COVID-19 pandemic in Italy

On 31 January 2020, the Italian Council of Ministers appointed Angelo Borrelli, head of the Civil Protection, as Special Commissioner for the COVID-19 emergency.[32][33]

Italian government task force to face the COVID-19 outbreak in the Civil Protection situation room on 23 February. Prime Minister Giuseppe Conte and Health Minister Roberto Speranza are in the foreground, from behind

On 22 February, the government announced a new decree imposing the quarantine of more than 50,000 people from 11 municipalities in Northern Italy. The quarantine zones are called the Red Zones and the areas in Lombardy and Veneto outside of them are called the Yellow Zones.[34] Penalties for violations range from a €206 fine to three months of imprisonment.[35] The Italian military and law enforcement agencies were instructed to secure and implement the lockdown.[36]

Schools were closed in ten municipalities in Lombardy, one in Veneto and one in Emilia Romagna. All public events were cancelled and some commercial activities were halted or were allowed to resume only until 6 pm.[37][38] All religious services were cancelled.[39] Regional train services to the most affected areas were suspended, with trains skipping stops at Codogno, Maleo and Casalpusterlengo stations.[40][41]

People with symptoms were advised to call the 112 emergency number, instead of going directly to hospitals, in an effort to limit the disease's spread.[42] The Ministry of Health provided a website and a direct line (1500) from which people could obtain the latest updates and information, as well as report suspected cases.[43]

Educational trips to destinations in Italy and abroad were suspended. Universities in Lombardy, Veneto, Trentino Alto-Adige, Piedmont and Emilia-Romagna suspended all activities from 23 February until 1 March.[44][45][46][47][48][49]

On 22 February 2020, Prime Minister Giuseppe Conte suspended all sporting events in the regions of Lombardy and Veneto, which included three Serie A football matches in those regions, as well as one in Piedmont, that were to be played the following day.[50][51][52] The following week, six Serie A matches were initially to be played behind closed doors, but all were later suspended,[53][54][55] as were two Coppa Italia matches.[56][57]

Authorities in Veneto cancelled the last two days of the Carnival of Venice on 23 February.[58] Authorities in Piedmont cancelled the last three days of the Carnival of Ivrea.[59]

La Scala, Duomo di Milano and Piccolo Teatro in Milan, as well as Basilica Di San Marco in Venice, were closed until further notice.[60][61][62] A Giorgio Armani fashion show, which was scheduled on Sunday, the last day of Milan Fashion Week 2020, went ahead without any media or buyers present; it was instead streamed live online.[63][64]

In addition to the emergency phone numbers 112 and 118, new dedicated numbers were added for the different regions – Lombardy 800894545, Campania 800909699, Veneto 800462340, Piedmont 800333444 and Emilia-Romagna 800033033.[65][66][67][68] The Ocean Viking, a rescue ship operated by MSF and SOS Mediteranee that was carrying almost 300 migrants, was quarantined for 14 days in Pozzallo, Sicily.[69] Trenitalia and Italo, the major providers for Italy's high-speed trains, ordered the installation of hand-sanitiser dispensers on all trains as well as the distribution of masks, disposable gloves and disinfectants to all onboard staff members.[70]

Empty shelves at the Esselunga supermarket in Bergamo, 26 February 2020

Supermarkets in Lombardy and Emilia-Romagna were emptied by customers as residents stockpiled food and supplies.[71][72][73] Streets, parks and train stations in multiple cities in Lombardy were left deserted.[74][75]

On 24 February 500 additional police officers were assigned to patrol the quarantined areas in Lodi and Veneto.[76] Additional toll-free numbers were added for other regions — Valle D'Aosta 800122121, Trentino Alto Adige 800751751, Friuli Venezia Giulia 800500300, Toscana 800556060, Umbria 800636363, Marche 800936677 and Lazio 800118800.[68]

The governor of Basilicata, Vito Bardi, instituted a mandatory 14-day quarantine for people arriving from areas in Northern Italy affected by the outbreak.[76] The Ministry of Health announced that it had engaged 31 laboratories in Italy to carry out the analysis of swabs from suspected COVID-19 cases.[77] Minister Roberto Speranza appointed Walter Ricciardi, a member of World Health Organization's executive committee and former president of Italian National Institute of Health, as a special adviser for relations between Italy and international health organisations.[78] Filming of Mission: Impossible 7 starring Tom Cruise in Venice was halted.[79]

Major companies such as IBM, Enel, Luxottica, PwC and Vodafone continued to allow employees to work from home. Generali Tower in Milan and Palazzo Madama in Rome installed thermal scanners to measure temperatures of visitors and employees.[80][81] FAO Headquarters in Rome conducted temperature checks on visitors entering the building.[82]

Multiple regions in Italy such as Liguria, Trentino Alto Adige, Friuli Venezia Giulia, Abruzzo and Marche decided to close all schools and universities for two days to a week. Court proceedings were postponed until further notice.[67]

Starting from the 9th week of the year, ICU cases related to COVID-19 started to appear in the hospitals. Their spike showed a different behaviour than the cases of seasonal flu.[83][84]

The FTSE MIB Index fell by 6% and other stock market indices across Europe were also affected.[85] Over 300,000 calls per day were logged on Lombardy's toll-free line as well as the emergency number 112.[86] Some of the residents inside the Red Zone managed to leave the quarantined areas daily, bypassing the checkpoints by going through back roads.[87][88]

On 25 February, Aviano Air Base closed all schools until 28 February.[89] General Tod D. Walters issued a travel ban covering the areas of Italy affected by the outbreak for US service members and their families.[90] Driver's licence exams were suspended in Lombardy and Veneto.[91] The number of checkpoints in the Red Zones was increased from 15 to 35, and army personnel were sent to help staff the checkpoints.[92]

The Italian Basketball Federation suspended all of its championship games, including Lega Basket Serie A.[93]

Istituto Tecnico Economico Enrico Tosi in Varese, Istituto Comprensivo di Pianoro in Bologna and Liceo Attilio Bertolucci in Parma conducted lessons for students online while waiting for the schools to reopen.[94][95][96] The University of Palermo suspended all activities until 9 March.[97]

Morgan Stanley, Barclays, Mediobanca and UniCredit requested their Milan staff to work from home.[98]

Multiple fairs and exhibitions were rescheduled. Salone del Mobile was postponed to 16 to 21 June.[99] Bologna Children's Book Fair was rescheduled to 4 to 7 May.[100] Cosmoprof Worldwide Bologna, a cosmetic fair, was rescheduled to 11 to 15 June.[101] Expocasa, a furniture fair in Turin, was rescheduled initially to 28 March to 5 April but later to future date to be announced later.[102][103] Roma Motodays was postponed to 17 to 19 April.[104]

Italy opened a probe into skyrocketing online prices for masks and sanitising gels. Police issued warnings that criminals were using false identities and posing as health inspectors to gain access to people's homes to steal money, jewellery and other valuables.[105]

On 26 February, Director of the Italian National Institute of Health Franco Locatelli announced that swabbing would only be performed on symptomatic patients, as 95% of the swabs previously tested were negative.[106]

The Italian Minister of University and Research, Gaetano Manfredi, announced that online lessons would be delivered to students in areas affected by the outbreak starting on 2 March.[107] Palermo and Naples closed all schools until 29 February.[108][109] The University of Basilicata installed a thermal scanner and continued all teaching activities as per normal.[110] The University of Bari suspended all medical- and health-related internships for medical and healthcare students.[111] Politecnico di Milano conducted thesis mentoring for more than one thousand students graduating the following week using Skype.[112]

The Italian Winter Sports Federation decided to proceed with the Women's World Cup alpine skiing races at La Thuile, Aosta Valley on 29 February.[113] The MIDO Milan Eyewear Show was rescheduled to 5 to 7 July.[114]

On 27 February, Taranto, Apulia closed all schools until 29 February.[115] Multiple schools were closed in Roseto degli Abruzzi.[116] D'Annunzio University suspended all activities until 29 February.[117] Cartoocomics Fair in Milan was rescheduled to 2 to 4 October.[118] The Winter Rescue Race in Piedmont was cancelled.[119] University of Bologna planned to set up a remote teaching project in which exams and lessons would be delivered to students online, to be partially completed on 2 March.[120] Messina closed all schools from 29 February to 3 March.[121]

