CHIARA BOCELLI-TYNDALL.- Coronavirus in Italy – a view from “exile”

On Sunday, February the 23rd my Australian husband and I was in Florence Italy, where we regularly enjoy an alternative residence, and lifestyle, to that of Basel Switzerland. We had tickets for a coveted opera performance of Donizetti’s Don Pasquale, that afternoon when we heard the news.

Several hundred positive coronavirus cases had been detected in Lombardy, near Milan. This time, Italian nationals, not Chinese, as were the two elderly tourists admitted earlier on to a Rome hospital. At that time, there were no cases of infection in Tuscany, where one of the biggest Chinese community in Europe lives in Prato, near Florence. Some primordial fear took us: we closed our apartment in Florence, gave our opera tickets to someone who did not mind mixing with a big crowd in the theatre and hoped that the Swiss borders would still be open.  They were!

One month later, Italy counts 63,927 coronavirus positive cases, including 6,077 deaths (official numbers on 23/3) the highest-burden anywhere of COVID-19 casualties. The focus of infection was and still is in its most prosperous and productive northern Lombardy region, in that Po valley of my childhood and around the Milan of my university and “my” La Scala theatre. In provincial Lombardy, one of the wealthiest regions of Europe with countless big and small internationally connected factories of all kinds, the virus claims the highest toll: 28,761 infected. It appears that the virus had been circulating undetected for several weeks mistaken for a seasonal ’flu’ and that a local hospital had become the focus of infection. We watched on TV, heartbroken, the countless coffins lined up in a church in Bergamo for a last farewell often without family members, the last unbearable departure from the beloved who died alone in isolation with at the most the comfort of a voice from a cell phone held by a priest or a health worker.

Too poignant is the memory for many of us Italians of the pages written by Alessandro Manzoni in 1827 in his literary masterpiece “I promessi sposi” (The Betrothed) describing the plague in Milan in the 17th century; the human responses to the alarm, the denial first, the immediate search for the culprit (always “foreigners”), the indecision of the authorities torn between ignorance and correct public health measures. While the plague did not respect age, COVID-19 seems especially lethal in the old and infirm. The high COVID-19 related mortality registered in Lombardy may be better explained by accurate epidemiological data at the end of the emergency, as other countries, such as Spain, France and the USA, which lagged by days to weeks behind Italy, are showing the same if not faster progression of disease and casualties.

These are mostly people with concomitant serious medical conditions, and elderly. Yet these folk had the right to a few or many more years of life with their families, with the grandchildren they have raised in the intergenerational extended family still present in the Italian society especially in provincial areas. It was chilling for me and my compatriots to hear Boris Johnson announce as a matter of fact the unavoidable loss of the most fragile in society as demanded possibly by the economy of Brexiterian UK. This was then. The tune is of now as alarmed as anywhere else.

In these dramatic circumstances, the Italian government response initially underestimated the gravity of the epidemic, comparing it with seasonal ‘flu in a well-intentioned desire for reassurance. That was until the number of infected cases and casualties demanded the measures constantly suggested by the scientific advisors. Successive lock-down restrictions were imposed on schools, people, entertainment and industrial production. The central authorities seemed to chase the situation which was always one step ahead of their decisions attempting to balance public health needs with the pressure of continuously industrial production. Those still obliged to work in the so-called essential production lines, feel unprotected and threaten strikes with the support of their unions.

The movement restriction measures (you all know the hashtag “io resto a casa”, I stay home ) were not clearly spelled out with a single voice and people thought that going to the beach in the first sunny weekend was a healthy way of staying outside. Many thousands of southern Italians working or studying in Milan crowded the last trains going South to join their families after a badly timed announcement of the restriction of movements. Unfortunately, no lesson learnt, the same scenes of mass migration out of Paris France were seen a few days later at the announcement of similar restrictions. Each region in Italy and they are 20 and administratively independent, went on its own way, implementing measures as deemed locally necessary and intending to show their political distance from the Rome government. Mass surveillance was effective in the containment of the epidemics in China and South Korea besides the coordinated infrastructure of equipment and personnel. The monitoring of people’s movements through telephone apps as in South Korea and available also in Italy, is still seen in this country, rightly or wrongly, as an infringement of privacy and still debated.

With the spreading of the epidemic, the Italian health system (ranked highly in the WHO list) which is public with universal coverage showed both its merits and limits. Although each region administers independently the allocated money from Rome, progressive nationwide cuts in government health expenditure -as it has been the case in other countries with a public health service- is stretching the system to its limits during the Covid-19 emergency. The resilience and reactive capacity of Lombardy, with rare cooperation between politically different administrations at regional and municipal levels is remarkable. As the number of intensive care patients grows, more public beds are allocated through a full collaboration by private hospitals, and new modular prefabricated structures as in Wuhan, are built.

Silvio Berlusconi set a generous precedent by donating privately 10 million Euros to the Lombardy hospitals. Others followed suit -perhaps this was the inspiration for Donald Trump to donate his own $100,000 paycheck! Protective masks and respirators for intensive care patients are in short supply but 25 million Euros were donated in few days by the Italian people to the Public Protection Organization, which is responsible for the allocation of all medical equipment. The Italians have also discovered that their health care professionals are committed to a point of heroism in a pre-existing situation of chronic understaffing and payment. A high percentage of them are infected and some have died on duty, highlighting the necessity for the constant care and monitoring of personnel on the front line. The Italian FDA equivalent (AIFA) is coordinating nationwide clinical trials with several potentially effective anti-COVID-19 drugs.

Protocols and updates are of public access on the organization website, hopefully of help to others in the future. While the tragedy goes on outside, the Italians are locked up in their homes, they cannot easily now avoid the army and police checkpoints and, unruly as we have always been described, behave quietly and on the whole respectful of the impositions. I have not seen hoarding of toilet paper -maybe the use of the bidet has an advantage- and they queue patiently in front of supermarkets. Food, with the lockdown of restaurants and tourist industry, is still available. Of course, social media have become essential for personal contacts and web facilitated connectivity becomes a necessity for schooling, smart working, telemedicine etc. But the beautiful squares of the Italian cities, filled until recently by a merry crowd of aperitivo drinkers, are surrealistically silent and empty with more pigeons than people; the ducks have come back in the fountain “La Barcaccia” at the foot of the Spanish steps in Rome.

Silence is alien to Italian public life, the Italians felt initially disoriented by the imposed isolation. With the improvised patriotic surge, they rediscovered a sense of community, broke the silence and isolation, singing from windows and balconies, for everyone to listen to or to join in, the national anthem, opera pieces, pop songs etc. Some organize collective gym lessons on their balconies, others, in Naples, “tombola” (bingo). Not quite yet up to the standard of Boccaccio’s Decameron, 100 tales told by ten young people sheltered in a secluded villa outside Florence in the 14th century to escape the plague.

Iconic Italian companies are also dropping, momentarily, their exclusive luxury goods production and pitching in; Ferrari making ventilators and Prada, Gucci and Valentino face masks and protective clothing. All this after the first two weeks of lock-down. How much longer will such restrictions be tempered with optimistic good humour before they explode in frustration and violence, domestic and public. Not to mention the socio-political consequences: the now barely suppressed friction between government and opposition, held in check by the health emergency, is bound to explode. Radical economic measures will have to be beyond party politics.  However, we Italian are resilient, resourceful and find unity in an emergency, which is a bit how the country lives and always survives…. they say!

Chiara Bocelli-Tyndall is a molecular biologist who grew up in Italy has lived and worked in Australia, London and Basel.

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