COVID-19 containment with style: A first-hand account of the virus containment efforts in Italy

13 March 2020, 1113 EDT

This is a guest post from Gabriel Cardona-Fox who lives in Bologna, Italy with his wife Patricia and two daughters.  He is an Associate Fellow at the Bologna Institute for Policy Research at Johns Hopkins University’s School of Advanced International Studies (SAIS) – Europe. He received a PhD from the University of Texas at Austin, an MA from Johns Hopkins SAIS and a BA from Princeton University.  His research revolves around internal forced migration and humanitarian affairs.  

This week, Italy put in place some of the most draconian restrictions on freedoms and movement of any western society since the end of World War II, in an effort to contain the COVID-19 virus. Together with 60 million other people in the country, my family has been having to adapt to this new strange reality. For the past two and a half years, we have been living in the beautiful medieval city of Bologna, where I have a research fellowship at Johns Hopkins’ School of Advanced International Studies.

With over 15,000 confirmed cases, Italy is home to the largest outbreak outside of China. As the number of infected has grown exponentially over the past two weeks, Italy’s hospitals, particularly in the northern region of  Lombardy, are quickly becoming overwhelmed – sometimes operating at 200%  capacity.  There are some frightening reports of triaging and a lack of respirators.

The tightened nation-wide quarantine measures announced two nights ago by Premier Conte include the closure of all shops, bars, pubs and restaurants. Only food stores, pharmacies, and essential service providers like opticians and computer technicians are allowed to remain open. Home delivery is still permitted but people are strongly encouraged to stay at home and visit grocery stores sparingly, one family member at a time.

People who do not live under the same roof are to maintain a distance of a meter or more from each other in public. Banks, post offices and other essential services will continue to operate.  Schools and universities are to remain closed until April 3. A few schools are conducting online education but most are not. This means that an entire generation of children and adolescents are idling at home.

Big businesses such as factories are allowed to remain open but they must adopt appropriate measures to limit contagion. 

Since Monday, all Italians are forbidden to travel or leave their house unless for “urgent, verifiable work situations and emergencies or health reasons.” Those who venture outside must fill and sign an official auto-declaration form justifying their movement which they may need to present if stopped by the police. Everyone is being asked to stay indoors unless they need to go to work or buy essential provisions. Violating these restrictions can result in up to three months of prison and a hefty fine.

Since the announcement of additional restrictive measures, there have been several conflicting official pronouncements regarding the details of the new restraints, and various cities are offering competing interpretations. This, of course, is not unusual for a country known for its byzantine and chaotic government bureaucracy. It is unclear, for example, if people will still be able to exercise outdoors while maintaining a safe distance from others, and how far one can walk the dog. Endless debates on the matter are ensuing in social media platforms.

Rather than elaborating on the details of the new restrictions, as these tend to change frequently, the government is appealing to Italians’ sense of civic responsibility, urging them to use common sense in an effort to protect the most vulnerable, their parents and grand-parents.  In an aging society such as Italy’s this is a particular concern that carries a lot of weight and may partly explain why the COVID-19 mortality rate in Italy has been so much higher than in China.

Unlike China, Italy is not enforcing these stringent limitations on freedoms with a heavy hand.  Police checkpoints are almost unheard of, except perhaps in train stations, airports and some border areas.  Italian cities do not look at all like the ghost towns of Hubei province. Carabinieri and state police continue to patrol public areas but do not seem to be asking anyone for their auto-declaration forms. A group of teenagers was fined yesterday for congregating illegally in a park in Bologna prompting the closure of all city parks until April 3. There are no soldiers on the street, helicopters or drones surveying the population. Instead, authorities have been engaging in a game of cat and mouse with citizens, scolding them on television and occasionally slapping them on the wrist with fines and warnings when they break the rules. 

Since the restrictions were put in place it is not uncommon to see people out in public shopping for cigarettes, fresh produce and groceries, walking their dogs, exercising, and sun-bathing on benches, albeit in significantly smaller numbers than normal. A few people occasionally do congregate in small groups in public to check-in with their neighbors and catch up with the news. They keep a safe distance from each other, some of them wearing face masks, resembling a group of college students about to begin a game of hacky sack.  Their encounters are brief and nervous.