On 28 February, during an interview with Rai News24, Professor Massimo Galli from the Luigi Sacco Hospital in Milan suggested that the majority of newly recorded cases were pre-existing cases that were finally detected during the extensive tests performed on people (and their relatives) who had come in contact with confirmed patients.[122] The rapid increase of positive cases was the result of the blanket testing approach that was deployed following the first confirmed case in Codogno.[123]

The Ministry of Health announced new guidelines for reporting cases. It would no longer report asymptomatic cases (positive swabs taken from patients who were not showing symptoms), which had counted as 40 to 50% of all reported cases at the time. These people would undergo isolation at home and would be followed up with new tests until they were negative.[124][125] Universities in Lombardy extended their closure until 7 March.[89]

On 1 March, the Council of Ministers approved a decree to organise the containment of the outbreak. In the decree, the Italian national territory was divided into three areas:[126]

The number of new cases and deaths per day in Italy from COVID-19 showing the effects of lockdown and lifting

• A red zone (composed of the municipalities of Bertonico, Casalpusterlengo, Castelgerundo, Castiglione D'Adda, Codogno, Fombio, Maleo, San Fiorano, Somaglia and Terranova dei Passerini in Lombardy, and the municipality of Vo' in Veneto), where the whole population is in quarantine.
• A yellow zone (composed of the regions of Lombardy, Veneto and Emilia-Romagna), where social and sports events are suspended and schools, theatres, clubs, and cinemas are closed.
• The rest of the national territory, where safety and prevention measures are advertised in public places and special sanitisations are performed on means of public transport.

On 4 March, the Italian government imposed the shutdown of all schools and universities nationwide for two weeks as the country reached 100 deaths from the outbreak.[127][128] The same day, the government ruled that all sporting events in Italy would be played behind closed doors until 3 April.[129]

On 5 March, when the newly appointed Emilia-Romagna regional minister of health, Raffale Donini, tested positive for COVID-19, Governor Stefano Bonaccini appointed Sergio Venturi as commissioner for the emergency. Venturi was the regional minister of health until February 2020.[130]

Montage of notices on shops in Bologna declaring their temporary closure, or requiring people to stay at least one metre apart

In the night between 7 and 8 March, the government approved a decree to lock down Lombardy and 14 other provinces in Veneto, Emilia-Romagna, Piedmont and Marche, involving more than 16  million people.[131] The decree "absolutely avoided any movement into and out of the areas" and, like the previous one, it provided sanctions of up to three months in prison for those who violated the lockdown.[132] It was possible to move into and out of the areas only for emergencies or "proven working needs", which must be authorised by the prefect.[133] The decree also established the closure of all gyms, swimming pools, spas and wellness centres. Shopping centres had to be closed on weekends, while other commercial activities could remain open if a distance of one metre between customers could be guaranteed.[134] The decree imposed the closure of museums, cultural centres and ski resorts in the lockdown areas and the closure of cinemas, theatres, pubs, dance schools, game rooms, betting rooms and bingo halls, discos and similar places in the entire country.[134] Civil and religious ceremonies, including funeral ceremonies, were suspended. All organised events were also suspended, as well as events in public or private places, including those of a cultural, recreational, sporting and religious nature, even if held in closed places.[135] This measure was described as the largest lockdown in the history of Europe,[136][137] as well as the most aggressive response taken in any region beyond China, and paralysed the wealthiest parts of the country as Italy attempted to constrain the rapid spread of the disease.[138][139]

Riots broke out in many penitentiaries throughout Italy after restrictions on conjugal visits were imposed by the government in the 8 March decree.[140] Nine prisoners died in Modena and three in Rieti,[141][142] while 76 detainees escaped from Foggia's penitentiary.[143][144][145] Two prison agents were assaulted and kidnapped in Pavia.[146] On 9 March in Bologna, detainees took control of the Dozza penitentiary, forcing personnel to exit the building.[147] On 11 March, two prisoners were found dead in Bologna's penitentiary.[148] In total, fourteen prisoners died in the whole country.[149]

On 9 March, the government announced that all sporting events in Italy would be cancelled until at least 3 April, but the ban does not include Italian clubs or national teams participating in international competitions.[150] In the evening, Conte announced in a press conference that all measures previously applied only in the so-called "red zones" had been extended to the whole country, putting approximately 60 million people in lockdown. Conte later proceeded to officially sign the new executive decree.[151][152]

Queue in front of a supermarket after the introduction of social distancing rules

On 11 March, the government allocated 25 billion euros for the emergency.[153] In the evening, Conte announced a tightening of the lockdown, with all commercial and retail businesses except those providing essential services, like grocery shops and pharmacies, closed down.[15][14][154] He also appointed Domenico Arcuri as Delegated Commissioner for the Emergency. Arcuri will cooperate with Commissioner Angelo Borrelli with the aim of strengthening the distribution of intensive care equipment.[155]

On 19 March, the Army was deployed to the city of Bergamo, the worst hit Italian city by the coronavirus, as the local authorities can no longer process the number of dead residents. The city's mayor Giorgio Gori said the true number of dead could be much higher than reported.[156] Army trucks transported bodies to crematoriums in several other cities, as cemeteries in the city were full.[157] On the following day, the Army was called in to assist the police forces in enforcing the lockdown.[158]

On 20 March, the Ministry of Health ordered tighter regulations on free movement. The new measures banned open-air sports and running, except individually and in close proximity of one's residence. Parks, playgrounds, and public green were closed down. Furthermore, movement across the country was further restricted, by banning "any movement towards a residence different from the main one", including holiday homes, during weekends and holidays.[159]

On 21 March, Conte announced further restrictions within the nationwide lockdown, by halting all non-essential production, industries and businesses in Italy, following the rise in the number of new cases and deaths in the previous days.[160] This measure had also been strongly asked for by multiple institutions, including trade unions, mayors, and regional presidents, as well as medical professionals, but was initially opposed by the industrialists.[161][162][163][164][165][166]

On 24 March, in a live-streamed press conference, Conte announced a new decree approved by the Council of Ministers. The decree imposed higher fines for the violation of the restrictive measures, and regulation of the relationship between government and Parliament during the emergency. It included also the possibility of reducing or suspending public and private transport, and gave the regional governments power to impose additional restrictive regulations in their Regions for a maximum of seven days before being confirmed by national decree.[167][168]

On 1 April, the government extended the period of lockdown until 13 April, with health minister Speranza saying that the restrictive measures had begun to yield the first positive results.[169]

People in Pavia wearing protective masks

On 6 April, the government announced a new economic stimulus plan, consisting of €200 billion of state-guaranteed loans to companies and additional €200 billion of guarantees to support exports.[170]

On 7 April, after more than a month of suspension, the Italian Basketball Federation officially ended the 2019–20 LBA season, without assigning the title.[171]

On 8 April, a government's decree closed all Italian ports until 31 July, stating that they do not ensure the necessary requirements for the classification and definition of "safe place", established by the Hamburg Rules on maritime search and rescue."[172]

On 10 April, Conte announced the prolongation of the lockdown until 3 May, as well as the reopening of some businesses like bookshops and forestry.[173]

On 26 April, the Prime Minister announced a starter plan for the so-called "phase 2", that would start from 4 May. Movements across regions would still be forbidden, while the ones between municipalities would be allowed only for work and health reasons, as well as for visits to relatives. The plan allowed the re-opening of manufacturing industries and construction sites, however schools, bars, restaurants and hairdressers would stay closed.[174][175]

On 13 May, Education Minister Lucia Azzolina announced schools would remain closed until September.[176]

On 16 May, Conte announced the government plan for the easing of restrictions. Starting from 18 May most businesses could reopen, and free movement was granted to all citizens within their Region; movement across Regions was still banned for non-essential motives. Furthermore, on 25 May swimming pools and gyms could also reopen, and on 15 June theatres and cinemas.[177]

On 3 June, free movement within the whole national territory was restored, de facto ending the lockdown started in March.[178]

Penalties for breaching isolation were increased with fines from €500 to €5,000 and imprisonment of up to 18 months.[179]

Starting from July 2020, many countries in Europe, including Italy, witnessed a new rise in detected coronavirus cases.[180][181] On 7 October, the Parliament postponed the end of the state of emergency to 31 January 2021, and Prime Minister Conte imposed the use of protection mask outdoors.[182] On 13 October 2020, the Italian government reintroduced stricter rules to limit the spread of COVID-19.[183] Demonstrations and gatherings of people were strictly forbidden.[184] Regions and municipalities were given the power to only tighten, but not release, containment measures.[185]

Italian regions and the central government began reinforcing hospitals to accommodate more sick and infected with COVID-19. All hospital facilities were upgraded and expanded with a larger capacity for beds and intensive units than in March 2020. The Italian government also purchased about 19 million doses of flu vaccine, to be distributed to the population. Tracking applications, monitoring systems with the help of surveillance drones and predictive systems are used to understand the progress of the epidemic. If containment fails, the possible cases of infections will rise to about one million people and about 80,000 will died before the end of the pandemic, but the release of the COVID-19 vaccine is imminent and can change this dramatic projection.

