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COVID-19 in Italy: Jeopardizing the Political Landscape and Public Health

By Benjamin D. Fort

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Citation

Fort B. COVID-19 in Italy: jeopardizing the political landscape and public health. HPHR. 2022;62.

COVID-19 in Italy: Jeopardizing the Political Landscape and Public Health

Abstract

Objective

To further analyze the implications the COVID-19 pandemic has on Italy’s future leadership and public health.

Methods

I sampled primary & secondary data extracted from other scientific analysis in correlation with this topic.

Results/Discussion

In the course of the COVID-19 pandemic, Italy struggled immensely with battling the virus. Many of the critical & efficient response efforts were unfulfilled. From the lack of compliance with regulations, to the polarized response techniques, all analyzed through the global case & death statistics, factors of performance, and the evaluation of response efforts.

Conclusion

The conducted research reveals Italy’s inadequate response and how the lack of leadership could potentially result in permanent repercussions in regard to their future political landscape & public health if an efficient solution is not applied.

Introduction

The global pandemic that shook the whole world was like something out of a horror movie. State of Emergencies were issued globally which involved mass-shutdowns of everything minus essential businesses. It was like everywhere across the globe was a ghost town and the planet was hollow. This created an eerie vibe and stemmed a mysterious fear inside of a lot of answer-seeking individuals. Lingo such as “social distancing”, “six-feet apart”, “self-quarantine”, “mask mandate” are all terms associated with this pandemic. COVID-19 likely originated in a “wet market” in Wuhan, China. A wet market refers to a marketplace with vendors selling live animals such as cats, dogs, rabbits, fish, and bats. The name “wet market” is a reference to the need to be constantly washing the floors in these venues due to animal slaughter and to the melting ice used to preserve the food. The common denominator among those who caught the virus in China had some level of exposure to the Huanan Seafood Market in Wuhan. Researchers believe the new virus probably mutated from a coronavirus common in animals which jumped over to humans in the Wuhan marketplace.[1] Coronaviruses are a family of viruses that can cause mild to moderate upper-respiratory tract illnesses such as the common cold, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).[2]

 

This pandemic known as COVID-19 or “Corona virus” especially shook Italy pretty significantly & ill-mannered. Over the decades, Italy has suffered from political instability making them an already feeble nation. This started with the establishment of the “clean hands” operation in the 1990s that exposed its corruption in politics, there were high hopes that radical reform would emerge however, all hope was lost with the appointment of upper-class businessman Silvio Berlusconi who later indulged in numerous scandals and corruption affairs. Since then, Italian politics never healed and to this day there is pure chaos on its chamber’s floors which reflects that the people inside the chamber are not respected and its political environment is failing. Italy also saturated economic struggles, resulting in a bankrupt economy. They were experiencing war debt that completely disrupted the Italian economy as well as a rapidly increasing population, which along with the two and a half million men who came out of the armed forces made the matter of poverty worst as unemployment and poverty rates were really high and increasing. This caused the price of food to rise and violent armed strikes to occur frequently. These political & economic instabilities followed by a shift in Italian government correlate with Benito Mussolini’s quote “Democracy is beautiful in theory; in practice it is a fallacy” (March 23rd, 1919).[3] To dissect this assertion from Mussolini, it is essential to note that here, Mussolini is expressing that Democracy may sound good but it is actually easier said than done. Moreover, one might seek a goal of Democracy however, in action, it may appear to be more challenging than expected. These challenges and instabilities also pose a threat to public health. With rising poverty follows decreased sanitation & nutrition. All of which can be encapsulated through global case & death statistics, responsible factors of performance, and the assessment of response exertions.

 

 

 

Methods

As stated, various primary and secondary sources were used in this data sample collection. For example, the collection was composed of an array of credible data sources such as Johns Hopkins University & Medicine, U.S. National Library of Medicine National Institutes of Health, and Harvard Business Review just to name a few. For the purpose of this research, my intentions were to include such sources in this study that were reliable and robust in order to fabricate a methodical analysis.

