Italy and the virus: the story of Lombardy

This article was firstly written in Italian, and was later translated into English. A few sentences and words were adapted for fluency, but the content and information remain unchanged. Thanks to Alice Ferro and Chris Lewisfor translation

This is the story of how the coronavirus arrived in Lombardy, the most affected region in Italy. Or rather, this is what I was able to piece together from home, in front of my computer, looking for some answers in published news articles. All links cited below refer to Italian articles.

Although this story has yet to reveal its ending, it is one that will ultimately be defined by the political parties operating within. While Matteo Salvini’s party Lega Nord — Northern League — try to exploit the situation to challenge the current government, the future elections for the Mayor of Milan stand in the background. The city remains one of the few in the country without right-wing governance — and has crucial strategic political value. Between good and bad, left and right, lie people’s health and their rights.

On February 21st, at 54 minutes past midnight, Ansa — the main Italian press agency — reports the first positive case of coronavirus. Found in Codogno, not too far from Milan, the individual is named ‘patient one’, although he could potentially be patient two-hundred. In fact, the virus had already been spreading in the area, unbeknownst to all.

On the same day, in Vo’ Euganeo (Veneto Region), two other cases are reported, with one dying at 11:40pm that same evening. According to the doctor Massimo Galli: “The hypothesis is that at least a large part, if not the whole epidemic” — which emerged on the 21st February in Codogno — “started from someone who became infected in Germany around the 24th, 25th or 26th January, and then came to the area spreading the infection, either completely unconsciously, as probably asymptomatic, or because they mistook the symptoms of Covid-19 for those of a usual flu” (https://bit.ly/3b53dY6).

“All the scientific data collected” — underlines the Head of the Hospital Sacco in Milan and professor of Infectious Diseases at the Università Statale in Milan — “allow us to hypothesize a genetic trail that leads straight to the outbreak of coronavirus which broke out in Bavaria, Germany, after a Chinese employee of the Webasto company attended a working meeting in Munich”. Still asymptomatic at the time, she first noticed some discomfort on the return trip. During her stay in Germany, the woman infected a Bavarian colleague, marking the origin of the Covid-19 outbreak in Europe. It’s directly from there that the virus arrived in Italy.

Yet, there is another family of viruses coming directly from China. An Italian study concluded that the virus was already present in Italy in January. It’s also because of this fact that it isn’t possible to find a ‘patient zero’.

On February 22nd, the Italian Prime Minister Giuseppe Conte decides to lock down the surroundings of Lodi (Lombardy) and Vo’ Euganeo (Veneto), both becoming ‘red zones’. However, the virus was already present in the area, and not only there. In fact, the contagion had already arrived in both Bergamo and Brescia via two fairs. These were a hay fair in Nembro (Bergamo) and an animal fair in Orzinuovi (Brescia), both attended by farmers from Codogno. Importantly, the virus had already been detected in Brescia as well.

Jean Pierre Ramponi, Health Director of the Hospital of Chiari (Brescia), reports the first Coronavirus-positive patient on the 23rd February. Meanwhile, two additional cases arrive in Alzano Lombardo (Bergamo), where the virus has been allowed to flourish (https://bit.ly/2U5fbvg). Although doubts have been raised of the Codogno Hospital’s management of the situation, it’s important to note that the virus began its attack with the smaller, less prepared hospitals. The expert opinion is unanimous: it was very difficult to detect the disease in the first place.

Yet, things don’t add up. Three cases were enough in Lodi and Vo’ Euganeo to declare them ‘red zones’, but not in Val Seriana (Bergamo). Why is that?

On February 19th, Atalanta, Bergamo’s football team, play a Champions League match against Valencia at the San Siro stadium in Milan. More than 45,000 fans arrive from Bergamo, and 2,500 from Valencia. After a quick tour of the city centre, both sets of supporters meet outside the stadium in friendly spirit, exchanging team scarves — and the virus. In fact, both groups will discover cases in their area, but not yet. On February 23rd in Zogno (Bergamo), all diners who had attended a local trattoria on February the 14th are contacted by the local health authority, as one has the virus. Note that Zogno is 20 km from both Alzano Lombardo and Nembro, the two places in Val Seriana (Bergamo) where the epidemic breaks out just a few days later. On February 13th, a man dies in the region of Valencia. Although his death doesn’t seem suspicious in the beginning, his body is later exhumed on March 3rd. He was infected by Covid-19. Evidently, the situation was already very dangerous.

On February 26th, the Technical Commission of the Civil Protection, the Italian disaster management body, recommend the closure of Bergamo’s surrounding area. Yet, at that time, politicians are still underestimating what is to come, and the media engage in polemics against perceived alarmism. Both right and left-wing politicians speak of Covid-19 as a ‘normal flu’, stating that Italy must not stop in the face of it. An interesting example comes from Dario Nardella, the Mayor of Florence, who had decided to allow free museum entrance between the 7th and 9th of March, exacerbating an already concerning situation. Unfortunately, the Civil Protection’s recommendation remains unheard.