On 25 October, Conte introduced new restrictions, imposing the closing of gyms, swimming pools, theatres and cinemas, as well as the closing of bars and restaurants by 6pm.[186]

Predictive systems have proven reliable and confirmed the increase in cases and deaths since October 2020. The start of the vaccination campaign on 27 December 2020 did not limit the spread of the virus in the population that is still vulnerable, but safeguarded doctors and health professionals and partly the elderly and immuno-depressed patients. However, the appearance of numerous variants of the more lethal virus such as the English one,[187][188] and those still to be assessed as dangerous such as the South African and Brazilian or Amazonian ones together with a slowdown in the vaccination campaign due to a poor supply of vaccines will lead to a worsening of the prospects for containing the virus. and an increase of another 40,000 deaths by spring 2021.

On 15 March, President of Campania Vincenzo De Luca imposed a strict quarantine on Ariano Irpino, in the province of Avellino, and four other municipalities in the province of Salerno, Atena Lucana, Caggiano, Polla, and Sala Consilina.[189]

On 16 March, President of Emilia-Romagna Stefano Bonaccini imposed a strengthened quarantine on the municipality of Medicina, near Bologna, since it had developed an intense outbreak. People were not allowed to enter or exit the town for any reason.[190]

In early April, Lombardy and Tuscany made it compulsory for all residents to wear a face mask when leaving their home.[191]

Due to the spike in COVID-19 cases in August, Italy's health minister, Roberto Speranza announced the closure of nightclubs in some parts of the country and made masks mandatory between 6 pm and 6 am, in crowded areas and at social gatherings. The restrictions came into effect from 17 August 2020.[192]

On 15 October 2020, the president of Campania De Luca, closed all schools and universities until 30 October 2020.[193] On 23 October, De Luca announced a regional lockdown, imposing restrictions to all not essential movements as well as a curfew.[194] In the night, riots and clashes happened in the streets of Naples to protest against the lockdown.[195]

The strategy of mass-testing asymptomatic carriers was proven to be successful in stopping the spread of the virus in one Italian town.[196][197][198] This strategy in Italy was supported by the region of Veneto.[199]

The vaccination campaign began on 27 December 2020, when Italy received 9,750 doses of the Pfizer–BioNTech vaccine. These doses were entirely used in the following days to vaccinate part of the medical and health personnel of hospitals. As a member of the EU, Italy would receive vaccine doses together with the other EU countries in a coordinated task managed by the European Commission.[200][201]

The first Italian region to start with vaccinations was Lazio, in the Spallanzani Hospital in Rome. On 6 January 2021, the European Medicines Agency (EMA) gave the green light to the Moderna vaccine.[202]

As of 14 January 2020, a total of 972,099 vaccines were administered in Italy.[200]

Restrictions to travel from Italy, as of 31 March 2020

  Italy

  Entrance refused to people from Italy

  Enforced quarantine for people arriving from Italy

On 23 February 2020, Austria suspended all trains to and from Italy for a few hours because of suspected cases.[89][210] Romania instituted a quarantine for people arriving from Lombardy and Veneto.[211]

On 24 February, an Alitalia flight from Rome arriving at Mauritius was blocked by the local authorities, who imposed quarantine or repatriation.[212] Of the 212 passengers, 172 were allowed to disembark while 40 passengers returned to Italy.[213] An intercity bus operated by Flixbus from Milan to Lyon was quarantined at Gare de Lyon-Perrache station for health screening.[214]

Brazil added Italy to its COVID-19 alert list for passenger medical checkups.[215] Argentina, France, Croatia, Egypt, Greece, Ireland, Israel, Latvia, Lithuania, Ukraine, Serbia and South Africa issued multiple recommendations that included postponement of school trips to Italy, a 14-day quarantine for people arriving from Lombardy and Veneto and a warning for all citizens to not to travel to regions of Italy affected by the outbreak.[216][217][218][219][220][221] A joint WHO and ECDC mission arrived in Italy to support COVID-19 control and prevention efforts.[222] Following the discovery of a case involving an Italian citizen, the H10 Costa Adeje Palace in Tenerife was put on lockdown.[223]

The European Parliament's Director General for Personnel, Kristian Knudsen, requested that staff who had travelled to areas affected by the COVID-19 outbreak, including parts of Italy, China, Singapore, and South Korea, to self-quarantine and work from home for 14 days.[224][225]

On 25 February, the United Kingdom and Malta recommended that travellers coming from Italy self-quarantine for 14 days and for all citizens not to travel to regions of Italy affected by the outbreak.[89][226][227] Malta installed thermal-scanning devices to monitor passengers arriving via Malta International Airport, as well as passengers disembarking from vessels at the Grand Harbour and the Virtu Ferries catamaran terminal in Marsa, which had direct connections to Pozzalo and Catania in Sicily.[228] Prague International Airport introduced special arrival gates for selective screening of passengers arriving on flights from Italy.[229][230] Kuwait, Iraq, Jordan and Seychelles suspended all flights to and from Italy.[231][232][233] Bulgaria suspended all flights to and from Milan until 27 March. Australia, Saudi Arabia, Netherlands and the United States issued a travel advisory for all citizens not to travel to parts of Italy affected by the outbreak.[231][234]

Two Flixbus buses via Italy were stopped at the Croatian border for a few hours as the passengers underwent health checks.[89]

Goldman Sachs, Deloitte, Citigroup Inc, Credit Suisse, Lazard, Credit Agricole, Nomura, Banque Populaire and BNP Paribas requested that staff who had recently returned from Italy to work from home for at least 14 days and deferred non-essential travel to Italy.[98][235]

On 26 February, the European Parliament postponed internships until 1 October for 35 trainees who declared residence addresses in affected regions of Italy.[236] Six American universities — Elon University, Fairfield University, Florida International University, New York University, Stanford University and Syracuse University — postponed or cancelled their study-abroad programmes in Italy, mainly in Florence.[237][238]

Russia, Spain and Turkey issued a recommendation for all citizens not to travel to affected regions of Italy.[239][240] El Salvador barred the entry of travellers arriving from Italy.[241]

The chief executive of the Irish Rugby Football Union, Philip Browne, cancelled Six Nations Championship rugby matches between Ireland and Italy from 6 to 8 March in Dublin.[242]

On 27 February, Israel barred entry to foreign nationals travelling from Italy. Officials at Ramon Airport refused to let 25 foreign nationals arriving on a Ryanair flight from Bergamo to disembark. Israelis were allowed to enter and had to quarantine at home for 14 days.[243][244][245] After being denied permission to dock in Ocho Rios, Jamaica and George Town, Cayman Islands on 26 February, the MSC Meraviglia, operated by MSC Cruises, was finally able to dock in Cozumel, Mexico. The cruise liner was carrying 4,500 passengers and 1,600 crew members, one of whom was reportedly showing flu-like symptoms.[246][247][248][249] Another Italian cruise liner, the Costa Favolosa, which was denied permission to dock at Tortola, British Virgin Islands on 26 February, was finally able to berth in Sint Maarten.[250][251] The final two stages of the UAE Tour were cancelled after two Italian staff members of one of the teams tested positive for SARS-CoV-2. Following this discovery, the W Abu Dhabi and the Crowne Plaza Abu Dhabi, both on Yas Island, were put on lockdown.[252]