Results

Case & Death Statistics

One of the immense variables that reflect Italy as a whole is the data collection & statistics divided up into the quantity of confirmed cases by the government as well as confirmed deaths associated with the pandemic. After studying the statistics, the results were mind-blowing, especially in regard to how little of a country Italy is & their population size. Based on the most recent demographic census, Italy has a current population size of 60,374,017.[1] According to Johns Hopkins University & Medicine there has been a total of 4,259,133 confirmed cases following 127,542 deaths which leads to a three percent Case-Fatality and 211.52 deaths per 100k population.[2] What makes these statistics mind-blowing is when in comparison with other countries like Mexico. Mexico for instance, only had 2,513,164 confirmed cases in comparison to Italy, following 232,803 deaths and a 9.3 percent Case-Fatality with 182.48 deaths per 100k population.[3] These statistics are shocking as Mexico has a total population a little over double the size of Italy’s but with about two million less confirmed cases than Italy. However, Mexico suffered more deaths than Italy which resulted in a significant increase in Case-Fatality percentage. These statistical disparities result from the lack of healthcare & poor sanitation Mexico experiences which Italy may fall victim to if there is no change. Among the Latin American countries, Mexico invests the least into healthcare in relation to their GDP, and their health expenditure per capita lags significantly compared to other emerging economies in the region.[4] Mexico’s water & sanitation crisis also contributes to the astronomical disparities. The struggle to provide its citizens with safe drinking water results in water scarcity and reduced access to safe utilities.

 

Furthermore, the community fails to do their share in battling sanitation efforts as there is a low rate of participation and usage of sanitation. This most likely contributes to the lack of education on sanitation specifically, among rural regions. In Mexico City 904,000 lack access to safe water and three million lack access to improved sanitation.[5] This is shocking as it highlights the severity of these issues Mexico struggles with which contribute to the excessive amounts of deaths experienced during the pandemic.

In regard to Italy, the northern region was hit harder than the southern region by the pandemic. To break it down, northern regions such as the city of Lombardy was one of Italy’s hardest hit regions by COVID-19 from the start of the pandemic. Lombardy resulting with over 87,000 confirmed cases and almost 16,000 deaths, making it the highest number per capita in Italy. Following its neighboring regions such as the province of Piedmont suffering from over 30,000 confirmed cases, both of these northern Italian regions are persuasive examples that represent the suffering of northern Italy. In comparison with southern Italian regions there are great disparities. Southern regions such as Sicily resulting from over 3,000 cases, Calabria with just over 1,000 confirmed cases, and Basilicata with only almost 400 cases express how the south did not suffer nearly as badly as the north. The justification for Lombardy’s suffering has led to suspicions from GPs allegedly ignored or dismissed by regional health authorities, is one explanation for the region becoming Italy’s ground zero.[6]  Therefore, the neglect exhibited by GPs towards regional health authorities in the north, and the statistical comparison between northern & southern regions shimmer how the pandemic was far more lethal in northern Italy than that of southern Italy.

Responsible Factors of Performance

There are a vast number of factors responsible for the poor performance of Italy resulting in the country doing worse than average. Referring back to the great disparities between the north and the south, one of the factors is the low level of compliance with public health measures in the earlier stages. For example, Italy experienced a mass flow of people from the hardest hit northern regions (Lombardy) towards the south, prior to the national lockdown which contributed to the spread of the outbreak in unaffected southern regions.[1] These southern regions include places such as Sicily and Calabria which now have suffered from around a combined total of about 4,000 confirmed cases. Another factor also relating to the disparities between the north & south, has to do with the suspicions of Lombardy’s close trade ties with China (where the virus originated from) which also confirms why its Italy’s wealthiest region. Additionally, Lombardy has the highest population density in Italy following a pollution surplus which also makes this population more vulnerable.