The new restrictions meant to isolate people are clearly difficult for many to accept. Italians share strong social bonds and a culture of “the piazza” (or square) that propels them to spend a lot of time outside of the house socializing with neighbors and friends. Resisting the urge to leave one’s home is like trying not to touch one’s face. It’s hard not to do it even when we know we should avoid it.

For the moment, the general atmosphere remains calm and civil. The anxiety is palpable but there are no signs of panic. After premier Conte announced the new provisions on television, there was a brief run on automatic cigarette vending machines, but this quickly subsided as it became clear that the tabaccherie would remain open. Riots erupted in a number of prisons when a stop to visitations was announced, but aside from this there have been no reports in the press of looting, vandalism, or any other sort of social unrest.

The police have been cracking down on criminal cartels that have sought to capitalize on the shortage of hand sanitizing gel and face masks by selling them on the black market at highly inflated prices.

Food stores for the most part are well stocked and have not been particularly crowded since the original rush to the stores subsided a few weeks ago and Italians over-packed their small refrigerators and pantries with dry pasta and other provisions. People express confidence in Italy’s excellent public health system – one of the best in the world – even if they regularly make it a hobby to complain about it.

Italians are primarily worried about the impact that this pandemic will have on the country’s fragile economy. Small businesses, cafes and restaurants will likely take a big hit. Those relying on tourism, which accounts for 13% of the country’s economy, are likely to see their troubles extend through the Easter break and into the summer season. In response to this the Italian government, in concert with the rest of the EU, has announced the creation of a sizable emergency stimulus package aimed to help businesses. A moratorium on mortgages and taxes has also been put in place.  It’s still unclear whether Italians will be required to pay their home utility bills this month.

These incremental restrictions were put in place with a frightening speed that caught many people off guard. For the past few days our family has been effectively locked-down in our apartment in the center of Bologna.  Like others, we have been adapting to this reality and settling into a new routine. Our two daughters (11 and 14) have fortunately been able continue their classes online at their International School, however most Italian schools were not sufficiently prepared for anything like this.

Italian society, renowned for its chaotic nature and the artistry of circumventing rules, against all odds, is forging ahead with a relatively successful containment effort. As many commentators have pointed out, Italy offers a good case study of how an advanced western democracy can tackle the spreading pandemic without imposing Chinese style methods of social control. Much of this effort is relying on Italy’s strong ethos of solidarity and civic responsibility that are, for the most part, foreign to a country like the United States. With a few exceptions, Italy’s fractured political establishment has been unified in its response to the crisis and has not shown anything like the type of political polarization seen lately in America.

Italians are resignedly accepting the increasingly onerous restrictions on their mobility and lifestyles, and they are doing it with resilience and elegance – riding their bikes with a face mask and a Gucci scarf, making sure to carry their signed auto-declarations.

The quarantine has been forcing my family and others to slow down and take advantage of our time at home together. Like others, we try to distract ourselves by cooking, gardening, reading, working on a large jigsaw puzzle, and watching Netflix movies at night. Internet connectivity has slowed down significantly, as millions of people enclosed in their houses migrate to virtual world, where even local gyms have begun offering fitness classes online. We do our best to stay informed, reading the Italian and international press, connecting with our small group of expat friends, and checking on each other regularly. It has been particularly sad to see a city usually vibrating with life reduced to the quietude of empty cafes and abandoned piazzas.

Bologna has witnessed several deadlier epidemics and experienced worse privations  throughout its history. The Italian Plague that swept through the country in the 17th Century wiped out close to a fourth of the city’s population. The hardships imposed by World War II are still fresh in the minds of the older generation Bolognese, whom against all medical advice stubbornly continue to venture out of their homes every morning to buy their newspaper and freshly baked bread. 

It is likely that as the numbers of infected and deceased continue to grow – Bologna currently counts over 100 infected and 22 patients in intensive care – restrictions on mobility will become more onerous, including the imposition of curfews. The most recent nation-wide figures appear to suggest that the measures imposed are having an effect in that the number of new infections is slowing down. 

With a nervous smile my neighbors remind me that this too shall pass. Life is a little tougher for the moment, but when this blows over in a few months Bologna’s medieval towers and famed porticoes will remain standing as they have for ages.  Andrà tutto bene!