On 28 February, Germany enacted new health security measures for international arrivals including Italy.[253]

On 29 February, the United States Centers for Disease Control and Prevention upgraded the status of Italy to Level 3 (guidance to avoid non-essential travel because of widespread community transmission).[254] Multiple companies such as Amazon, Google, TD Bank Group, Bank of Nova Scotia, London Stock Exchange Group and Cargill, Inc. deferred all non-essential travel to countries affected by major virus outbreak, including Italy.[255] The University of Notre Dame ended its Rome Global Gateway programme and evacuated 106 students from Rome.[256]

On 3 March, India suspended all visas to nationals of Italy, as well as visa to foreign nationals who have travelled to Italy on or after 1 February 2020. Passengers arriving directly or indirectly from Italy must undergo medical screening at the port of entry.[257]

On 4 March, Thailand declared that people travelling from Italy must be quarantined for 14 days after arriving, with no exceptions.[258]

On 8 March, Romania declared that people travelling from Italy must be quarantined for 14 days after arriving on a connecting flight or by road, with no exceptions, and suspended flights from Italy from 9 to 23 March.[259]

On 10 March, Slovenia barred entry to foreign nationals travelling from Italy.[260] On same day also Austria barred entry to foreign nationals travelling from Italy with exception for people with medical documents and people who travel only through Austria to Germany without stop in Austria.[261]

On 18 March, Nigeria placed an indefinite suspension on all flights coming from Italy with immediate effect.[262]

Samaritan's Purse aeroplane with medical aids at the Verona Villafranca Airport

The Italian government asked for medical equipment from the European Union mechanism of civil protection, and on 11 March complained about the slow response of the other European countries.[263] The Italian Permanent Representative to the European Union, Maurizio Massari, wrote: "unfortunately, not a single EU country responded to the Commission's call."[264][265] Eventually, Germany, France and Austria donated millions of protective masks to Italy, however aid arrived from non-EU countries like China, Russia and Cuba before it arrived from any other EU country.[266][267][268]

The lack of masks became an issue during the peak of the emergency, partly because of the requisitions of imported goods bought by Italy in transport hubs in other countries such as Poland[269] and Turkey.[270][271] Masks were confiscated by mistake in Czechia. It was happen during a raid against Chinese reseller Zhou Lingjian.[272]

Since early March, the German government restricted the export of products essential to its national health service. Italian distributors were advised they could not be supplied with surgical gowns, protective masks, glasses, particulate respirators, nor visors.[273][274] France also imposed similar export restrictions and the German health minister Jens Spahn defended Germany's decision.[275] On 12 March, the German ministry issued a decree suspending the export restriction in particular emergency cases, and promised to send one million protective masks to Italy.[276]

On 13 March, a team of nine Chinese experts, among whom there was the manager of the 40,000 Chinese doctors who had been sent to Wuhan and a leading cardio-pulmonary reanimation doctor, arrived in Rome to share their expertise. The Chinese Red Cross brought 31 tons of respiratory devices, electrocardiographs, 40 ventilators, tens of thousands of masks, and other medical equipment supplied by the hospital of the School of Medicine of Shanghai Jiaotong University.[277][278][279] While the head of the Italian Red Cross, Francesco Rocca said these medical supplies were donated by the Chinese Red Cross, other sources claimed that these were paid products and services.[280][281] Chinese billionaire and Alibaba co-founder Jack Ma also donated 500,000 masks and other medical supplies, which landed at Liege Airport in Belgium on 13 March and were then sent to Italy.[279][282]

On 17 March, Undersecretary at the Ministry of Health, Sandra Zampa announced the purchase of many new ventilators as well as the importing of one and a half million masks from South Africa.[283]

The Agnelli family donated €10 million to the Government's coronavirus funds. The family's companies Fiat and Ferrari also brought 150 ventilators and offered to help make new ventilator units, in addition to providing a fleet of vehicles to be used to distribute food and medical supplies to the elderly.[284][285]

On 21 March, the Cuban government sent 52 medical staff (35 doctors and 17 nurses) specialised in infectious diseases who had dealt with the Ebola outbreak. They arrived in Milan on 22 March and entered service in Cremona on 24 March.[286][287]

Albanian physicians arrived in Fiumicino Airport, April 2020

On 21 March, US Secretary of State Mike Pompeo said that the United States Air Force "sent a C-130 filled with medical supplies to Italy".[267] On 30 March, US President Donald Trump said that the US was to send $100 million worth of medical and hospital supplies to Italy.[288]

After a phone call with Conte, Russian president Vladimir Putin arranged the Russian army to send medical help to Italy.[289] On 22 March 2020, Russia sent nine military transport planes with eight mobile brigades of military medics, a team of about one hundred military virologists and epidemiologists, special disinfection vehicles, and other medical equipment and pharmaceuticals to Italy. The fuselage of the plane also carried a message for the nation, which read: "From Russia with Love".[290] President of Lombardy Attilio Fontana and Italian Foreign Minister Luigi Di Maio expressed their gratitude for the aid.[291]

The US-based evangelical group Samaritan's Purse opened a coronavirus field hospital in the parking lot of Cremona hospital.[292]

On 24 March, Germany took in six coronavirus patients from the Bergamo hospital to be treated in Saxony.[293] Later the same week, the German health minister said that Germany would take in a total of at least 47 Italian patients.[294] On 25 March, a C-130 from Ramstein Air Base in Germany delivered humanitarian supplies to Aviano Air Base.[295]

Somalia sent twenty volunteer doctors to Italy to help fight COVID-19.[296] Albania also sent a group of thirty medical staff members to Lombardy.[297] Serbia sent four planes carrying medical equipment to Italy.[298]

On 2 December, a team of 20 doctors and nurses of from the Sheba Medical Center in Israel flew to Italy to help a Piedmont District hospital cope with a surge in COVID-19 patients.[299][300]

The pandemic outbreak heightened the pressure on the Italian healthcare system.[301]

On 9 March, Alessia Bonari, a nurse from Grosseto who worked at a hospital in Milan, posted on Instagram stating that she was physically strained from being overworked and was scared to work after treating over 10,000 patients who have tested positive. Bonari and her co-workers had been extremely exhausted due to the pressures of work, and according to her, health caretakers had been working in uncomfortable conditions. The post, which reached global notoriety, contained a photo of her bruised face from wearing unfit masks and hazmat goggles, and stated that "the protective devices are bad." She concluded her post persuading others "to be selfless, to stay at home and thus protect those who are most fragile."[302][303][304]

An intensive care nurse, showing her bruised face during the peak of the pandemic, in Pesaro

On 17 March, undersecretary at the Ministry of Health Sandra Zampa announced the purchase of many new ventilators as well as the importing of one and a half million masks from South Africa.[283]

In order to deal with the numbers of COVID-19 patients, intensive care units were expanded, and new hospitals were created, especially in Lombardy.[305][306][307] In Emilia-Romagna, professor Marco Ranieri developed a method to double the efficiency of ventilators in ICUs.[308] The lack of a single protocol for hospitals was considered to be a problem.[309]

Due to hospitals overcrowding with coronavirus patients, thousands of cancer patients experienced difficulties in getting access to treatment and transplants, with their lives put at even higher risk. Dozens of cancer hospital sections were indeed either dedicated to host coronavirus wards, or closed after personnel got infected.[310] According to a study, cancer patients represented 17% of coronavirus fatalities in Italy.[311]

In March 2020, oncologist Luigi Cavanna of the hospital of Piacenza was one of the first physicians in Italy to focus on house calls, realizing that too many critically-ill COVID-19 patients were arriving at his hospitals and that some of them could have been treated earlier at home before a possible escalation of the symptoms.[312][313][314]

A letter published on the NEJM Catalyst Innovations in Care Delivery claimed that one of the reasons for the high death count in the area of Bergamo was hospital contamination.[315] Progressively, different hospitals became dedicated to COVID-19 patients only, and more rigid separations were set up between hospital sections and triage structures.[316][317][318][319] In some regions, hotels were used to host healthcare workers or patients,[320][321] and in Liguria a ship was adapted to host people in quarantine.[322] On 1 April, the first Italian drive-through testing facilities opened in Alessandria[323] and in north-western Tuscany.[324]