On February 29th, the WHO declares the Sars-CoV-2 virus to be a “very high global threat”. On March 1st, the Government publish a first decree to contain the contagion in the affected areas, deciding not to create new ‘read zones’. “We are evaluating the possibility to extend the red zone on the basis of certain epidemiological, geographical and feasibility criteria of the measure,” says the President of the Higher Institute of Health, Silvio Brusaferro, on March 3rd, while talking about Bergamo and surroundings (https://bit.ly/2Qt9e94). Meanwhile, on March 1st, a new football match is played with open doors, Lecce vs. Atalanta. I’ve no idea how many people from Bergamo travel to Lecce (Apulia Region) to watch the match this time, but I imagine quite a few, given their passion for the team. In any case, this provides a new chance for the virus to spread around the country.

Between Alzano Lombardo and Nembro (Bergamo) “the mass of positive cases of Coronavirus is now a reality” and for this reason “we asked the Istituto Superiore di Sanità (Italian Higher Healthcare Institute) for assessments on a new red zone to suggest to the Government, to then implement the best strategy”. This statement comes from Giulio Gallera, Welfare Councilor for the Region of Lombardy (https://bit.ly/3bosOLV). “The number of new infected people in the Bergamo area is the highest, with 129 new cases”. It’s already March 3rd, however the situation doesn’t seem urgent, despite the recommendations on new red zones from the Civil Protection dated February 26th.

On the following day, March 4th, there’s no news. On the Eco di Bergamo, they report: “In the area of Bergamo — explains Gallera (Lombardy Welfare Council) — the infections have slightly decreased, only 48 more than on Tuesday. However, it remains one of the areas with the greatest presence of cases, there are 423. We have asked Roberto Speranza, Ministry of Health, for guidelines from the Government, and he said that in the evening, a final decision will be made on the measures to be taken next. We await their assessments and we are ready to accept any measures, even the strictest, that the Government may set on” (https://bit.ly/2wkzj3k). Reading this, Gallera seems to be expressing a shy request, rather than denouncing a now alarming situation.

On March 4th, the Government decides to close all schools and universities all over Italy — the atmosphere has now radically changed. And then March 7th comes, a day that will be impressed in our memory for the rest of our lives. Following, I provide a short personal note of that day to frame the atmosphere.

We are in Sestri Levante (Liguria Region), waiting for the train to Manarola, in the Cinque Terre. On the train, everyone is talking about the virus, keeping distant from each other, with some people trying to not touch the seat handle, by covering their hands with their sleeve. Nobody is wearing a mask.

The weather is beautiful in Manarola. There are a few tourists, but the restaurant overlooking the sea seems crowded. At the pier, we keep distance from other people, and later find a street leading us to an isolated terrace overlooking the sea. Roberta — my friend — calls me. We talk about the situation, and I tell her that I don’t believe they will lockdown Lombardy. It seems impossible.

Later that day, we are having dinner with some friends in Sestri Levante. We don’t kiss and hug to say hello, something a bit ridiculous to think about now. Then, the news about the new government’s decree arrive: Lombardy will, indeed, be locked down. Some friends at dinner start panicking. Phone calls and texts keep coming, and some people decide to rush back to Milan. I’m drinking some gin and tonic, and eating some pasta with bottarga, and I think “tomorrow is another day, and we’ll see”.

That night, Milan’s Central Station is overcrowded with people wanting to go back to the South, unconsciously carrying the virus with them.

The decree is published during the night and is signed off in the morning of the 8th of March. Lombardy together with other 14 northern provinces become ‘red zones’. Yet, it’s already too late, because the virus has been quickly spreading, as in the meanwhile, nothing has changed in Bergamo and Brescia.

“We” — recounts Emilio Del Bono, Mayor of Brescia, to the Fatto Quotidiano on March 17th — “as 12 Mayors of Lombard cities, had already asked both the Region and the Government, on March 7th, to close production activities, only keeping open hygiene and food supply chains, in addition to the maintenance of essential public services”.

Was the Government too reluctant or the Region of Lombardy? — “Mr. Fontana (President of the Region of Lombardy) had always held a strict position, but what was felt was the pressure of the industrial world on both Rome (the Government) and Milan (the Region of Lombardy)”.

In Val Seriana (Bergamo), authorities decided to act earlier, although unclearly. It’s Camillo Bertocchi, Mayor of Alzano Lombardo (Bergamo) who tells the Corriere della Sera, on March 15th (https://bit.ly/2UiIUQa): “Saying it now is easy, [but] we had understood the situations’ gravity since February 23rd. And we were all [pushing] for stricter measures, which were reiterated on February 25th, despite the slackening at the national level. The bars around here were already closing after 6pm. But do you want to know something? Not only were we criticized, [but] we also received a warning from the Ministry of the Interior through an official communication that forbade Mayors [like us] to take any decisions on their own. We asked for rigor and clarity, we didn’t want to disorientate the citizen. We have to listen to the territory: it was not the signal of one Mayor, but of seven, from Torre Boldone to Albino”. Note that Nembro is part of the area.

