higher than reported.[243] Army trucks transported bodies to crematoriums in several other cities, as cemeteries in the city were full.[244] On the following day, the Army was called in to assist the police forces in enforcing the lockdown.[245]
On 20 March, the Ministry of Health ordered tighter regulations on free movement. The new measures banned open-air sports and running, except individually and in close proximity of one’s residence. Parks, playgrounds and public green were closed down. Furthermore, movement across the country was further restricted, by banning “any movement towards a residence different from the main one”, including holiday homes, during weekends and holidays.[246]
On 21 March, Conte announced further restrictions within the nationwide lockdown, by halting all non-essential production, industries and businesses in Italy, following the rise in the number of new cases and deaths in the previous days.[247] This measure had also been strongly asked for by multiple institutions, including trade unions, mayors, and regional presidents, as well as medical professionals, but was initially opposed by the industrialists.[248][249][250][251][252][253]
On 24 March, in a live-streamed press conference, Conte announced a new decree approved by the Council of Ministers. The decree imposed higher fines for the violation of the restrictive measures, and a regulation of the relationship between government and Parliament during the emergency. It included also the possibility of reducing or suspending public and private transport, and gave the regional governments power to impose additional restrictive regulations in their Regions for a maximum of seven days before being confirmed by national decree.[254][255]
On 1 April, the government extended the period of lockdown until 13 April, with health minister Speranza saying that the restrictive measures had begun to yield the first positive results.[256]
On 6 April, the government announced a new economic stimulus plan, consisting of €200 billion of state-guaranteed loans to companies and additional €200 billion of guarantees to support exports.[257]
On 7 April, after more than a month of suspension, the Italian Basketball Federation officially ended the 2019–20 LBA season, without assigning the title.[258]
On 8 April, a government’s decree closed all Italian ports until 31 July, stating that they do not ensure the necessary requirements for the classification and definition of “safe place”, established by the Hamburg Rules on maritime search and rescue.”[259]
Local measures
On 15 March, President of Campania Vincenzo De Luca imposed a strict quarantine on Ariano Irpino, in the province of Avellino, and four other municipalities in the province of Salerno, Atena Lucana, Caggiano, Polla, and Sala Consilina.[260]
On 16 March, President of Emilia-Romagna Stefano Bonaccini imposed a strengthened quarantine on the municipality of Medicina, near Bologna, since it had developed an intense outbreak. People were not allowed to enter or exit the town for any reason.[261]
Screening and testing policies
The strategy of mass-testing asymptomatic carriers was proven to be successful in stopping the spread of the virus in one Italian town.[262][263][264] This strategy in Italy was supported by the region of Veneto.[265]
Lockdown areas
On 22 February, the government established a lockdown for eleven municipalities in Lombardy and Veneto.[266]Map of the ten Lombard municipalities under lockdown since 22 February
| Comune | Province | Region | Population |
|---|---|---|---|
| Bertonico | Lodi | Lombardy | 1,118 |
| Casalpusterlengo | Lodi | Lombardy | 15,293 |
| Castelgerundo | Lodi | Lombardy | 1,498 |
| Castiglione d’Adda | Lodi | Lombardy | 4,646 |
| Codogno | Lodi | Lombardy | 15,907 |
| Fombio | Lodi | Lombardy | 2,317 |
| Maleo | Lodi | Lombardy | 3,098 |
| San Fiorano | Lodi | Lombardy | 1,839 |
| Somaglia | Lodi | Lombardy | 3,837 |
| Terranova | Lodi | Lombardy | 927 |
| Vò | Padua | Veneto | 3,305 |
| Quarantine total | 53,785 |
On 7 March, the government prepared to extend until 3 April the restricted zone to all of Lombardy, plus fourteen other provinces in Veneto (3), Emilia-Romagna (5), Marche (1) and Piedmont(5).[268] The lockdown affects over 16 million people, roughly a quarter of Italy’s total population, and prevents people from entering or leaving the zone, except “for proven occupational needs or situations of need or for health reasons”,[269] under threat of fines.[270] The enclave nation of San Marino, which is nestled between two of the provinces, has been effectively locked down as well.[271]
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