How Italy Became the Pandemic’s Epicenter


Reuters- courtesy of BBC News

McKenna Christy, Co-editor-in-chief

Every day matters. This is now one of the most important phrases policymakers and leaders have used to spread awareness of how drastically the coronavirus is progressing. In Italy, during the early months of 2020, every day was normal, even when Covid-19 had begun to silently infect citizens, it posed seemingly little threat to people’s lifestyles. This was the Italian government’s first and most crucial mistake. 


The factors that are attributed to why Italy was hit so hard by the pandemic are now easy to pinpoint as it is now the United States’ turn to not make the same mistakes that are currently possible. It is first important to understand some of the timeline and events leading up to Italy becoming the new epicenter of the pandemic and why this is the case. The reaction and restrictions implemented were gradual. On Feb. 18, a 38 year-old man, who is now known as “patient-one,” went to a hospital in Lombardy with severe flu symptoms, but he was sent home. It was only a few hours later that he became sicker and returned, finally he was admitted, and on Feb. 20 he tested positive for the virus. During this time, “patient-one,” had infected hundreds of people after going to the hospital twice, according to Walter Ricciardi, a World Health Organization board member. Also, Italy could not identify a patient zero because the man did not have “any direct contacts with China.” 

Although the coronavirus was spreading, Prime Minister of Italy, Giuseppe Conte continued to downplay the situation, which led to a wave of confusion amongst the population. People continued to hold and attend events and be in crowded spaces without any awareness of the severity of the coronavirus. Also, it is important to note that Italy has the second oldest population in the worth, with 23 percent of it being over the age of 65. 


The restrictions continued slowly, and on March 8, Mr. Conte made the decision of “restricting movement” in the northern regions of Italy, which is home to a quarter of the population. The confusion remained as people were unsure of what the measure meant. On March 9, the Prime Minister pushed the restrictions to cover the entire country, however the restrictions were not enforced early enough. Italy did not have the same information that other countries had at that point in time. The United States is not able to fix all of the mistakes Italy made because of the time waited to take early restrictive measures. However, there are lessons we can still apply to the upcoming decisions made by our nation’s policymakers and leaders. 


Harvard Business Review contributors, Gary P. Pisano, Raffaella Sadun, and Michele Zanini detailed five lessons that should be taken from Italy’s approach to the coronavirus. 

“Recognize your cognitive biases:” It’s pretty clear that people in Italy and now the United States were quick to downplay the coronavirus. Although our leaders were warned by experts what could, and quite frankly has happened as a result of the “nonlinear fashion” of the pandemic, they sought to follow the opinions of their “inner circle,” which is now an evident symbol of the severe complications they have when dealing with crisis. While Italian government officials continued breaking social distancing recommendations themselves, experts in behavioral studies call this reaction “confirmation bias.” This behavior refers to the “tendency to seize upon information that confirms our preferred position or initial hypothesis.” People and nation’s leaders need to recognize this growing coronavirus for what it is. The biggest lesson the United States should have taken from Italy was to have taken action “when the threat appears to be small.” However, the most likely fear that government officials had in implementing restrictions early on, were probably that if it had worked, then their actions would be viewed as “an overreaction.” What the United States should learn from Italy, since we are already faced with nearing the height of the pandemic, is that we need our policymakers and leaders to “take the time to discover, organize, and absorb the partial knowledge that is dispersed across different pockets of expertise.”

“Avoid partial solutions:” The Italian government’s restrictions grew gradually, and even in the beginning contrasted. In some ways, this might have been a reasonable response, however “it backfired for two reasons.” Every single day matters with this pandemic, as you’ve probably heard the White House Task Force mention every press briefing. They aren’t wrong when they say it because of all the information Italy knew was “not predictive of what the situation would be just a few days later.” “As a result, Italy followed the spread of Covid-19 rather than prevented it.” And secondly, the measures taken to lockdown some northern regions of Italy “touched off a massive exodus to southern Italy, undoubtedly spreading the virus to regions where it had not been present.” The measures that need to be taken need to occur all at once. And these actions need to follow a system, an example of this would be “the approaches taken in China and South Korea.” Testing for the coronavirus in these countries was met with strict “contact tracing” and then was “combined with an effective communication system that collects and disseminates information on the movements of potentially infected people…” The health care system is in desperate need to be fixed as the United States combats the coronavirus.. In hospitals, there need to be “wholesale reorganizations,” and instead of the focus being single patient care there needs to be a shift to “a community system approach,” which would be much more fitting for the population. There needs to be a focus on the healthcare system because “the need for coordinated actions is especially acute right now in the United States.”

“Learning is critical:” There is a lot to learn from the successes and failures from the measures taken by the countries that were able to contain the coronavirus early. Italy serves as a prime example of what the United States should and should not do based on the similar structures of decentralized health care systems. In two neighboring regions of Italy, Lombardy and Veneto, took two different measures during the early onset of the virus. Veneto’s approach differed in that it was “multi-pronged.” However, Lombardy “opted instead for a more conservative approach to testing,” as it only ran half of the tests that Veneto had. All of the measures taken in Veneto were credited to “have considerably reduced the burden on hospitals and minimized the risk of Covid-19 spreading in medical facilities.” This is applicable to what the United States can do as the federal, state, and local governments navigate together the best measures to take, and it is perfectly acceptable and suggested that the government experiments with approaches. 

“Collecting and disseminating data is important:” Italy struggled with “two data-related problems.” The first one was seen toward the beginning of 2020 as Italy lacked the robustness of a disease research infrastructure. Hospitals weren’t able to record all of the infections and didn’t have a way to share them publicly. Secondly, testing was inconsistent, putting them behind the pandemic because the data wasn’t accurate enough, and consequently there was an uncertainty of how well certain measures were working. Therefore, there is a need for “macro (state) and micro (hospital) level” data. It is still understood that health care practices are different in that they all do not offer the same services. And even though this is the case, “we should be fully aware of them and plan the allocation of our limited resources accordingly.” In the end, by strictly following this approach of data analysis, policymakers will be able to respond by making the right decisions and stopping the approaches that don’t work, and quickly. 

“A different decision-making approach:” Finally, Italy has taught us that we will not know how to stop the coronavirus for an uncertain amount of time. This has to be understood because there are still important factors to follow that can drastically help in the meantime. “First, there is no time to waste, given the exponential progression of the virus.” Also, this crisis does “require a war-like mobilization.” Policymakers cannot take the same approach to making decisions as if it were “business as usual.” This pandemic will require policymakers to respond quickly and create an organized system that promotes learning and observing through experimenting with a wide range of approaches to combat the coronavirus.