 

Moreover, Lombardy delayed shutdown efforts. Mainly because they were pressured by business associations to maintain operations. According to a Professor at Brescia University, Arnaldo Caruso expressed how production never completely stopped and how workers continued to work during the lockdown and without all of the precautions that later followed.[2] These non-compliant efforts performed by the region of Lombardy echo how northern Italy was impacted by the pandemic & how these irresponsible response efforts negatively reflect the country as a whole. Another factor to consider is Italy’s failure to revise their national pandemic plan the ‘National Plan for Preparation and Response to an Influenza Pandemic’.

 

This was established after the re-emergence of the H5N1 avian influenza pandemic that struck eastern Europe in 2003. If there had been revisions to this plan in the last fourteen years it could have been used as a reference to help establish one for the COVID-19 pandemic and potentially resulted in a more urgent & efficient response to this current pandemic. Due to a lot of these objectives introduced in the national pandemic plan being unfulfilled during the beginning of the COVID-19 pandemic the Italian Prime Minister had threatened to terminate powers from regions & autonomous provinces because they were ‘in charge of implementing healthcare but not prepared to face a national emergency’ and complained about the lack of application of ‘unspecified’ preparedness protocols.[3]

 

This exemplifies the Italian government’s frustration with health officials’ negligent efforts to battle the pandemic by menacing to exercise withdrawals of power in responsible regions and provinces. This type of operation from the Italian government is similar to American Democracy with the Executive branch being granted the authority to oversee other branches of government under certain circumstances involving events that require immediate emergency response such as the right to exercise Executive privilege over the Legislative branch’s ability to manage Separation of Power via “Checks and Balances”.

 

Evaluation of Response Efforts

Aside from dwelling on the poor response efforts to the pandemic by this country, it is essential to reflect and provide insight on what to do differently in the future and provide better alternative approaches for future pandemics & instances. First, it is vital to be conscious of information on vaccinations. A consideration that needs to be made is being educated on the differentiation between emergency authorization and full approval by the Food & Drug Administration (FDA). With that being said, treatments may be granted emergency use authorization where the potential benefits outweigh the potential risks of treatment though, treatment is still not considered “safe”.

 

In order to gain full approval all variables have to be researched & tested such as the long-term effects which this process can require several years of testing before it can be granted full approval. This is where individuals have to be conscious on their decisions to seek treatment or not with considerations of medical history and how underlying conditions they may suffer from are at stake, they may potentially create a reaction if the desired treatment is accepted. Next, it is critical to recognize your cognitive biases in the next pandemic. In other words, it is important to terminate action based on opinions & gut feeling but rather, use the time to absorb and discover the limited information available from variable sources of expertise. For example, one source explains how some notable Italian politicians engaged in public handshaking in Milan to make the point that the economy should not panic and stop because of the virus.[1] This backfired as a week later one of those politicians was diagnosed with COVID-19. This amplifies why it is crucial to ditch the concept referred to as “confirmation bias” by many Behavioral Scientists as this concept seizes information that reinforces our preferred hypothesis or demonstrates a “monkey see, monkey do” analogy.

 

Additionally, another step to take for the future is to avoid partial solutions. The Italian’s experienced a gradual increase of lockdown restrictions rather than immediate & complete ones. This was an inconsistent & inefficient approach for numerous reasons. First, Pisano stated how Italy followed the spread of the virus rather than prevented it.[2] This is justified as dealing with the pandemic “in the moment” rather than in advance resulted in an unpredictive future. In other words, in just a few days cases spike and the pandemic is running ramped. Secondly, Pisano explained how When the decree announcing the closing of northern Italy became public, it touched off a massive exodus to southern Italy, undoubtedly spreading the virus to regions where it had not been present.[3] This highlights the issues with gradually increasing lockdown restrictions and how Italy contributed to the spread rather than prevention as by only shutting down one part of the country rather than the whole country it allowed for a rapid spread of the virus in regions that were unaffected prior to the announcement.

