It was the epicenter of the coronavirus pandemic in March, but now Italy is holding back the onslaught of the second wave of the disease much better than several of its European neighbors.
A few months ago, the case of Italy surprised the world by the speed with which the virus spread and claimed lives. Now, the figures presented by Italy are much better, and even relatively low for the European context.
The most obvious comparison arises with Spain.
Last spring, both countries went hand in hand, and what happened in Italy, in terms of both the alarming numbers of contagion and deaths and the measures taken by the authorities to contain the pandemic, were replicated in Spain two weeks later. .
Now, however, the situation in both countries no parallels.
While the cumulative incidence rate in 14 days (the number of cases reported in that period of time per 100,000 inhabitants, a key number to determine the speed at which the contagion progresses) reaches 33.5 in Italy, in Spain it rises to 300.5, according to the latest data from the European Center for Disease Prevention and Control (ECDC).
In France, the cumulative incidence rate is 185.8, while in the United Kingdom it is 69.3. In Germany it is 25.8.
The mortality rate per million inhabitants in the last 14 days is 2.6 in Italy, while in Spain it is 22.9; in France, 8.6; in the UK 3.2 and in Germany 0.7.
Despite these figures suggesting that the epidemic continues under control in Italy, the country’s authorities remain cautious and avoid triumphant remarks.
In fact, the prime minister, Giuseppe Conte, has called on Italians on several occasions to be vigilant.
But in any case, the question that arises for many is: what is Italy doing well?
Experts consider that there is not a single answer, but a combination of factors: a gradual reopening, good test and contact tracing skills, strict security measures and individual discipline.
Strict confinement and progressive lifting of restrictions
Italy was the first Western country to be hit by the virus, at a time when very little was known about it and its transmission.
He was also the first western country to adopt strict containment measures -first at the regional level and then at the national level (on March 10) -, which included restrictions on mobility and the closure of businesses (with the exception of supermarkets and pharmacies).
“Confinement was very strict in Italy”, recalls the epidemiologist and professor at the University of Milan in dialogue with BBC Mundo Carlo La Vecchia. “The epidemic was essentially concentrated in Lombardy (north). When the national quarantine was decreed, the center and south of the country did not have a high number of cases.”
Italy was not one of the first countries to lift the restrictions, and when it did, as of May 4, it did so gradually, and that, for La Vecchia, allowed a greater control of the epidemic in the early summer months.
At first, mobility was only allowed at a regional level, and although now it has been extended to the entire national territory, in trains, for example, there are limits to the occupancy capacity.
Furthermore, in Italy the state of emergency Due to the epidemic, which expires in mid-October and grants greater powers to the central and regional governments, making it easier to make decisions with greater agility and react if there is an increase in cases.
In fact, for example, in mid-August, when there was an increase in the number of cases, the government ordered the closure of all nightlife venues and the mandatory use of mask between 6:00 pm and 6:00 am in “any place at risk of crowds”, including bars, restaurants and public squares.
And here something also comes into play that the experts consulted by BBC Mundo consider as a fundamental factor in explaining the current situation in the country: the Italians took compliance with the measures seriously.
Discipline and responsibility of citizens
“The confinement lasted a long time, it was very severe and it was also highly respected,” he tells BBC Mundo Julián Miglierini, BBC journalist in Rome.
Restrictive measures, such as the use of masks, are still widely respected.
For Miglierini the reason is clear: Italian society he does not want to experience something like what the country experienced again the month of March.
“There are people who say that the effect of those days on the population made Italians much more aware of the risks,” he says.
“Italians are taking care so that this does not happen again.”
The journalist considers that there is also a kind of “collective trauma” because Italy was the first Western country to be affected in a very strong way by the pandemic.
“It was a time when it was not known what the transmission was, very little was known about the virus, so Italians felt a little more exposed in this regard,” explains Miglierini.
“Italy has not been able to recover from that and there is a lot of fear of returning to that nightmare scenario for Italian society.”
The epidemiologist Andrea Crisanti agrees that both the gradual lifting of all restrictions and the fact that “Italians took all measures to prevent the spread of the virus very seriously” are some of the factors that explain the current situation in Italy.
However, the professor of Epidemiology and Virology at the Hospital of the University of Padua and Imperial College London points out that by themselves they do not explain the current dynamics of the spread of the coronavirus in Italy.
Effective ability to test
Crisanti notes as an important factor “that Italy is using its testing and contact tracing capabilities.”
The number of tests that Italy performs per 100,000 inhabitants is 1,018 and the positive rate is 1.7, according to the ECDC.
In Spain these figures stand at 1,317 tests per 100,000 inhabitants, with a positive rate of 10.9. In France there are 1,554 tests, and a positive rate of 5.4, while in the United Kingdom the figures are 2,715 tests and a rate of 1.4 positives.
However, La Vecchia considers that the number of tests carried out is not very high, and that may explain the relatively low number of positives.
However, Miglierini explains that tests are being done in key places, for example, in the airports and ports.
But for Crisanti there is something even more important, and that is that “Italy is doing more than just tracking contacts”: it is what he calls “network testing”.
It consists, according to the epidemiologist, in that when a person shows symptoms, they are tests all the people in their interaction networks -friends, neighbors, co-workers- regardless of whether or not they have been in contact with that particular person.
“It is about not assuming a prior knowledge of contacts, because in many cases people do not remember who they have had contact with, or under what conditions they have spoken with someone,” explains Crisanti.
“This is how we identify a number of people who are infected and who would otherwise escape us.”
“Italy is now better prepared to use what I think is the appropriate strategy,” considers the epidemiologist from the University of Padua.
Both Crisanti and Miglierini point out that the next two or three weeks are fundamental to see how the number of cases evolves, for the effect that the reopening of schools may have, which was done in a staggered manner during September.
“There is a conception here that you cannot claim victory because perhaps in two weeks the cases will begin to rise, and the government is also being very cautious in this regard,” says the journalist.
“There is an idea that we had to be ahead of the curve, and now we are behind when compared to Spain or the United Kingdom, but nobody is calling victory.”
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