Five lessons from Italy for U.S. city leaders

(Source AP Photos)

Overwhelmed hospitals. Huge numbers of patients dying per day. Doctors forced to make the impossible decision to care for one patient over another. Italy’s struggles with Covid-19 are now well known around the world, yet they deserve special consideration from U.S. city leaders who are already faced with situations that were, just two weeks ago, unthinkable.

And that’s not just because, according to public health officials, the extraordinary rate of new infections in the U.S. appears to be following a similar trajectory to what Italy experienced. It’s also because Italian city leaders have gained experience in what works, what doesn’t, and what they might have done differently if they had the benefit of just two more weeks.

Here are five lessons Italy’s local and regional leaders have learned in the past month that U.S. city leaders might find especially helpful.

  1. Take the threat seriously — now. Bloomberg reports that “the government and political leaders were initially very complacent about the problem,” with a number of local politicians, including in Milan, rushing “to say that people should get on with their normal lives” and that “Milan doesn’t stop” even as cases were beginning to emerge. This approach on the local level mirrored nonchalance at the top, as The New York Times cites. “In the critical early days of the outbreak, [Prime Minister Giuseppe] Conte and other top officials sought to downplay the threat, creating confusion and a false sense of security that allowed the virus to spread.”

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2. Implement social distancing early. The Times reports “Italy’s piecemeal attempts to cut off [the contagion]–isolating towns first, then regions, then shutting down the country in an intentionally porous lockdown–always lagged behind the virus’s lethal trajectory.” Sandra Zampa, under secretary at the Ministry of Health, tells the paper: “We closed gradually, as Europe is doing, Spain, Germany, the U.S. are doing the same.” In retrospect, she says, she would have closed everything immediately.

3. Communicate clearly and powerfully what residents need to do. Political leaders offered mixed messages about what was and wasn’t allowed in a lockdown. “Even once the Italian government considered a universal lockdown necessary to defeat the virus,” the Times writes, it failed to communicate the threat powerfully enough to persuade Italians to abide by the rules, which seemed riddled with loopholes.” That eventually changed, reports the Guardian, quoting Italian psychologist Sara Raginelli: “The moment the politics changed and started to speak in a more clear and direct way, people’s behavior also changed and people developed more of an attitude of awareness.” In many cases, that straight talk often came from the county’s mayors, as this video demonstrates.

4. Enforce restrictions. As the military has moved into some areas to enforce closures, hundreds of mayors have asked for an even tighter crackdown, the Times reports. The mayors’ voices were echoed by the president of the Lombardy region, Attilio Fontana, who “complained that 114 troops the government deployed were insignificant, and that at least 1,000 should be sent.” Fontana adds: “If we had shut everything down in the beginning, for two weeks, probably now we would be celebrating victory.”

5. Protect health-care workers. One in 10 of those infected with the novel coronavirus in Italy are health-care workers. “That percentage is likely to shrink as the contagion spreads,” U.S. News reports, “but the absolute number of hospital workers is limited and the personal toll on them as this crisis drags on will be tremendous.” The mayor of Bergamo, Giorgio Gori, tells the Times the lack of resources “forced doctors to decide not to intubate some very old patients,” who then died. And Fidenza Mayor Andrea Massari, who had to shut down the overcrowded local hospital for 19 hours to relieve staff who had worked 21 days without a break, tells Reuters that move meant some people “died at home.”

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