By Ben Spencer and Mario Ledwith for the Daily Mail
HOW BAD IS CORONAVIRUS IN ITALY?
Italy is the worst-hit country other than China, with 366 deaths and 7,375 confirmed cases of the virus [subs: please update figures later].
The country has imposed the most restrictive measures since World War Two, with 16million people now needing permission to travel.
HOW DID IT GET SO BAD?
On January 22 stringent protocols were introduced which said anyone should be swabbed coronavirus if they have alarming symptoms.
But apparently these were lifted on January 27 to only include people who had travelled to China.
Critics say this is down to Italy’s false sense of security because it believed it had put up robust border defences against the virus.
The country had stopped all direct flights from China – the only EU country to do so.
It had also introduced temperature-screening at airports – despite its highly questionable effectiveness.
While politicians in other countries – including Britain – conceded from the start that it was ‘inevitable’ coronavirus would arrive, and started to put protocols in place to cope with it, Italy had focused on putting up barriers in a bid to stop it entering the country.
WHAT HAPPENED NEXT?
By the time Italian politicians realised the virus had arrived in their country, it was too late to control it.
The first case was a 38-year-old Italian man who had never been to China – known as ‘paziente uno’ or ‘patient one’.
He arrived at a hospital in Codogno near Milan on February 18 but was not initially tested for coronavirus.
Before he even got to hospital, he had infected his pregnant wife, a friend he went running with, and three elderly people in a bar he frequented.
In hospital he saw doctors four times before he was tested for the virus. He was eventually tested and diagnosed on 20 February – but even then there was a three-hour delay before he was put in isolation.
By then he had infected several staff members and patients.
SO WHO INFECTED PATIENT ONE?
Doctors are still to find out how he was infected. The implication is that the virus had been circulating in the community for weeks before ‘patient one’ was even infected.
WHAT DID THAT MEAN FOR ITALY?
Other countries adopted an early strategy of ‘containing’ the virus – by identifying symptomatic people arriving from China and other affected countries, isolating them if they had symptoms, treating them in secure units if they tested positive, and tracking down anyone they had been in contact with.
This ‘track and trace’ strategy – which has been effectively used around the world to control the Sars, Ebola and Mers virus outbreaks in recent years – is essential to stop imported cases from becoming ‘endemic’ within a country.
In Britain that phase of the coronavirus strategy is just coming to an end in Britain as the virus is now being transmitted within the community.
But in Italy the virus had escaped before they knew it was even in the country.
WHAT OTHER MISTAKES HAVE BEEN MADE?
Critics say once the decision was made to ‘lock down’ the virus, the implementation of protocols across the nation was left up to regional governments – and the way it was handled was patchy at best.
For example in San Marco in Lamis, in the Apulia region in south-east Italy, the body of a 74-year-old man who died was released by health authorities before he was tested for coronavirus.
It later transpired he had already infected his wife and daughter, who met dozens of relatives and friends at his funeral. Seventy of them are now in quarantine.
The episode has been described as ‘a catastrophic mistake’.
BUT WHY IS THE DEATH TOLL SO HIGH?
The rising number of deaths may in part be explained by Italy’s elderly population.
Around 23 per cent of Italians are aged over 65, making it the second oldest country in the world after Japan.
Initial data suggests the elderly and those with underlying health conditions are more likely to die if they contract the virus.
Public health officials in Italy have been keen to stress that the average age of fatalities there is 81, with the vast majority aged over 65 and already ill.
HAS IT CREATED A POLITICAL ROW IN ITALY?
Tensions have threatened to boil over concerning how Lombardy, Italy’s richest region, reacted to the outbreak.
In the early days of the outbreak, authorities there carried out widespread testing, even on those who displayed no symptoms.
The approach was described as ‘exaggerated’ by Italian Prime Minister Giuseppe Conte, who said the measures ‘would end up dramatising the emergency’.
Government officials suggested that the positive results for those with no symptoms could cause panic.
The blame game then saw officials in Lombardy hit back at Mr Conte for his refusal to adopt a proposal in February calling for the mandatory quarantine of students returning from China.
Attilio Fontana, president of the region, said: ‘They told us it was a racist behaviour.’
WILL ITALY’S LATEST RESPONSE WORK?
On paper, the Italian Government’s draconian decision to place 16 million in quarantine, could curtail the rampant spread of the virus.
But it remains entirely unclear if the measures are adequate given the virus is now in every region of the country.
The rules, which affect a quarter of Italy’s population, are too wide in scope to be strictly enforced by the authorities, leaving people to police themselves.
Though failure to comply with the measures can result in a small fine or three-months in jail, the measures are still being seen as advisory.