How the coronavirus surprised Italy again
By Chico Harlan and Stefano Pitrelli,
Massimo Percossi EPA-EFE/Shutterstock
ROME — After being so devastated by the coronavirus in the spring, Italians saw the ability to reclaim aspects of normal life as a matter of national pride.
They flocked to outdoor cafes and reserved spots at the beach. They put on their masks, resumed using public transportation and returned to their offices. They relished in having successfully brought the virus in check — and pitied Americans for failing to do so. Italy’s worst-to-first pandemic rebound seemed to offer a model for the world.
But now that Italy has been caught up in Europe’s second wave, startled by the virus once more, pride has given way to recriminations and a crisis of confidence. There’s a growing sense that the country and the continent misplayed their second chance.
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“You can’t treat the coronavirus like a hurricane,” bunkering down and expecting the problems to be gone, said Neil Ferguson, an epidemiologist at Imperial College London. “It’s intimately tied with the contacts in society. No European country got close to New Zealand-like levels. The virus was always sitting there, ready to resurge, if contact rates increased.”
Francesca Volpi
Bloomberg News
Travelers fill out declaration forms before traveling from the central railway station in Milan on Friday.
Government advisers and those who study infectious diseases say tight spring lockdowns in Europe tamped down virus transmission for months while covering up other shortcomings that have now come fully into view. Those experts say the outbreaks now engulfing the continent were seeded by a summer of borderless travel, with countries such as Italy eager to salvage lost tourism earnings.
In the rush to reclaim normalcy, creative ideas for how to remake society for the pandemic failed to take hold. Experts advising the Italian government had recommended that factories and other workplaces stagger start times to eliminate rush-hour peaks. They said shops should consider longer hours to reduce crowding. Apps would track infections and perform contact tracing in a way humans never could.
But too few people downloaded the apps to make them useful. Contact tracing collapsed as cases again started to boom. The buses in Rome and Milan were crammed during rush hour.
Italy is now among more than two dozen countries in Europe that are faring worse than the United States, with more per capita cases and deaths. Several European nations have returned to shutdown mode. Italy has instituted a nationwide curfew and sealed off several major regions — the kind of economy-wrecking measures it had hoped were over. Italian Prime Minister Giuseppe Conte had said in August that the country would be able to deal with any future increases in cases without limits on “economic activity.”
Filippo Venezia
EPA-EFE/Shutterstock
Staff wear protective equipment in the covid-19 unit of the Papa Giovanni XXIII hospital in Bergamo, Italy, on Tuesday.
All along, some degree of resurgence was inevitable — especially as the weather cooled and people began to socialize more indoors. But Italian health officials had reasoned a second wave wouldn’t be nearly as severe as the first. Hospitals were more prepared. Treatments had advanced. And, crucially, it was inconceivable that the virus would again lay a trap of the sort at the outset of the pandemic, when it had spread undetected for weeks.
“In the summer, the virus was, to some extent, yesterday’s news,” said Flemming Konradsen, director of the school of global health at the University of Copenhagen. “It became very difficult to communicate persuasively to all groups in a society that we should keep our guard high, because it was less seen, less acute.”
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Several European scientists, including in Italy, made the case the virus had weakened, a minority scientific position that nonetheless captured attention with summer hospitalization rates so low.
Guglielmo Mangiapane
Reuters
Barber Luigi Pinzo, 80, sweeps the floor as he prepares to close his salon after 60 years. He lost customers because of coronavirus fears.
Italy had given itself one of the best chances among European countries to sustainably contain the virus after the spring crisis. Its emergence from the March and April lockdown had been anything but swift or reckless, with new reopenings coming at two-week intervals, to gauge their riskiness. Life, initially, was dominated by caution. Even stepping into a coffee shop felt risky — and bars instead offered at-the-door takeaway in plastic cups.
But week after week, things relaxed, fed by the encouraging daily case numbers that seemed to confirm a little socializing wasn’t so bad. By midsummer, even the nightclubs were open, applying fanciful social distancing rules. As in other European countries, the second wave took shape first with the young, who then passed the virus to older generations.
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Hospitals now have more protective gear, more ventilators and more intensive care capacity than in the spring. But Italy’s breakdown came in an earlier line of defense: Contact tracers increasingly struggled to identify and isolate infected people before the virus spread through communities.
The contact tracing system “crumbled as soon as we exceeded 1,000 cases per day,” said Andrea Crisanti, a virologist at the University of Padua who advised the Veneto region in the spring.
Crisanti said no country could keep pace with contact tracing when it is seeing 35,000 cases per day, as Italy is now. But Italy could have given itself a better chance to contain the wave if it had built more labs across the country, performing granular surveillance of hot-spot neighborhoods and workplaces, at the first beginning of the uptick.
Crisanti said Italy should have been testing 400,000 people per day at the end of the summer when it was instead testing 75,000.
Matteo Bazzi
EPA-EFE/Shutterstock
Students cluster around the entrance of a middle school classroom in Como, Italy, on Friday. A new government decree requires classes above sixth grade in high-risk areas to shift to remote learning.
The summer heightened the dangers for what Italians call the “rientro” — the post-holiday return to city life. That’s when, all of a sudden, movement in Rome was nearly back to pre-pandemic levels, when schools were restarting, and remote work tapered off.
That’s also when the photos of the buses and metro cars started to go viral.
The crammed public transit has become symbolic of how political squabbles and pushback on scientific recommendations have added to the risks facing everyday Italians. Conte, the prime minister, recently said there were “criticalities” stemming from public transit crowding.
The scientific committee advising the Italian government had warned months earlier that transit would be highly risky during peak hours, and the health ministry had called it “absolutely necessary” to reorganize the network of buses and trains. But into the summer, regions successfully pressured the government to push up the maximum capacity for public transit, from 60 to 80 percent.
The center-left government and right-leaning regions argued about how to pay for revamped bus and train lines, and little was done. Idled tour buses — rather than being brought into circulation for commuters — instead went largely unused.
A group of scientists and health experts wrote in a recent open letter that the 80 percent capacity “does not allow for adequate distancing.”
And in any case, drivers and passengers say the buses are sometimes filled well beyond that.
Yara Nardi
Reuters
Passengers travel by bus in Rome on Oct. 15. Capacity limits on buses have not been regularly enforced.
“We had deluded ourselves into thinking we could be dealing with this second wave the Italian way, without a grand plan — with some improvisation, without thinking things through,” said Stefano Malorgio, secretary general of a national transportation union, who said local and national leaders should have consulted with workplaces to stagger start times.
One Roman bus driver, speaking on the condition of anonymity for fear of being disciplined or losing his job, said he sometimes feels a sense of “danger” aboard, and worried about bringing an infection back home to his children. He said buses have become far more of a free-for-all than supermarkets, where people stay in orderly lines. Commuters, he said, sometimes cram for space, pushing themselves through the door — leaving the driver feeling powerless to regulate it.
“Do I just stop the bus?” he said. “How can I jeopardize my safety telling someone he cannot get in? What does he care, if he needs to go to work?”
He said he and his colleagues share photos of packed buses on a WhatsApp group.
The government recently seemed to acknowledge the situation had gotten out of hand. In its latest round of restrictions, which included the ordering of a nationwide curfew, it also lowered the public transit capacity — to 50 percent.
The driver was skeptical it would make a difference. There was no system in place to count, he said.
