THE NEW YORK TIMES, SATURDAY, AUGUST 1, 2020 Y A
Tracking an OutbreakGlobal Response
ROME — When the coro-
navirus erupted in the West, Italy
was the nightmarish epicenter, a
place to avoid at all costs and a
shorthand in the United States
and much of Europe for uncon-
trolled contagion.
“You look at what’s going on
with Italy,” President Trump told
reporters on March 17. “We don’t
want to be in a position like that.”
Joseph R. Biden Jr., the presump-
tive Democratic nominee, used It-
aly’s overwhelmed hospitals as
evidence for his opposition to
Medicare for All at a presidential
debate. “It is not working in Italy
right now,” he said.
Fast forward a few months, and
the United States has suffered
tens of thousands more deaths
than any country in the world. Eu-
ropean states that once looked
smugly at Italy are facing new
flare-ups. Some are imposing
fresh restrictions and weighing
whether to lock down again.
Prime Minister Boris Johnson
of Britain on Friday announced a
delay to a planned easing of meas-
ures in England as the infection
rate there rose. Even Germany,
lauded for its efficient response
and rigorous contact tracing, has
warned that lax behavior is
prompting a surge in cases.
And Italy? Its hospitals are ba-
sically empty of Covid-19 patients.
Daily deaths attributed to the vi-
rus in Lombardy, the northern re-
gion that bore the brunt of the pan-
demic, hover around zero. The
number of new daily cases has
plummeted to “one of the lowest in
Europe and the world,” said Gio-
vanni Rezza, director of the infec-
tive illness department at the Na-
tional Institute of Health. “We
have been very prudent.”
And lucky. Today, despite a tiny
uptick in cases this week, Italians
are cautiously optimistic that they
have the virus in check — even as
Italy’s leading health experts
warn that complacency remains
the jet fuel of the pandemic. They
are aware that the picture can
change at any moment.
How Italy has gone from being
a global pariah to a model — how-
ever imperfect — of viral contain-
ment holds fresh lessons for the
rest of the world, including the
United States, where the virus,
never under control, now rages
across the country.
After a stumbling start, Italy
has consolidated, or at least main-
tained, the rewards of a tough na-
tionwide lockdown through a mix
of vigilance and painfully gained
medical expertise.
Its government has been
guided by scientific and technical
committees. Local doctors, hospi-
tals and health officials collect
more than 20 indicators on the vi-
rus daily and send them to re-
gional authorities, who then for-
ward them to the National Insti-
tute of Health.
The result is a weekly X-ray of
the country’s health upon which
policy decisions are based. That is
a long way from the state of panic,
and near collapse, that hit Italy in
March.
This week, Parliament voted to
extend the government’s emer-
gency powers through Oct. 15 af-
ter Prime Minister Giuseppe
Conte argued the nation could not
let its guard down “because the vi-
rus is still circulating.”
Those powers allow the govern-
ment to keep restrictions in place
and respond quickly — including
with lockdowns — to any new
clusters. The government has al-
ready imposed travel restrictions
on more than a dozen countries to
Italy, as the importation of the vi-
rus from countries is now the gov-
ernment’s greatest fear.
“There are a lot of situations in
France, Spain, the Balkans, which
means that the virus is not off at
all,” said Ranieri Guerra, assistant
director general for strategic ini-tiatives at the World Health Orga-
nization and an Italian doctor. “It
can come back at any time.”
There is no doubt that the priva-
tions of the lockdown were eco-
nomically costly. For three
months, businesses and restau-
rants were ordered closed, move-
ment was highly restricted —
even between regions, towns and
streets — and tourism ground to a
halt. Italy is expected to lose about
10 percent of its gross domestic
product this year.
But at a certain point, as the vi-
rus threatened to spread uncon-
trollably, Italian officials decided
to put lives ahead of the economy.
“The health of the Italian people
comes and will always come first,”
Mr. Conte said at the time.Italian officials now hope that
the worst of the cure came in one
large dose — the painful lockdown
— and that the country is now safe
to resume normal life, albeit with
limits. They argue that the only
way to start up the economy is to
keep tamping down the virus,
even now.
