How Italy Flattened the Curve

12 mins read

Stefano Annovazzi Lodi / CC BY-SA (https://creativecommons.org/licenses/by-sa/2.0)

I am not an epidemiologist, mathematician or statistician, so if you ask me how Italy flattened the curve and got its coronavirus crisis under control I can only offer the perspective of a guy who lives here. Even after more than 20 years as an expat American in Italy, I still sometimes feel like an anthropologist, although these days one who is pretty proud of the subjects he studies. As I see it, Italy was able to bring life back to some degree of normalcy for three main reasons.

LOCKDOWN AND REOPENING

You might remember that Italy was the first European country to experience community spread, or at least, the first to admit to it. As result, Italy was one of the first to shut its borders to outsiders but also to shut in its own people. When the first Italian to contract the virus was found in February, his entire small community, Codogno, in the Milan hinterlands, was literally cordoned off from the rest of the country in an attempt to contain the spread of the virus. But it was already too late. By March 10, Italian Premier Giuseppe Conte had put the entire population of the Italian peninsula under lockdown, which he colloquially called “io resto a casa” or “I’m staying at home.”

Conte’s action saved many lives. We didn’t even begin to open up for a full two months after that, and this reopening has been conducted in a slow and phased way, paying close attention to the number of new cases and deaths. Many small Italian businesses are still shuttered, while large companies like the one I work for ask as many people as possible to work from home. There is still no decision around a clear date for school reopening, much to the chagrin of working parents. We also follow strict rules for social distancing in all public places; signs and pavement bubbles remind us to keep our distance and queue properly, while disinfectant gel is found at every store and we’re required to use it before entering. And almost everyone is wearing their masks.

Initially we could take walks, bike ride, or exercise outside, but even these activities were shut down. While this became a source of frustration and complaint, most Italians (strangely, given their history of rule flaunting) were pretty damn good about it. We only left our homes to go to the grocery or pharmacy, to work, or worst case, to the hospital. Not even the usual Sunday visit to the nonni (grandparents) was allowed. Our lockdown was almost draconian; at one point, during the height of the pandemic, we could be fined close to $500 for walking our dogs more than 500 meters from our homes! Stay at home meant exactly that.

CLEAR AND CONSTANT FLOW OF INFORMATION

The Italian government continually provided simple instructions on exactly what to do and what not to do. TV stations, both state-owned and private channels, aired simple announcements at every commercial break – let me say that again, every single commercial break – listing the 5 to 10 things we needed to do to stay safe and keep others safe. We heard these points so often that when I wrote them down in emails to friends and family, I did so from memory. Every time I went into the grocery store, a voice coming over the muzak between songs reminded the few of us who were allowed in at a time to keep our distance, wear a mask, and use the gloves that had been provided.

And speaking of voices, some days hearkened back to Italy’s past (maybe they still do this in the south) when politicians would blast their platforms around town on loudspeakers. On several mornings during the height of the crisis, a car with a loudspeaker drove all around my small town with this announcement: “This is your mayor speaking. Please stay inside your homes. The coronavirus is not a joke. The coronavirus is a dangerous disease so please take it seriously and only leave your homes for necessities such as groceries or medicines.” While odd, the message got across.

The Civil Protection Agency also held regular press conferences on TV. These were boring affairs with the agency talking numbers and rules and how they saw things developing based on the current available science. Think about that – no talk of UV light or bleach injections. Suffice to say, it wasn’t a “show” in search of good ratings or a campaign rally but clear, simple-to-understand scientific information. For people getting caught up in conspiracy theories, we use shaming in Italy to great effect. Since everyone in the north knows someone who has died, often a family member, giving the tin-foil hat wearer a stern look or verbal admonition is usually enough to quell any unfounded ideas they are promoting.

Importantly, wearing masks was portrayed as a given. TV ads showed people wearing masks; celebrities reminded people of their importance; and all the politicians, even Matteo Salvini of the contentious Northern League (La Lega), were seen wearing them. So to answer your inevitable question, no, mask wearing has not been politicized but is seen as an act of courtesy and civic duty. Here in the north everybody has at least one mask. When not being fully worn, it is pulled down under the nose or chin, worn on the wrist, or kept in a pocket to be put on properly when coming upon a crowd or entering into any business.

LOCAL KNOWLEDGE

Back when I was a California surfer, we used the term local knowledge to refer to everything you needed to know to get in and out of a surf break safely, from tides and rip tides to submerged rocks to sharkiness (a real word to a surfer); and also the more subtle aspects, like who was the boss of the break, or the person you didn’t want to piss off. It sounds pretty banal but in certain places along the coast, local knowledge could very well mean the difference between life and death or at least serious injury.

In Italy, during the height of our crisis and especially during reopening, local knowledge meant knowing other people’s business, including everyone else’s “sickness in the family” history. We also relied on small-town gossip to know where the hotspots were or who in our circles could be infected. For example, when my teenage daughter was finally able to meet up with her friends again, one girl who had been seeing her boyfriend during the entire quarantine got blacklisted. The parents all decided that the girls could go for a walk in the woods and a picnic as long as that girl was not invited. Of course, ostracizing a kid isn’t nice but that’s the kind of survival mechanism that kicked in.

Further, when the reopening began, Italians didn’t all go rushing out to big parties or events but favored small gatherings, usually outdoors in their gardens, with family and maybe some friends and neighbors. Perhaps the simple pleasure of being able to once again unite with our congiunti – Giuseppe Conte’s word for describing family and friends – was enough for most Italians who had just been through a few rings of Dante’s inferno.

Numerous political, cultural and historical factors have helped Italy as well. Testing is free and widely available with a quick turnaround time, allowing for a proper 2-week quarantine; tests also are available privately from €35 to €75. Contact tracing has been used extensively although not as effectively as in our neighboring Germany, where they are doing so with their usual precision. Plagues also may permeate the European collective consciousness much more strongly than the American consciousness, notwithstanding having suffered through the 1918 Spanish flu pandemic, which was addressed in this article in The Atlantic.

Overall, cleanliness could play a role in our success. Not to criticize Americans, but I can assure you that Italians are almost maniacal in their housekeeping. While they are rightly famous for dirtying their public spaces like trains and city streets, on all socioeconomic levels, the Italian home is always spotless. During the pandemic, houses were kept even cleaner. Realizing it wasn’t enough to just wash our hands, we cleaned and disinfected surfaces daily.

We are still not out of the woods yet! It’s the time of year when Italians exercise their birthright of taking a long vacation at the beach. Despite a slightly larger space between one lounge chair/umbrella and the next, the crowds are already gathering along the Adriatic where three generations of women – grandmas, moms and daughters – will dance to the latest tormentoni (catchy summer songs) and splash in the shallow waters of Rimini and Riccione. From Tuscany to Apulia, the Italian nightlife has started up again, and you can bet the kids are shedding their masks in the discos. As I write this, today’s totals are 252 new cases with only 5 deaths, still pretty good numbers when compared with Florida and California, but as I said, I’m neither an epidemiologist nor a statistician. Just a guy who lives in Italy where, with solid scientific information, strong leadership from our government leaders and a huge collective effort, we have managed to flatten the curve. Viva l’Italia!


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