Hospitals in Italy’s central and southern regions are bracing themselves as the number of confirmed coronavirus cases grows daily.
The rise, which has been particularly steep in Lazio, Campania and Puglia, is believed to be largely the result of the thousands of people who fled south after Lombardy, where the outbreak in Italy began, was quarantined on 8 March. The entire country was put under lockdown on 9 March and rules were tightened on 11 March.
The number of deaths across Italy rose to 3,405 on Thursday, overtaking China as the country with most fatalities in the pandemic.
“Looking at the situation in central and southern Italy, you see cases increasing, especially over the last few days,” said Giorgio Sestili, a physicist who is collating studies from Italian scientists and sharing them on the Facebook page Coronavirus – Data and Scientific Analysis.
“We think this could be due to the many people from the north who travelled south after the 9 March lockdown, and who might have transferred the virus.”
According to data from Italy’s civil protection authority, there were 823 cases of Covid-19 in Lazio as of Thursday night, compared with 102 on 9 March. In Campania, cases rose from 120 to 652 in 10 days, in Puglia from 50 to 478, in Sicily from 54 to 340, in Calabria from 11 to 169, and in the central Abruzzo region from 30 to 385.
Governors of several southern regions have asked for their borders to be closed off. Soldiers will patrol the streets in Sicily and Naples to ensure citizens comply with the quarantine rules. The Sicilian government has stopped all flights, with the exception of two daily between Rome and the cities of Palermo and Catania, after 30,000 people landed from the north in the space of a week. Some 15,000 also fled to their families in Puglia.
Compared with better equipped hospitals in the richer north, there are fears that those in the south will struggle to cope with an escalation in cases. The health system in the south has been blighted by cost-cutting, and more than 40 hospitals have closed in recent years.
Authorities in Campania have converted two hospitals between Naples and Salerno to treat patients with Covid-19, which will increase the number of intensive care beds in the region to more than the current 600.
“But the problem is that Campania could become a point of reference for other regions in the south that don’t have much capacity,” said Dr Serena Masino, a lecturer in economics and international development at the University of Westminster in London who has spoken to doctors in the south as part of her research.
“Doctors there are very concerned about a lack of equipment. As of Wednesday, we still had doctors in the main Covid-19 hospitals in Naples without face masks. One doctor had been using the same one for three days. The other concern is family doctors. In Calabria they received masks and goggles last week, but in Campania, as of Wednesday, they had nothing.”
Doctors have also called for testing to be increased in the south, especially among medical workers, after aggressive testing in Vo’ Euganeo, a town in Veneto where the first person in Italy died of coronavirus, halted the illness.
Giuseppe Craparo, a doctor in Palermo, said hospitals in the south were bracing themselves for a “massive tsunami” of coronavirus patients. “We live in a state of perpetual anticipation, tension and fear,” he said. “Our goal is to attempt to spread the number of cases over time. In recent days, we’ve only been carrying out emergency operations and were asked not to perform any routine surgical operations in order to leave the intensive care ward as open as possible.”
Pasquale Gallerano, a physician at a hospital in Sciacca, a town in the Sicilian province of Agrigento, said about a dozen cases had so far emerged. “But if we experience an outbreak of the magnitude in the north, we will face enormous pressures,” he said. “We currently have no space in intensive care and are already sending Covid-19 patients to Palermo.”
Cases of the virus rose across Italy to 41,035 on Thursday, including 4,440 people who have recovered.
“The next few days will still be very difficult,” said Sestili. “But the fundamental thing over the next few weeks will be how the regions in the centre-south perform, because if we succeed in keeping it under control there, we can hope for a positive outcome.”