The strategy of closing down
completely invited criticism that
the government’s excessive cau-
tion was paralyzing the economy.
But it may prove to be more ad-
vantageous than trying to reopen
the economy while the virus still
rages, as is happening in coun-
tries like the United States, Brazil
and Mexico.
That does not mean that calls
for continued vigilance, as else-where in the world, have been im-
mune to mockery, resistance and
exasperation. In that, Italy is no
different.
Masks often are missing or low-
ered in trains or buses, where they
are mandatory. Young people are
going out and doing the things
young people do — and risk in that
way spreading the virus to more
susceptible parts of the popula-
tion. Adults started gathering at
the beach and for birthday barbe-
cues. There is still no clear plan for
a return to school in September.
There is also a burgeoning, and
politically motivated, anti-mask
contingent led by nationalist Mat-
teo Salvini, who on July 27 de-
clared that replacing handshakes
and hugs with elbow bumps was
“the end of the human species.”
At his rallies, Mr. Salvini, the
leader of the populist League
party, still shakes hands and
wears his mask like a chin guard.
In July, during a news conference,
he accused the Italian govern-
ment of “importing” infected im-
migrants to create new clusters
and extend the state of emer-
gency.
This week, Mr. Salvini joined
other mask skeptics — nicknamed
the “negationists” by critics — for
a protest in the Senate library,
along with special guests such as
the Italian crooner Andrea Bo-
celli, who said he did not believe
the pandemic was so serious be-
cause “I know a lot of people and I
don’t know anyone who ended up
in an I.C.U.”
But the country’s leading health
experts say that the lack of severe
cases is indicative of a decrease in
the volume of infections, as only a
small percentage of the infected
get very sick. And so far, Italy’s
malcontents have not been nu-
merous or powerful enough to un-
dermine what has been a hard-won trajectory of success in con-
fronting the virus after a calami-
tous start.
Italy’s initial isolation by Euro-
pean neighbors at the outset of the
crisis, when masks and ventila-
tors were hardly pouring in from
across the borders, may actually
have helped, Mr. Guerra, the
W.H.O. expert, said.
“There was competition ini-
tially, there was no collaboration,”
Mr. Guerra said. “And everyone
acknowledged Italy was left alone
at that time.” As a result, he said,
“what they had to do at that time
because we were left alone turned
out to be more effective than other
countries.”
Italy first quarantined towns
and then the Lombardy region in
the north and then the entire pen-
insula and its islands, despite the
near absence of the virus in much
of central and southern Italy. That
not only prevented workers in the
industrial north from returning
home in the much more vulnera-
ble south, but it also fostered and
forced a unified national response.
During the lockdown, move-
ment was strictly limited, be-
tween regions and towns and
even city blocks, and people had to
fill in “auto-certification” forms to
prove that they needed to go out-
side for work, health or “other ne-
cessities.” Masks and social dis-
tancing regulations were enforced
by some regional authorities with
steep fines. Generally, if grudg-
ingly, the rules were followed.
As searing scenes of human suf-
fering, empty streets and the
heavy toll on an elderly genera-
tion of northern Italians spread,
the transmission rate of the virus
quickly decreased, and the curve
flattened, as opposed to other Eu-
ropean countries, such as Swe-
den, which pursued an alternative
to locking down.
That the initial outbreak was lo-
calized in the overwhelmed hospi-
tals created enormous stress, but
it also enabled doctors and nurses
to expedite contact tracing.
Then the country reopened,
gradually, expanding liberties at
two-week intervals to respond to
the virus’s incubation period.
The lockdown eventually had a
secondary effect of decreasing the
volume of virus circulating in soci-
ety, and thus reducing the proba-
bility of coming in contact with
someone who had it. At the end of
the lockdown, the virus circula-
tion had steeply fallen off and in
some central and southern re-
gions, there were hardly any
chains of transmission at all.
“It’s always a matter of proba-
bility with these pathogens,” said
Mr. Guerra, adding that new early
alarm systems such as the moni-
toring of wastewater for traces of
virus had lowered the probability
of infection even more.
