Coronavirus Italy: Lombardy province at centre of outbreak offers glimmer of hope

On 21 February, the Lombardy province of Lodi was at the centre of Italy’s coronavirus outbreak when the first locally transmitted case was confirmed in the town of Codogno. The town was immediately put under lockdown, with 10 others across the province, which lies south of Milan, following suit the next day.

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Today, as calls to emergency lines return to pre-outbreak levels, Lodi is offering a glimmer of hope for how the rest of Italy might overcome the pandemic and make its way out of the lockdown.

In recent weeks, the province, which has a population of about 230,000, has seen a sustained decline in the rate of new infections, with total cases by Monday reaching 2,278, a rise of 23 since Sunday.

“The first few days were very brutal, characterised by a significant number of patients with breathing difficulties,” said Stefano Paglia, the chief of the emergency unit at Codogno and Lodi city hospital.

“Now the situation is normalising, we still deal with some Covid-19 patients, but the situation has gone from one of maximum emergency to returning to more ordinary levels of management.”

Fabrizio Canevari, an operations manager at Soreu della Pianura, a safety and first aid service that manages calls to emergency numbers covering four Lombardy provinces, including Lodi, said: “On day three of the outbreak we had 2,300 calls, on Sunday there were 480, so we are returning to a relatively normal level of activity.”

The emergency unit at Codogno hospital was closed immediately after the first coronavirus case was detected, with services transferred to the hospital in Lodi city. Up until last week, the hospital had treated 1,700 Covid-19 patients, of whom 300 died.

“There are positive signs in Lodi because the early lockdown blocked, or at least greatly limited, the circulation of the virus,” said Walter Ricciardi, an adviser to the Italian health ministry on the coronavirus outbreak and a member of the World Health Organization.

“For sure, there is less pressure now and for this reason the health services can manage a situation which in the early days could only be done with a great deal of effort, but I predict we’ll still need several days before things completely return to normal.”

The province of Bergamo, north of Milan, suffered a similar fate to Lodi at the beginning of the outbreak, in that the virus was initially misdiagnosed at a hospital in the town of Alzano Lombardo, allowing it to spread to other patients and health workers.

Although the first case in Bergamo was confirmed on 23 February, the province of 1.2 million people only went into lockdown with the rest of the Lombardy region on 8 March, during which time it quickly became Italy’s “ground zero”. As of Monday, there were 9,815 confirmed coronavirus cases across Bergamo province, while the death toll in March was 2,060, according to official figures.

“There is also a trend of improvement in Bergamo but whereas Lodi is in an advanced stage of progress, Bergamo is still in the thick of the situation,” added Ricciardi.

Across Italy, the curve of new cases is flattening, with 1,941 new infections registered on Monday, the lowest day-to-day rise in a week. Italy’s lockdown is currently due to expire on 13 April, however easing restrictions at this stage would be “premature”, said Ricciardi.

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“China implemented measures for three months and had a plateau [of new infections] that continued for 20-25 days before it started to decrease,” he added. “We’re in the first month-and-a-half of the lockdown, so I think we still need to resist and wait for the curve to fall definitively.”

The Italian government is studying a combination of measures that would allow the country to gradually move towards easing the lockdown, including a system to test, trace and contain the virus.

“We are assessing the technological solutions for testing and tracing and hope to do experiments over the next two weeks. The system should be ready by the end of the month, or early May,” said Ricciardi.

Italy’s southern regions have so far managed to stave off a surge in infections.

“Cases in the south are still going up but they are going up slowly,” said Giorgio Sestili, a physicist who is collating studies from Italian scientists and sharing them on the Facebook page Coronavirus – Data and Scientific Analysis. “However, the lockdown is still fundamental.”