Safety Failures, ‘Bad Luck’ Fuel Italy’s Coronavirus Surge

(Bloomberg) -- Behind the coronavirus upsurge that has turned Italy into Europe’s worst-hit nation is a combination of bad luck and safety protocols that fell short. Health authorities say the country’s meticulous search for new cases is inflating the tally.

The government of Prime Minister Giuseppe Conte is battling to cope as the caseload escalates to 283, with seven deaths. Vast swathes of rich northern Italy’s Lombardy and Veneto regions, stretching from Milan to Venice, are in a virtual lockdown.

Just why Italy is suffering more than its neighbors is a question bedeviling the government and health authorities. The virus’s rapid spread there contrasts with more modest clusters elsewhere in Europe, including at a German auto parts supplier and in a French ski resort, where authorities quickly identified an original carrier and kept the illness from spreading.

The Italian outbreak has been traced to a 38-year-old man who sought treatment at a hospital in Codogno, near Milan, on Feb. 18, where he infected dozens of patients and medical staff. He had not been to China recently and how he became infected remains a mystery.

“At the root of all this is sheer misfortune,” said Fabrizio Pregliasco, a virologist at Milan University. “Who would have imagined that a person with symptoms similar to pneumonia, in Codogno in an agricultural province of Lombardy, could have the coronavirus?”

Containment Measures

Previously Italy had registered only three cases, all of them in Rome, including a married Chinese couple in the capital for a holiday.

Fifty-four new cases were reported in Tuesday, Italian emergency chief Angelo Borrelli said to reporters in Rome, with 40 of those in Lombardy. Three cases have been identified in the province of Milan. Italian measures to identify the virus have been robust, and could account for the increased number of detected cases, World Health Organization executive board member Walter Ricciardi said.

Conte blamed the surge on a hospital he did not name, saying that from there the disease had spread because safety protocols were not respected. Conte told Rai television in an interview late Monday that the government may limit the powers of local health authorities if they fail to coordinate.

Lawmaker Riccardo Molinari of Matteo Salvini’s anti-migrant League party retorted that too much stress had led Conte to say “something inconceivable, almost fascist.”

After the outbreak near Milan, the government ramped up containment measures and testing. Police are manning roadblocks to stop anyone from leaving or entering an area of some 50,000 people in Codogno and other towns south of Milan, where most cases have been identified.

Across Lombardy and Veneto, schools and universities closed and public events were canceled as stocks and bonds tumbled on concern the spread would prompt a recession. Venice suspended its annual pre-Lenten Carnival, and Serie A soccer matches were postponed.

Lower-than-expected growth due to the virus may lead Italy’s deficit to GDP ratio to exceed the 2.2% target for 2020 agreed with the European Commission, newspaper Il Sole 24 Ore reported. That may lead Rome to request budget flexibility of 2 billion to 4 billion euros, the newspaper said.

The health authorities’ mobilization to seek out new cases goes beyond the efforts of other European countries, Conte said, noting that Italy had carried out 4,000 tests for the virus in hospitals.

‘Very Meticulous’

“The Italian approach is very meticulous,” said Massimo Andreoni, a professor of infectious diseases at Rome’s Tor Vergata University. “We’re looking for all the contacts that a given person has had. We’re testing thousands of people. The more we seek, the more we find. But we still don’t have a cast-iron explanation for the numbers of cases.”

Health officials’ sleuthing also has yet to turn up an initial spreader -- dubbed “patient zero” by Italian newspapers -- from whom the man in Codogno caught the illness. In line with World Health Organization safety protocols, he was not tested initially for the virus as he said he had not had contact with anyone who had been to China recently.

Later, his wife said he had met with a businessman who returned from the country. That man, however, tested negative.

One theory floated by health experts is that the location of the outbreak could be due to the Lombardy and Veneto regions having close business ties with China.

Conte, who has expressed his surprise at the surge, has drawn criticism for making Italy the first European Union country to ban flights to and from China. The WHO’s Ricciardi said this had stopped authorities from tracing arrivals as travelers could use stopovers to reach the country.

Andreoni defended the measure. “The ban improved the situation because fewer Chinese people decided to come to Italy,” he said. “In any case, you can’t start testing for the virus everyone who steps off from a plane, whether it’s from China or anywhere else.”

No Symptoms

As in other countries, efforts to contain the virus are complicated by the discovery that some people infected with it have few or no symptoms, and others are easily confused with victims of annual seasonal influenza.

For Conte’s government, isolating affected areas is now the priority rather than seeking the patient behind the recent outbreak. The premier has resisted calls to suspend the Schengen agreement, which allows free movement across the borders of EU members.

“The Codogno outbreak is the tip of the iceberg, and now the priority is to go underwater and find out how big the iceberg is with more tests,” said Milan University’s Pregliasco. “We should be able to establish in two weeks’ time, the duration of the incubation period, whether the containment efforts are effective or not.”

--With assistance from Flavia Rotondi, Alberto Brambilla, Ross Larsen and Marco Bertacche.

To contact the reporter on this story: John Follain in Rome at jfollain2@bloomberg.net

To contact the editors responsible for this story: Ben Sills at bsills@bloomberg.net, Jerrold Colten, Karl Maier

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