Discussion

Italy’s response to this pandemic has also threatened its public health in regard to lack of health education, its lingering inequalities in healthcare, and technological discrepancies. For example, inequalities in healthcare consist of workforce shortages due to lack of opportunities, insufficient salaries, and poor career prospects centered around meritocracy. Moreover, after constitutional reform in the early 2000’s a shift developed from nationally to regionally based organization of health services, increasing the inequality between northern and southern Italy without reducing the costs of the system. Finally, considerable technological discrepancies persist between small hospital facilities versus larger universities, and between the public and private sectors. In order to restore Italian healthcare, reinforcements in research & medical care need to be applied while retaining an ethical approach (Piscitelli, et al., 2019).        

Conclusion

To conclude, it is evident that Italy was drastically shuddered by the Coronavirus and has many lessons to learn and apply for future reference that can be analyzed through global case & death statistics, responsible factors of performance, and the evaluation of response efforts. The virus was speculated as Italy’s biggest crisis since WWII. In order for Italy to regain its strength they must acquire stringent guidelines and remain committed to those objectives early on. In unexpected events it is crucial to comprehend new information and apply it sooner than later. Italy must re-organize its governance which will assist in sufficient funding in healthcare, overcoming workforce scarcities, and comprehension that preparation for future pandemics cannot be delayed.

Disclosure Statement

The author has no relevant financial disclosures or conflicts of interest.

References

  1. Bosa I, Castelli A, Castelli M, et al. Response to COVID-19: was Italy (un)prepared?. Health Econ Policy Law. 2022;17(1):1-13. doi:10.1017/S1744133121000141.
  2. Carmosino, A. Background & History of the Coronavirus (COVID-19). Psych Central. https://psychcentral.com/coronavirus/background-history-of-the-coronavirus-covid-19#1. Accessed August 20, 2021.
  3. Giuffrida, A. Why Was Lombardy Hit Harder than Italy’s Other Regions?. The Guardian. https://www.theguardian.com/world/2020/may/29/why-was-lombardy-hit-harder-covid-19-than-italys-other-regions. Accessed August 20, 2021.
  4. (n.d.). Accessed July 10, 2021. Retrieved August 20, 2021, from https://worldpopulationreview.com/countries/italy-population.
  5. (n.d.). Accessed July 10, 2021. Retrieved August 20, 2021, from Mexico’s Water Crisis – Water In Mexico 2021 | Water.org.
  6. John Hopkins University. Mortality Analyses. Johns Hopkins Coronavirus Resource Center. Published 2020. https://coronavirus.jhu.edu/data/mortality. Accessed January 31, 2022.
  7. ‌ Pisano GP, Sadun R, Zanini M. Lessons from Italy’s Response to Coronavirus. Harvard Business Review. Published March 27, 2020. https://hbr.org/2020/03/lessons-from-italys-response-to-coronavirus. Accessed January 31, 2022.
  8. UKEssays. Political instability of Italy. https://www.ukessays.com/essays/history/political-instability-of-italy.php#:~:text=Italy%20had%20many%20problems%20especially%20related%20to%20Political. Accessed January 31, 2022.
  9. Ríos, A. “Topic: Health in Mexico.” Statista. November 18, 2020. https://www.statista.com/topics/5042/health-in-mexico/. Accessed July 10, 2021.
  10. Piscitelli P, Miani A, Mazza A, et al. Health-care inequalities in Italy: challenges for the Government. The Lancet Public Health. 2019;4(12): e605. doi:10.1016/S2468-2667(19)30229-4.

About the Author

Benjamin D. Fort, B.S.

Benjamin D. Fort is a Social Science scholar from Baltimore, MD. His research areas include public health topics relating to Disease & Infection control, Biomedical Engineering, and Men’s Mental Health. He received his formal training at Towson University. He currently volunteers for Johns Hopkins University & Medicine. He serves as an avid member of the National Honors Society with future endeavors to pursue a M.Ed. in Educational Leadership & Higher Education and become a professor in Social Sciences. 

 

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