At least ten different clinical trials were ongoing in Italian hospitals at the beginning of April.[325] The supercomputer of ENEA in Portici was used to run advanced simulations related to other possible drugs.[326] Some of the treatments employed for COVID-19 patients involved the administration of antiviral drugs. Remdesivir was tested with promising initial results in Naples.[327] Despite doubts from the scientific community, Avigan (favipiravir) was also included in testing protocols by Italian Medicines Agency (AIFA) even though it was not authorised in Europe.[325][328][329] Similarly to France, hydroxychloroquine (the less toxic version of the malaria drug chloroquine) was also tested:[325][330] in Lazio, its use was reported by the second week of April on a significant fraction of the roughly a thousand COVID-19 patients confined at home.[331] Later prohibited by AIFA, the use of hydroxychloroquine was approved again in December by the Council of State upon request of some general practitioners.[332]

Plasma treatment already tried in China (transfer of antibodies from recovered COVID-19 patients to sick people) was tested at the hospital of Pavia (and later in Mantua) under the supervision of professor Cesare Perotti;[333] the first two donors involved in the research programme were a married couple, both doctors and among the first COVID-19 patients reported in the province.[334][335] The final results published in May showed a reduction in mortality.[336] In the beginning of April, based on the results of autopsies showing the presence of micro-thrombosis in the lungs of COVID-19 patients, doctors in Tuscany and other areas of northern Italy started to use heparin to reduce the risk of blood clotting;[337][338][339] the news was originally circulating on social media from internal chats of healthcare workers and considered a hoax by virologist Roberto Burioni,[340][341] but protocols including low-molecular-weight heparin were formally submitted as a treatment proposal to AIFA.[337] A programme involving 14 research centres was approved on 13 April.[342][343]

Nurses of the coronavirus task force to support health structures in Northern Italy

The workforce of the healthcare system underwent massive reorganisation. Pediatricians were assigned to adult patients and as a result, their insurance coverage had to be adapted.[344] Retired professionals were asked to go back to work to fill the vacancies, despite the high risk for their age group.[345][346][347] At the peak of the pandemics volunteers from the rest of the country were sent to hospitals in critical areas of northern and central Italy.[348][349]

Healthcare workers were also affected by coronavirus infections, with a higher percentage of the infected healthcare workers being women because of their predominance among nurses.[350] This resulted in death in a considerable number of cases, especially amongst general practitioners.[350][351][352] By the end of March, more than 60 doctors in Italy had died with COVID-19,[353] and the figure increased to 80 by 4 April[354] and later 145 by 22 April.[355] Healthcare personnel were also subject to high levels of stress,[356] and the risk of professional burn-out was considered high, particularly across nurses and in more affected areas.[357] Two suicides, one of a nurse in Jesolo and one of a nurse in Monza, were assumed to be related to psychological pressure.[358][359]

The emergency was an occasion to test or develop new protocols based on digital technologies. With the aim of reducing consumption of protective equipment, robots were introduced in hospitals in Varese,[360] and remote diagnostics were introduced to monitor home care patients in Lodi.[361] To facilitate home calls from patients, Istituto Italiano di Tecnologia in Genoa (IIT) and Istituto di robotica e macchine intelligenti (I-RIM) designed a robot for video calls that could be assembled by hospital personnel[362][363] and that was tested at the end of April in Pisa, Massa-Carrara and Induno Olona.[364] The Policlinico Universitario in Rome tested AI software for fast analysis of chest X-rays.[365]

Sets of personal protective equipment in a Civil Protection hub, ready to be distributed to the regions

The pandemic provoked large economic damage to the Italian economy. The sectors of tourism, accommodation and food services were among the hardest hit by foreign countries' limitations to travel to Italy, and by the nationwide lockdown imposed by the government on 8 March.[366] By April, finance minister Roberto Gualtieri predicted a 6% GDP decline for 2020.[367]

On 12 March, the Italian stock market was among the worst hit during Black Thursday, when the FTSE MIB index lost 17% of its value in one day.[368]

Multiple factories, like Fiat Chrysler, halted production in some of their plants.[369] On 21 March, the government issued the shutdown of all non-essential businesses, industries, and economic activities.[370]

The Economist predicts a 7% GDP decline for Italy in 2020.[371] Economist Alberto Bisin forecast that Italy's debt-to-GDP ratio would rise from 130% to 180% by the end of the year, due to borrowing and losses.[372] Multiple economists believe that Italy will struggle to pay back its debt.[372][367]

Although the virus has hit northern Italy hardest, economically deprived areas of southern Italy are suffering the most from the lockdown. Many residents of those areas work in the grey economy and are therefore not eligible for unemployment benefits.[373] In some places the Italian mafia was reported to be delivering groceries to needy residents. Prosecutors warned that the mafia was not acting out of altruism and was instead seeking control over residents.[374][371]

Some Italian small and medium-sized enterprises partially or totally converted their production to supply personal protective equipment at a local scale. Many of these items could not be approved for hospital use, but they were considered useful to supply demand for the general population.[375]

The protective masks donated by Grafica Veneta to the Region of Veneto

In Veneto, Grafica Veneta – the printing company of the Harry Potter books in Italian – started to mass-produce protective masks.[376][377][378] In Piedmont, Ci.Ti.Elle, a company from Castiglione Torinese specialising in textiles for hotels, put its twelve employers to assembling surgical masks for the regional Protezione Civile, and the hospitals of San Maurizio Canavese, Alessandria and Chivasso, with the support the Filmar company from Caselle for the elastics.[379] In Lombardy Cifra, a manufacturer from Verano Brianza specialising in sportswear, also converted its production line.[380] In the textile district of the province of Prato, the Machattie company started production of polypropylene masks in March, and the Dreoni company in Vaiano switched its production from car upholstery to protective masks with certified standard, with the help of the local population (its owner later died of COVID-19).[375][381]

Companies producing alcoholic beverages also underwent reconversion to produce alcohol-based hand sanitiser. In Piedmont this occurred in Canelli at the Ramazzotti factory (part of the Pernod Ricard group)[382] and in Chieri at the Martini plant.[383]

Isinnova, a local engineering startup from Brescia, provided emergency solutions to local hospitals to compensate the shortages of spare parts for the machines. Firstly, they produced venturi valves for respirators using 3D printers,[384][385] and later (in collaboration with Decathlon) they adapted a snorkelling mask into a non-invasive ventilator.[386] Using 3D-printer technology as well, Elmec Informatica started to produce for the hospital of Busto Arsizio, sterilisable protective masks in thermoplastic polyurethanes that could adapt to Continuous positive airway pressure (CPAP) antiviral filters.[387] The Italian National Mint and Printing House used the plastic film applied to identity cards to produce face shields.[388]

On 25 March, Italy, together with Belgium, France, Greece, Ireland, Luxembourg, Portugal, Slovenia, and Spain, sent a joint letter to the Council of the EU, calling for the issuing of a new common debt instrument, nicknamed in the media as "eurobond" or "corona bond", to help funding the measures taken against the coronavirus pandemic and the expected economic downturn to follow.[389] In subsequent conference calls between the leaders of the EU member states, the proposal saw the opposition of the Netherlands and Germany.[390][391]

On 9 April, after two meetings of the Eurogroup, the ministers of Finances of the Eurozone countries agreed to €500 billion aid, including the possibility of using the ESM, but without common debt instruments.[392][393]

An Italian flag with the slogan "Andrà tutto bene" ("Everything will be all right")

Subsequent to the imposing of the national lockdown, there were protests in some Italian prisons, with fourteen deaths among Modena, Bologna and Foggia's penitentiary.[394]

With all of Italy ordered to remain indoors, Italians took to their balconies to sing together, play music, and applaud the country's health care providers.[395] Some of the demonstrations were spontaneous, others were organised by social media and radio.[396] On 13 March at 6 pm, Italians throughout the country joined to sing the national anthem. At noon on 14 March, they stood on their balconies clapping to salute the nation's health care workers.[397] A video of opera singer Maurizio Marchini performing the aria "Nessun dorma" from his balcony in Florence went viral.[398]