Here too, things don’t add up. On the Giornale di Brescia on March 4th, the Mayor of Alzano Lombardo explains again (https://bit.ly/2U58Sb4): “The red zone is already operating here, but making the area ‘off-limits’, banning everyone to come and go, would create incalculable damage to our territory”. This is an area full of production companies, from Pigna Paper Mills, to Persico Group and Polini Motori. “Of course — he adds — the spread of the virus is important, and the numbers of cases are sure to increase. I don’t mean to say that there’s no emergency and that we don’t have to do everything possible to contain it but making this a red zone would be dramatic for our economy “.

Yet, what kind of economic damage is at stake? This is explained by the Eco di Bergamo, which provides some numbers on the businesses in the area (https://bit.ly/2WsuqA0). [There are] 3,700 employees [working for] 376 companies, for a total turnover of 680 million per year. The article also gives an insightful detail: “Among the problems to be solved, there would be, first of all, the one of non-resident employees [working] in the two municipalities, for whom companies are thinking of renting rooms in the few hotels in the area, to allow them to work”. In practice, the virus is a reality, but there are no real talks of stopping the production activities — even at the expense of employees’ health, which would be further jeopardized by gathering them in a few hotels. Put this way, the statement of the Mayor of Alzano Lombardo doesn’t sound too lacerating, which is possibly why he remains unheard. In fact, both the Office of the Region of Lombardy and the Government in Rome stay quiet.

Meanwhile, in Bergamo and Brescia, the virus keeps spreading. The assumption is that everyone is so quiet not simply because of mere inefficiency, but because they are facing pressure from industrialists’ associations. Lombardy is one of the most industrialized areas of the country. To confirm this assumptions there’s Gallera’s comment on March 19th. “When we asked to close down everything, I was overwhelmed by phone calls: lifetime friends and entrepreneurs who shouted at me, all telling me not to close down everything”. Although both Government and the Region of Lombardy didn’t want to give in, the virus was stronger than them, and even they had to surrender. Yet, is it because of such pressure, that during the past few days both Government and the Region of Lombardy have been blaming each other for closing down factories?

Also Giuseppe Remuzzi, who worked for many years at the Hospital of Bergamo ‘Papa Giovanni XXIII’, and who is now the Head of the Mario Negri Research Institute, thinks that the red zone would have been useful. During an interview with the Corriere della Sera, he says: “As everyone knows by now, we have two affected areas. Nembro and Alzano Lombardo. Back in December, GPs in Alzano Lombardo were faced with cases of pneumonia they had never seen before. But they thought it was an evolution of the annual flu strain”.

Did they make a mistake? — “It’s hard to know that you’re facing something new if you’ve never seen it before. Even us as researchers, were convinced the virus wasn’t that aggressive.”

Then what happened? — “Alzano Lombardo is a small industrial capital. There are contacts of all kinds. People coming and going from all over the world. Nembro is one of the liveliest towns in the area. Long story short, a busy place”.

Is there anything different that could have been done? — “Make a red zone. Right away, like in Codogno.”

Why wasn’t it done? — “I don’t know. I’m just saying that the absence of a red zone worsened a situation that was already serious” (https://bit.ly/2QoF1bh).

To recap, at the moment we have a combination of unprepared hospitals, inefficient and cynical politics, and the industrialists who are only concerned about keeping their companies open.

The atmosphere is also similar in Brescia, where, as Gallera tells Stampa, “Many have flown, it seems that at night someone has even moved the machinery from the sheds”. In fact, this is an area with over 1,300 associated companies. “Among the most concrete hypotheses is that, in the end, the idea prevailed of keeping open factories at all costs,” an article says.

Marco Bonometti, President of both Lombardy Confindustria (industrialists’ association) and Officine Meccaniche Rezzatesi, defines these “useless controversies”, while Giuseppe Pasini, from Confindustria Brescia, says that “industries cannot close because they are strategic for people and international supply chains and risk paying very high penalties. [Instead], others have safety standards”. But what about the quick spreading of the virus? Apparently, it’s the fault of the previous weekends, when many travelled around. “If only stricter measures had been taken earlier…” says Bonometti, somewhat cynically and hypocritically, “… but it’s useless to cry over spilt milk. From the weekend on I expect better results”.

I conclude my reflection with the photo that shocked Italy. A row of military trucks taking coffins away from Bergamo, because there is no more room in the city cemetery, and the coffins need to be taken to other crematoriums.