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Italy, resisting another coronavirus lockdown, shows peril of piecemeal restrictions

The Washington Post logo The Washington Post 10/26/2020 Chico Harlan, Stefano Pitrelli
a group of people walking on a sidewalk: Police officers patrol the city center of Rome to enforce a mask requirement. © Rocco Rorandelli/For The Washington Post Police officers patrol the city center of Rome to enforce a mask requirement.

ROME —The team of city police officers had been assigned to look for coronavirus rule-breakers, so one evening last week, they parked their cars in the middle of one of Rome's liveliest neighborhoods and walked from one restaurant to the next.

In 90 minutes on patrol, they didn’t find a single violator.

What they found, instead, was nightlife that conformed to the rules but nonetheless posed risks for spreading the novel coronavirus. Italy had imposed a mandate for mask-wearing outdoors — but it didn’t apply to the people eating at packed alfresco tables. The country had banned dining in groups of seven or more, but there were plenty of tables of four, five and six under mood lighting on the cobblestone streets.

“And it’s even busier than this on Friday nights,” one officer, Giovanni Cipriani, said.

At the beginning of the pandemic, Italy was a lockdown pioneer — the first among democracies to control the virus by ordering life to a standstill. But as a second wave of the virus explodes, Italy and other countries across Europe have been reluctant to return to such a harsh, economy-sapping approach, and so they are now demonstrating the perils of an alternate strategy.

[Covid-19 surge in Belgium leads to shortage of doctors, teachers and police]

The strategy is premised on the idea that more targeted, piecemeal measures can slow the infection rate while preserving jobs and businesses. It is also an acknowledgment that people, as their alarm has worn off and fatigue has set in, will be less tolerant of an order that again sends them back into their homes.

But experts say it’s hard to know which combination of targeted measures will be sufficient. Given the incubation period of the virus and the lag time between the onset of symptoms and when somebody might get tested, it can take 15 to 20 days to get a sense of whether restrictions are helping. By that time, the virus may have raced further out of control, with serious consequences for the health system.

“We are living in a delayed situation; when you do something today, you see the results 15 or 20 days later,” said Roberto Burioni, a professor of microbiology and virology at Vita-Salute San Raffaele University in Milan. “You’ll know in 15 days, and if it wasn’t enough, then you’ll take stricter measures. And they will come too late.”

a car parked on a city street: Officers Franco Masotina and Pina Bono didn’t find any violators during their patrol on Oct. 20. © Rocco Rorandelli/For The Washington Post Officers Franco Masotina and Pina Bono didn’t find any violators during their patrol on Oct. 20.

This month alone, Italy has tightened rules four times, first requiring masks outdoors, then trimming hours for restaurants, then granting mayors the power to institute curfews in nightlife areas. On Sunday, Italy took an even more forceful step, ordering restaurants and bars to close by 6 p.m., shuttering cinemas and theaters, essentially doing away with the kind of scene the police officers observed days earlier.

That move amounted to a clampdown on nightlife, but many activities halted during the initial lockdown continue. Shops, schools and museums all remain open.

[Italy imposes harshest coronavirus restrictions since spring lockdown as second wave sweeps Europe]
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Walter Ricciardi, the World Health Organization adviser to the Health Ministry, said in a TV interview that the latest measures are “not enough” and that Italy would need restrictions in proportion with the “uncontrolled” spread in some parts of the country.

Though Italy appeared to have controlled the virus into the summer, cases have grown exponentially — and now hospitalizations are rapidly rising, as well. On Sunday, the country recorded more positive cases — 21,273 — than in all of June and July combined. Most days throughout the late summer, Italy saw fewer than 10 deaths attributed to covid-19, the disease the coronavirus causes; but in five of the past six days, the toll has risen above 100. More covid-19 patients are in Italian intensive care units than on the day in March when Prime Minister Giuseppe Conte called for the initial lockdown.

In the run-up to that lockdown, Italians had felt fearful and dramatically curbed their activity even before the government orders. But it is different this time. Buses are crammed at rush hour. Many workers have returned to their offices. Even as Conte was announcing the latest measures Sunday afternoon, outdoor tables were packed with people sharing late lunches and early cocktails. The city had the feel of a store on the last day of a blowout sale, people trying to grab what they could before it was gone.

a group of people standing in front of a store: Pina Bono checks that restaurants are logging information on patrons, in case it’s needed for contact tracing. © Rocco Rorandelli/For The Washington Post Pina Bono checks that restaurants are logging information on patrons, in case it’s needed for contact tracing.

Fabrizio Pregliasco, a virologist at the University of Milan, said even that kind of permitted socializing was enabling the virus to spread.

“Once you lower the mask to grab a bite, you’re doing something risky,” he said, noting that many people who carry the virus are asymptomatic. “You’re sitting at a table with your friend who’s feeling all right, you think you know him, and he seems to be in good health. So you spend a long time with him and you pull down the mask, because dining requires conviviality, laughing, joking.”

In his address, Conte encouraged people to move around only for the purposes of work, school and health. He called the pace of the virus’s spread and the stress on the health-care system “worrisome.” But he also said the country could not afford another lockdown.

[Coronavirus cases hit records in Europe, surpassing U.S. numbers]

The initial, two-month lockdown succeeded in slowing the virus, and it opened the door for a summer in which Italy had one of the lowest infection rates in Europe. But it also left a devastating mark on the economy, which is predicted to shrink more than any other in Europe. Scores of businesses across Rome never reopened after the first lockdown, and entrepreneurs have warned that a second could be even more damaging.

“I wouldn’t be able to survive,” said Carla Cremonese, the owner of Hostaria da Settimio, whose restaurant saw a 60 percent revenue drop in the first half of the year and has only recently started to regain its footing.

Industry associations have been lobbying the government not to clamp down too hard, and an attempt to reintroduce first-wave restrictions in the southern region of Campania illustrated the political risks of going too far. On Friday, the regional governor, Vincenzo De Luca, had called for a lockdown, saying his area was on the “verge of tragedy.” But after a night of violent protests in Naples, he appeared to back away from his pledge.

Conte, speaking Sunday, said he hoped Italy could protect its health system while “at the same time preserving the economy.”

“We need to avoid finding ourselves anew having to choose between one and the other,” he said.

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