Some Italians have adapted the local custom of paying in advance at a cafe for a customer who can't afford it ("suspended coffee") by paying extra at grocery stores. Shops may double the amount and donate non-perishable foods to local aid groups like the Community of Sant'Egidio.[399]

Riots erupted on 23 October 2020 at night in Naples as people took to the street following the imposition of a curfew to reduce the spread of coronavirus. This came after Vincenzo De Luca, President of the Campania region, said that he was considering imposing a total lockdown, closing schools, businesses and leaving only essential services open, to prevent further spread of the virus. They were the first such demonstrations in Italy since the start of its coronavirus outbreak eight months ago.[400]

After the first outbreak in Lombardy and Veneto, the regional governments of Emilia-Romagna, Friuli Venezia Giulia, Liguria, Lombardy, Piedmont, Trentino, and Veneto closed all schools and universities from 23 February to 1 March.[401][402] The suspension was later extended, with the agreement of the national government, up to 8 March in Emilia-Romagna, Lombardy, and Veneto.[403]

On 4 March, the government announced the closure of all schools and colleges until 15 March.[404]

With the enactment of the lockdown of Lombardy and 14 more northern provinces on 8 March, the re-opening of schools in these areas was delayed to 3 April.[405] On 9 March, the government extended the lockdown to the national territory, closing all schools and universities until 3 April.[406]

Schools eventually stayed closed until the end of the academic year. Their safe reopening was organized by the Ministry of Education together with the Ministry of Health, and was scheduled on 14 September 2020. However some regional governments opted for delaying the reopening.[407]

In Italy, in-person gatherings for religious worship have been suspended and as a result, many churches broadcast Mass via online live-stream, radio and television.[408]

Church funerals cannot be held given the national lockdown.[409] In some northern cities, authorities have had issues in dealing with the storage of the high number of coffins, and churches have offered to care for them.[409] In the towns of Seriate and Bergamo, the Italian Army has volunteered to transport some of these coffins from churches and morgues to cemeteries and crematoriums in other provinces.[409][410]

President Sergio Mattarella at the Altar of the Fatherland during the Liberation Day, wearing a face mask

On 5 March, the Italian government decided to postpone the constitutional referendum that was due on 29 March. The referendum has been delayed until further notice.[411]

According to a few surveys, many Italians feel betrayed by the European Union's response to the crisis. This has led to an increase in euroscepticism, with the number of Italians agreeing that EU membership is a disadvantage jumping from 47% in November 2018 to 67% in March 2020, according to a Tecnè survey. Former president of the European Commission Donald Tusk said that the risk for the European Union is greater than the European debt crisis of 2009, and that despite the fact that EU aid to Italy is greater than from other countries, its perception is crucial.[367]

Top Italian figures have condemned an article in a German newspaper suggesting the mafia was waiting for an influx of European Union cash amid the coronavirus outbreak. Foreign Minister Luigi Di Maio said, “Die Welt, an important German newspaper, urged Europe this morning to not help Italy because ‘the mafia is waiting for money from Brussels’”.[412]

On 13 October 2020, it was announced that Juventus forward Cristiano Ronaldo has tested positive for COVID-19.[413] Many Serie A football players have tested positive for the COVID-19 and some matches played in stadiums without a public have been postponed.[414][415][416]

Even at the Giro d'italia 2020 some cyclists were found to be positive at COVID-19 and some withdrew from the race.[417]

On 15 October 2020, motorcycle racer Valentino Rossi confirmed that he was positive for COVID-19.[418] On the same day, swimmer Federica Pellegrini confirmed that she was positive at COVID-19.[419]

During the lockdown, wildlife was detected in many urban areas of Italy: roe deer were seen in urban centers in Piedmont,[420][421] eagles in Milan,[422] and bears in Trentino.[423]

Less frogs and toads were killed on the roads due to the lower car traffic; birds such as the common swift and the Kentish plover had more favorable conditions to reproduce, and some invasive species such as the American cottontail rabbit also propagated more rapidly.[424]

In the province of Mantua, damages to crops by wild animals increased drastically in 2020.[425]

Deaths statistics for Italy include coronavirus victims who died in hospital, as well as those who died outside of hospitals and were tested before or after dying. Post-mortem tests are routinely carried out, and there is no distinction between people who died "with" or "of" coronavirus, including patients with pre-existing conditions,[426] which make up 96% of the total death count.[427] However, in regions where the healthcare system has been overwhelmed by the pandemic (e.g. Lombardy), official death statistics likely missed a portion of deaths outside hospitals.[428][429][430] In some areas of northern Italy, a comparison of the average registered deaths over the previous years with the deaths in the first months of 2020 showed a sizeable excess of deaths that were not officially included in the coronavirus toll.[431][432] In the month of March, 10,900 excess deaths have been estimated, that have not been reported as COVID-19 deaths.[433]

Not all European countries count coronavirus-related deaths with the same criteria. For instance, in some other European countries, a distinction is made between deaths caused by coronavirus and deaths of people infected with coronavirus, thus often excluding deaths of people with pre-existing conditions.[434][435][436] In addition to this, some countries only report deaths in hospitals.[437][426][438]

The graphs show the development of the pandemic starting from 21 February 2020, the day when the Lombardy and Veneto clusters were first detected.

The first cases in Algeria,[239] CAR,[444] Côte d'Ivoire,[445] Morocco,[446] Nigeria,[447] Senegal,[448] the Seychelles,[449] South Africa[450][451] and Tunisia[452] were all linked to Italy.

First or early cases in Argentina,[453] Bolivia,[454] Brazil,[455] Canada,[456] Chile,[457] Colombia,[458] Cuba,[459] the Dominican Republic,[460] Guatemala,[461] Mexico,[462] the United States, [463][464] Uruguay[465] and Venezuela [466] were linked to Italy.

Armenia – Armenia confirmed that three cases were imported from Italy on 12 March.[467]

Azerbaijan – On 11 March a student tested positive after developing fever in Italy.[468]

Bangladesh – On 8 March, Bangladesh confirmed its first cases; two are Bangladeshis who had returned from Italy and another is a family member of one of the two who returned.[469]

India – On 2 March, New Delhi confirmed its first case, an Indian national who had returned from Italy.[470] On the same day, an Italian tourist who had arrived in Jaipur, Rajasthan on 29 February tested positive in a second test after having previously tested negative.[471] On 3 March, his wife also tested positive.[472] On 4 March 14 more Italian tourists who were kept at a quarantine facility in Delhi were confirmed positive, as well as the group's Indian driver.[473] A Paytm employee in Gurgaon who had returned from a vacation in Italy also tested positive.[474] On 8 March, five members of a family in Kerala tested positive, three of whom had returned from Italy.[475]

Israel – On 27 February, Israel confirmed that a man who had returned from Italy on 23 February tested positive.[476][477][478] On 28 February, his wife also tested positive.[479]

Japan – On 13 March, Japan confirmed that a man who had been in Italy since 6 January tested positive for coronavirus upon landing at Haneda Airport in Tokyo that day.[480]

Jordan – On 2 March, Jordan confirmed that a man who had returned from Italy two weeks earlier had tested positive, with other potential cases under observation.[481][482]

Mainland China – On 1 March, Qingtian County, Lishui, Zhejiang confirmed its first imported case, a 31-year-old Chinese woman who had worked at a restaurant in Bergamo.[483] On 2 March, seven more imported cases were confirmed in Qingtian County that are related to the first imported case.[484] Beijing reported one imported case on 3 March, four on 5 March, three on 6 March, one on 7 March and five on March.[485][486][487][488][489] On 4 March, Deqing County, Huzhou, Zhejiang confirmed two new imported cases from Italy.[490] On 10 March, Shanghai confirmed two new imported cases from Italy. They are native in Fujian and work in Italy.[491] Qingdao, Shandong also confirmed the first imported case from Italy.[492] On 11 March, Zhengzhou, Henan confirmed the first imported case, who stay in Italy.[493] On 12 March, Shanghai confirmed one more imported case.[494] On 13 March, Shanghai confirmed four more imported cases.[495] On 14 March, Shanghai confirmed one more imported case,[496] and Beijing also confirmed one more imported case from Italy.[497] On 15 March, Beijing confirmed two more imported cases,[498] and Shanghai also confirmed one more.[499] On 16 March, Shanghai and Guangxi separately confirmed one more imported case from Italy.[500][501] On 20 March, Beijing confirmed one more imported case.[502]

