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Feature Covid-19

On the front lines of coronavirus: the Italian response to covid-19

BMJ 2020; 368 doi: (Published 16 March 2020) Cite this as: BMJ 2020;368:m1065

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  1. Marta Paterlini, freelance journalist
  1. Stockholm
  1. martapaterlini{at}

Italy has rapidly become the country hit second hardest in the world by the coronavirus pandemic. Marta Paterlini reports on the front lines of a country in total lockdown

“Patient 1” can breathe on his own after more than two weeks in intensive care for severe pneumonia. The 38 year old marathon runner, admitted to hospital on 21 February 2020, is believed to be the source of local transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the virus responsible for covid-19) in Italy, now the country with the second highest number of deaths from the virus in the world.

The resulting government imposed state of emergency lockdown, which started in northern Italy and has expanded to the whole country, will last until at least 3 April in an attempt to contain a contagion that has, at the time of writing, infected over 24 747 people (including at least 2026 healthcare staff) and killed 1809. The fatality rate of 7.2 is now higher than in China (3.8).1

The outbreak is having catastrophic effects on the Italian economy, which is likely to plunge into a recession, as well as social and psychological effects on the population. Government officials, however, have decided that public health should take priority, as health authorities have raised concerns over a shortage of places in intensive care units.

Massimo Galli, chief physician for infectious diseases at Luigi Sacco Hospital in Milan, told The BMJ, “We had bad luck. I am convinced that the virus circulated undetected for at least four weeks before the awful outbreak we …

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