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Italy’s new coronavirus cases are slowing. How soon will normal life return?

The Washington Post logo The Washington Post 3/27/2020 Chico Harlan, Stefano Pitrelli
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ROME —Italy's nationwide lockdown is showing the first small signs of payoff. The number of coronavirus cases is still rising, but at the lowest day-on-day pace since the outbreak began. The World Health Organization calls the slowdown encouraging. The health chief in the hardest-hit region says there's "light at the end of the tunnel." 

The temptation, for a cooped-up and stressed-out country, is to embrace the first sign that the crisis may at last be easing.

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But while President Trump has talked about revving up the U.S. economy by Easter, Italy has set no such timetable — and experts say the nation is still at risk of the virus resuming its extraordinary, deadly trajectory.

Italy was the first Western country to contend with a mass outbreak and order a lockdown. But it is now at the forefront in making a more delicate calculation: figuring out how long the restrictions should last.

“If we loosen [restrictions] too early, we risk to jeopardize all the results,” said Roberto Burioni, a professor of microbiology and virology at Vita-Salute San Raffaele University in Milan. “My recommendation is: Don’t go after wishful thinking. You have to face the reality” of an extended lockdown.

a person in a dark room: Priest Don Giuseppe Arnaudo holds a crucifix in the Santa Maria degli Angeli Church in Northern Italy as part of a procession to bless houses against the coronavirus pandemic.

Priest Don Giuseppe Arnaudo holds a crucifix in the Santa Maria degli Angeli Church in Northern Italy as part of a procession to bless houses against the coronavirus pandemic.
© Marco Bertorello/AFP via Getty Images

Officially, Italy’s lockdown — which restricts people’s movement outside their homes and includes the closure of restaurants and retail stores — is supposed to end on April 3. But the government has signaled that the measures will surely be extended, something of little surprise to most people in the country.

As a way to guard against potential restlessness, Prime Minister Giuseppe Conte said this week that he is increasing fines, from 400 euros to 3,000 (about $440 to $3,300), for people who leave their apartments or houses without a valid reason. Fines are steeper still for people in vehicles who violate the lockdown. People who go outside after testing positive for the coronavirus could face up to five years in prison.

Conte did not specify how long the lockdown might last, although he batted down rumors in the Italian news media that it might be extended through the end of July.

“We are actually confident that well before this hypothetical deadline, we can truly go back to our life habits,” he said. 

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Some virologists say that rather than an end date, Italy and other countries will have to release the brakes gradually — as China is trying to do. Still, there are many uncertainties that could influence when to begin easing restrictions, including whether the virus will wane during hotter and more humid months. 

Even the size of Italy’s outbreak is unknown. Government officials and experts have said that because of limitations on testing, the spread of the virus could be significantly larger than the official data suggests. Andrea Crisanti, a virologist advising the Veneto region, said the country would have to conduct granular testing for the virus — in several geographic areas — to better gauge the true size of the outbreak and then determine more accurately how it is changing.

“You aggressively sample a big part of the population in a few infected areas” before you can consider changing the lockdown, Crisanti said. “Then, you maybe start to open some factories, test all people. I don’t think the lifting of the quarantine will be in one go.”

In the 4½ weeks since Italy detected the first signs of the outbreak, the country has lost more than 8,000 people to the virus. The rate of spread has appeared to slow, with cases growing day-on-day this week at about 8 percent, compared with 20 percent two weeks ago. But the daily toll remains staggering. The Italian government on Thursday reported that 662 people had died in the previous 24 hours. The Reuters news agency suggested that the government had omitted 50 deaths in one region and that the count should be higher. 

Although most of those deaths have taken place in the north, a nationwide sense of horror has helped with the enforcement of the restrictions. The lockdown has had widespread support: Between 76 and 90 percent approve of the measures, according to various polls.

And although some Italian politicians, such as the mayor of Milan, encouraged people in the early days of the outbreak to stay calm and socialize responsibly, that messaging has stopped cold. Italian politicians have not embraced Trump’s argument that the economic price of fighting the virus may be worse than the virus itself.

The main opposition, the far-right League, has its stronghold in the north, the area hit hardest by the virus. League regional governors in the north have accused Conte of ordering the lockdown too late and of initially allowing too many loopholes.

Politically, that means Conte does not face much pressure to relieve the restrictions prematurely. But Italians, under de facto house arrest for more than two weeks, naturally want to get back to normal life.

“If at the first signs of improvement we break ranks, we could have another peak on our hands in two to four weeks,” said Paolo Setti Carraro, an Italian doctor who was also involved in the global response to Ebola.

The temptation to get out of the house at the first chance was evident last weekend in Tokyo, where cherry blossoms were blooming, as people packed together in parks and restaurants, disregarding the protocols on social distancing. Japan has had a far-smaller outbreak than Italy, but experts there worried that the impulse among people to socialize as they previously did could allow the virus to spread rapidly.

Elsewhere, Hong Kong, Singapore and Taiwan appeared to have controlled the spread of the virus, but they are again experiencing an increase in infections.

“The risk is for the emotional feeling to prevail and to have people say, ‘Things are going better, let’s get rid of all this anguish,’ ” said Paolo Cruciani, a retired professor of psychology and former deputy head of the psychologists’ association in Italy’s Lazio region. “Then, boom, the virus comes back. The way to prevent this is a carefully considered mass communication to strengthen their rational vision. It’s a delicate moment: People can’t wait for all of this to end.”

chico.harlan@washpost.com

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