Malaysia – On 28 February, Malaysia confirmed that an Italian who was married to a Malaysian tested positive and was admitted to Sungai Buloh Hospital. He was in Italy from 15 to 21 February for work.[503]

Maldives – The Maldives' first cases were two staffers at Kuredu Island Resort who caught the disease from an Italian tourist who had returned to Italy and tested positive there.[504]

Oman – A case was recorded of a patient who had travelled to Milan.[505]

Saudi Arabia – On 14 March, Saudi Arabia announced 17 new cases, including some citizens who had recently travelled to Italy.[506]

South Korea – On 28 February, South Korea confirmed that a 38-year-old man living in Gwangjin who visited Milan from 19 to 24 February was admitted to Seoul Medical Centre.[507][508]

Sri Lanka – A group of infected Italian tourists passed on the disease to a 52-year-old tour guide.[509]

Thailand – On 5 March, Thailand announced that its 44th and 45th confirmed cases, a 29-year-old Italian and 42-year-old Thai, had arrived in Thailand from Italy on 2 March. Both were admitted in Chonburi Province.[510]

United Arab Emirates – On 28 February, two Italian staff members of the UAE Tour, tested positive.[511]

Vietnam – Case 17 had travelled to Italy (as well as to France and the UK).[512]

Albania – On 9 March 2020, Albania confirmed its first two cases, a father and son, of which, the son had traveled from Florence, Italy.[513] On 10 March, out of 10 new cases 6 new were close contacts of the first 2.[514]

Andorra – On 2 March, Andorra registered its first case, a man who had been to Milan.[515]

Austria – On 25 February, Austria confirmed its first two cases, a man and a woman who had visited their hometown in Bergamo, tested positive and were treated at a hospital in Innsbruck, Tyrol.[516][517][518][519] On 27 February, a couple who tested positive and their two children who were showing symptoms were admitted to Kaiser-Franz-Josef Hospital. The family was previously on holiday in Lombardy.[520][521] On 28 February, one of the children, a 15-year-old boy, tested positive.[522]

Belgium – Nine patients diagnosed with the virus had travelled from Northern Italy.[523] Belgium has confirmed that there are many more and that Italy is the source of most of its cases.

Belarus – A case was confirmed as having been imported from Italy.[524][525]

Bosnia and Herzegovina – A man working in Italy transmitted the virus to his child.[526]

Croatia – On 25 February, Croatia confirmed its first case, a man who had until 21 February stayed in Milan.[527][528] On 26 February, the man's brother tested positive and a Croatian man who worked in Parma, Italy also tested positive and was admitted to a hospital in Rijeka.[528]

Cyprus – One of the country's first two cases had a travel history to Milan.[529]

Czech Republic – On 1 March, Czech Republic confirmed its first three cases.[530] As of 8 March 24, 31 confirmed cases in the country have links to Italy, leading the government to institute a mandatory quarantine for all persons with a history of recent travel to Italy.[531]

Denmark – On 27 February, Denmark confirmed its first case, a man who had returned from a ski holiday in Valmalenco, Sondrio and quarantined at home.[532][533] On 28 February, a man who had returned from a ski holiday in Northern Italy on 15 February tested positive in Copenhagen and was placed in home quarantine.[534] On 29 February, an employee at the Aarhus University Hospital who had been to a conference in Munich, Germany, where he had met an infected person from Italy, tested positive.[535] On 3 March, five people who had returned from Northern Italy tested positive.[536][537]

Estonia – On 3 March, Estonia confirmed its second case, a patient who had arrived on 29 February from Bergamo and was travelling through Riga Airport.[538] Two other Estonian passengers from the same flight and one returnee from Bergamo arriving through Tallinn Airport tested positive on 5 March.[539][540] Two cases in Saaremaa were confirmed on 10 March: the patients had been in contact with the Power Volley Milano team members during the 2019–2020 CEV Challenge Cup matches held in Saaremaa on 4 and 5 March.[541][542] On 9 March 5 Milan players had been diagnosed with fever before a league match.[543] The infected in Saaremaa included the CEO of the Saaremaa VK volleyball club.[544] Saare County quickly became the worst hit part of the country.[545]

Finland – On 26 February, Finland confirmed that a Finnish woman who had visited Milan and was back in Finland on 22 February tested positive at the Helsinki University Central Hospital.[546] On 28 February, a Finnish woman who had travelled to Northern Italy tested positive at the Helsinki and Uusimaa Hospital District and was placed in home isolation.[547]

France – On 25 February, France confirmed that a man from La Balme-de-Sillingy who had returned from a trip to Lombardy on 15 February tested positive and was treated at Centre Hospitalier Annecy-Genevois, Épagny-Metz-Tessy.[231][548][549] His wife also tested positive and was admitted to the same hospital.[550][551] On 26 February 2020, a 36-year-old man who had made multiple trips to Lombardy tested positive and was treated at Nouvel Hôpital Civil, Strasbourg.[552][553][554] On 27 February 2020, a daughter and a friend of the infected couple from La Balme-de-Sillingy were confirmed positive.[555] An Italian man living in Montpellier who had just returned from Italy was admitted to Centre Hospitalier Universitaire.[556] A person who had travelled to Italy was admitted to Hôpital Bichat, Paris.[557] On 28 February 2020, two relatives of the infected couple from La Balme-de-Sillingy tested positive.[558] A 23-year-old fashion student from Nice who had recently returned from Milan tested positive at Nice University Hospital Centre and was admitted to Hôpital l'Archet.[559][560][561]

Germany – On 25 February 2020, Germany confirmed that a 25-year-old man from Göppingen, Baden-Württemberg who recently returned from Milan tested positive and was treated in Klinik am Eichert.[562][563] On 26 February 2020, the man's 24-year-old girlfriend and her 60-year-old father, a chief physician at University Hospital Tübingen, tested positive and were admitted to the same hospital.[564][565] A 32-year-old man from Rottweil, Baden-Württemberg who had visited Codogno with his family on 23 February tested positive and was admitted to a hospital for isolation.[566] On 27 February, Bavaria confirmed that a man from Middle Franconia tested positive after having contact with an Italian man who later tested positive.[567] Baden-Württemberg confirmed that two women and a man from Breisgau-Hochschwarzwald and Freiburg, respectively, tested positive. They had contact with an Italian participant at a business meeting in Munich who tested positive in Italy. A man from Böblingen who had had contact with the girlfriend of the patient from Göppingen also tested positive.[568] On 28 February, a man from Freiburg who had travelled to Bergamo tested positive and underwent isolation.[569] A man from Rhine-Neckar was admitted to the University Hospital Heidelberg.[570] A 32-year-old man in Heilbronn who was in Milan on 21 February fell ill and was admitted to a hospital.[571] As of 27 March 2020 Germany recorded 1443 cases directly linked to Italy[572]

Georgia – On 28 February 2020, Georgia confirmed that a 31-year-old Georgian woman who had travelled to Italy tested positive and was admitted to Infectious Diseases Hospital in Tbilisi.[573]

Greece – On 26 February 2020, Greece confirmed its first case, a 38-year-old woman from Thessaloniki who had recently visited Northern Italy and was admitted to AHEPA University Hospital.[574][575][576] On 27 February, her 9-year-old child tested positive and was admitted to the same hospital.[577] A 40-year-old woman from Athens who had travelled to Italy tested positive.[578][579][580][581] On 28 February, a 36-year-old woman from Athens who had recently travelled to Italy tested positive. Both were admitted to the Attikon University General Hospital.[582]

Hungary – Three of the seven cases in Hungary reported to date are linked to Italy.[583][584]

Iceland – On 28 February 2020, Iceland confirmed its first case, an Icelandic male in his 50s who had previously been to Northern Italy and was placed in strict isolation in Landspítali in Reykjavík.[585][586][587] On 5 March, a total of 34 cases had been confirmed in Iceland, most of which are imported cases from Italy.

