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Why the Coronavirus Was So Deadly for Italy
Lack of coordination and trust caused trouble for the country’s response to the pandemic
As any aficionado of the “Italian grandmothers making pasta” video genre might infer, Italy’s population has the world’s second-highest proportion of older adults. Twenty-three percent of the country’s residents are older than 65, and 20% of older Italians live with at least one child.
Italy’s age-diverse culture of multigenerational, high-density living has been blamed, in part, for the way the coronavirus spread through parts of the country like wildfire, resulting in what is to date one of the highest per capita death rates due to the virus worldwide. But other countries with large numbers of older residents and multigenerational households didn’t suffer the way Italy did — and in fact, within Italy itself, disease and death rates due to Covid-19, the disease caused by the novel coronavirus, varied dramatically between regions.
Decentralization drastically weakens the response
Italy had the misfortune of being the first Western democracy to confront the pandemic, and images from within its borders tell a story of individuals forced to make terrible choices without precedent: who gets medical care, who gets testing, who gets masks, and who does not. But those individual choices weren’t exclusively a consequence of Italy’s bad luck, nor of its population characteristics, which provided fuel to Covid-19’s fire: They were the result of a broadly decentralized, uncoordinated, and politicized public health response that often followed the flames instead of putting them out at their source.
Some people don’t appreciate how independently the various parts of Italy operate from one another nor how limited the influence of Italy’s national government is, says Eric Schneider, senior vice president for policy and research at the Commonwealth Fund, an independent healthcare research organization.
The downstream effects of a decentralized approach to the pandemic — in combination with an uncoordinated communications strategy — were evident early in Italy’s Covid-19 epidemic. The country’s first case was identified in the town of Codogno, in northern Italy’s…