Ireland – On 27 February 2020, Ireland's first case was confirmed by the Health Protection Surveillance Centre. The male patient had travelled to an affected region in Northern Italy.[588] A second, unrelated case was confirmed on 3 March, a female in the eastern portion of Ireland who had travelled to Italy.[589]

Latvia – On 2 March, Latvia confirmed its first case, a person who had travelled from Milan to Munich and then to Riga on 29 February.[590]

Lithuania – On 28 February, Lithuania confirmed its first case, a 39-year-old woman who arrived in Kaunas from Verona.[591]

Luxembourg – The nation's second and fourth cases were persons who had travelled to Italy.[592][593]

Malta – A 12-year-old Italian brought the infection to Malta.[594]

Moldova – On 7 March, Moldova confirmed its first case, a 48-year-old woman who had returned from Italy.[595] Moldova confirmed the existence of imported case from diseased Italy on 11 March.[596]

Netherlands – On 27 February, the Netherlands confirmed its first case, a man who had been in Lombardy and was admitted to Elisabeth-TweeSteden Hospital in Tilburg.[597][598] On 28 February, a woman from Amsterdam who had visited Lombardy was in home isolation in Diemen.[599]

North Macedonia – On 26 February, North Macedonia confirmed its first case, a woman who tested positive at the Clinic for Infectious Diseases, Skopje. She had stayed in Italy for a month and had been sick for two weeks. Upon returning to North Macedonia, she immediately reported to the clinic.[600][601]

Norway – On 27 February, Norway confirmed that two people who tested positive were linked to the outbreak in Italy. They were quarantined at home in Oslo.[602] On 28 February, an individual from Bergen and an employee of Oslo University Hospital, Ullevål tested positive and were placed in home isolation. Both had visited Northern Italy.[603][604] On 6 March, the Norwegian Institute of Public Health reported that 79 of the 113 confirmed cases in Norway were linked to the outbreak in northern Italy.[605]

Poland – Of the country's first five cases, two were from Italy, two were from Germany and one was from the UK.[606]

Portugal – On 2 March, a doctor who had travelled to Northern Italy and became ill on 29 February was confirmed positive at Hospital de São João in Porto. On 4 March, a 44-year-old man who had travelled to Italy was confirmed positive at the same hospital.

Romania – On 26 February, Romania confirmed its first case, a man from Gorj who tested positive after having come in contact with a 71-year-old man from Cattolica, Italy. The Italian man visited his wife's family and had several business meetings in Romania from 18 to 22 February. The Romanian man was admitted to National Institute of Infectious Diseases Prof. Dr. Matei Balș in Bucharest.[607][608] On 28 February, a 45-year-old man from Maramureș who had returned from Italy on 25 February was admitted to the Clinic of Infectious Diseases and then transferred to Cluj.[609] A 38-year-old woman who had returned from Bergamo tested positive was admitted to a hospital in Timișoara.[609] On 3 March, a 47-year-old man who had travelled in the same plane with the 38-year-old woman was confirmed positive and admitted to the same hospital.[610] The majority of confirmed cases in Romania are related to Italy.[611]

Russia – On 2 March, a Russian citizen who had returned from Italy was diagnosed.[612]

San Marino – On 27 February, San Marino confirmed its first case, an 88-year-old man with pre-existing medical conditions who was hospitalised at Rimini Hospital.[613][614]

Serbia – On 6 March, Serbia registered its first case, a 43-year-old man who had been to Budapest and Italy. At least one other case had been to Italy.[615]

Slovakia – An asymptomatic man who had travelled to Venice between 14 and 15 February transmitted the virus to his father and his wife.[616]

Slovenia – Many Slovenian cases are linked to Italy, including the nation's first case.[617]

Spain – On 24 February, a 69-year-old medical doctor from Lombardy who had been vacationing in Tenerife since 17 February tested positive at the University Hospital of the Nuestra Señora de Candelaria. A 25-year-old man returning from a holiday in Italy also tested positive in Asturias.[618][619][620][621] On 25 February, the wife of the doctor from Lombardy tested positive and was admitted to the same hospital where her husband was being treated.[622] A 36-year-old Italian woman living in Barcelona who had visited Bergamo and Milan from 12 to 22 February also tested positive.[231][619][623] A man from Villarreal who had recently travelled to Milan tested positive and was admitted to Hospital Universitario de La Plana.[624] A 24-year-old man from Madrid who had recently returned from Northern Italy tested positive and was admitted to Hospital Carlos III.[625][626] On 26 February, two Italian tourists who were vacationing with the Lombardy doctor and his wife also tested positive. The group were transferred to University Hospital of the Nuestra Señora de Candelaria and underwent quarantine.[627] A 22-year-old man from Barcelona who travelled to Milan between 22 and 25 February tested positive and was admitted to Hospital Clínic.[628][629] A woman from La Gomera who travelled to Italy between 4 and 8 February tested positive and was admitted to Hospital General de La Gomera in Tenerife.[630] On 27 February, a 44-year-old man from Valencia who worked as a sportswriter and had travelled to Milan's San Siro Stadium on 19 February to watch a football game tested positive and was admitted to Hospital Clínico Universitario de València. Two other people with whom he had made contact also tested positive and were admitted to the same hospital. Two more people who had visited the same football game in Milan were hospitalised at the same place.[631][632][633][634] A woman who had visited Milan was hospitalised at Hospital de Sagunto, Valencia.[634] An Italian student studying in Valencia who had visited Northern Italy was admitted to Hospital Universitario Doctor Peset.[634] A 22-year-old woman from Tenerife who had travelled to Italy from 19 to 25 February was admitted to Hospital Clínic.[635] An 18-year-old Italian student studying at IE University, Segovia, who had just returned from Milan, was admitted to Hospital General de Segovia.[636][637] On 28 February, a 27-year-old man from Aragon with a history of recent trips to Milan tested positive.[638]

Sweden – On 26 February, Sweden confirmed that a 30-year-old man who previously visited Northern Italy fell ill three days after returning to Sweden and was admitted to Sahlgrenska University Hospital in Gothenburg.[639][640][641] On 27 February, three patients in their 30s were confirmed positive in Västra Götaland. Two of them had been in contact with the Gothenburg patient, while the other had previously visited Italy.[642][643][644] On 28 February, a man in his 50s who had returned from Northern Italy on 24 February tested positive and was admitted to a hospital in Jönköping.[645]

Switzerland – On 25 February, Switzerland confirmed its first case, a 70-year-old man in the canton of Ticino who had previously visited Milan.[619][646] On 27 February, a 28-year-old IT worker from Geneva who had recently returned from Milan tested positive and was admitted to Geneva University Hospital.[647][648] Two Italian children on vacation in Graubünden tested positive and were hospitalised.[649][648][650] A 26-year-old man in Aargau who had visited Verona on a business trip the previous week tested positive and was hospitalised.[648] A 30-year-old woman who visited Milan was admitted to a hospital in Zurich.[648] A young woman who had travelled to Milan tested positive in Basel-City. She worked for a daycare centre in Riehen, and after her test was confirmed, the children at the daycare were put into a two-week quarantine.[651] On 28 February, her partner, a 23-year-old man, also tested positive in Basel-Country.[652] On 29 February, the man's mother tested positive as well. On 28 February, a 45-year-old-man who had travelled to Milan tested positive in Zürich.[652]

Ukraine – On 3 March, Ukraine confirmed its first case in Chernivtsi, a man who had travelled from Italy by plane to the Romanian city of Suceava and then to Ukraine by car with his wife.[653]

United Kingdom – On 27 February, the United Kingdom confirmed that a patient who had visited Milan tested positive and was admitted to Royal Free Hospital in London.[654] Northern Ireland reported its first case, an adult who had travelled from Northern Italy via Dublin and was admitted to Royal Victoria Hospital in Belfast.[655] On 28 February, Wales reported its first case, a patient who had returned from northern Italy was treated at a specialist unit in England.[656]

New Zealand – On 4 March, the New Zealand Ministry of Health confirmed its second case, a woman in her 30s who returned to Auckland from Northern Italy.[657]