As the government considers a
new decree to reopen night clubs,
festivals and cruise ship travel,
many health experts have im-
plored the country not to let down
its guard.
“Even if the situation is better
than in other countries, we should
continue to be very prudent,” said
Dr. Rezza of the National Institute
of Health, adding that he thought
the question of what Italy had
done right was better posed “at
the end of the epidemic.”ITALY
The Lessons of a Global Pariah That Turned Into a Containment Success Story
By JASON HOROWITZEmma Bubola contributed report-
ing from Milan.
Checking a passenger at Milan’s Central Station. Travel between Italy’s regions was not allowed un-
til early June. The country reopened gradually, expanding liberties at two-week intervals.CLAUDIO FURLAN/LAPRESSE, VIA ASSOCIATED PRESSA market in Naples in June. Italians are cautiously optimistic that they have the virus in check, but experts warn against complacency.GIANNI CIPRIANO FOR THE NEW YORK TIMESbolstered by a groundbreaking
agreement struck in July within
the European Union to sell 750
million euro ($892 million) worth
of bonds that are backed col-
lectively by its members. Those
funds will be deployed to the hard-
est hit countries like Italy and
Spain.
The deal transcended years of
opposition from parsimonious
northern European countries like
Germany and the Netherlands
against issuing common debt.
They have balked at putting their
taxpayers on the line to bail out
southern neighbors like Greece
while indulging in crude ster-
eotypes of Mediterranean profli-
gacy. The animosity perpetuated
the sense that Europe was a union
in name only — a critique that has
been muted.
The United States has spent
more than Europe on programs to
limit the economic damage of the
pandemic. But much of the spend-
ing has benefited investors,
spurring a substantial recovery in
the stock market. Emergency un-
employment benefits have proved
crucial, enabling tens of millions
of jobless Americans to pay rent
and buy groceries. But they were
set to expire on Friday and there
were few signs that Congress
would extend them.
Europe’s experience has under-
scored the virtues of its more gen-
erous social welfare programs, in-
cluding national health care sys-
tems.
Americans feel compelled to go
to work, even at dangerous places
like meatpacking plants, and even
when they are ill, because many
lack paid sick leave. Yet they also
feel pressure to avoid shops,
restaurants and other crowded
places of business because mil-
lions lack health insurance, mak-
ing hospitalization a financial ca-
tastrophe.
“Europe has really benefited
from having this system that is
more heavily dominated by wel-
fare systems than the U.S.,” said
Kjersti Haugland, chief economist
at DNB Markets, an investment
bank in Oslo. “It keeps people less
fearful.”
The more promising situation
in Europe is neither certain nor
comprehensive. Spain remains a
grave concern, with the virus
spreading, threatening lives and
livelihoods. Italy has emerged
from the grim calculus of mass
death to the chronic condition of
persistent economic troubles.
Britain’s tragic mishandling of the
pandemic has shaken faith in the
government.
If short-term factors look more
beneficial to European econo-
mies, longer-term forces may fa-
vor the United States, with its
younger population and greater
productivity.
A sense of European-American
rivalry has been provoked by the
bombast of a nationalist Americanpresident, making the pandemic a
morbid opportunity to keep score.
“There is a certain amount of
triumphalism,” said Peter Dixon,
a global financial economist at
Commerzbank in London. “Peo-
ple are saying, ‘Our economy has
survived, we are doing OK.’
There’s a certain amount of Euro-
pean schadenfreude, if I can use
that word, given everything that
Trump has said about the U.S.”
But for now, Europe’s moment
of confidence is palpable, most
prominently in Germany, the con-
tinent’s largest economy.
Though the German economy
shrank by 10.1 percent from
March to June — its worst drop in
at least half a century — the num-
ber of officially jobless people fell
in July, in part because of govern-
ment programs that have subsi-
dized furloughed workers.
Surveys show that German
managers — not a group inclined
toward sunny optimism — have
seen expectations for future sales
return to nearly pre-virus levels.
That buoyancy translates directly
into growth, emboldening compa-
nies to rehire furloughed workers.
Ziehl-Abegg, a maker of ventila-
tion systems for hospitals, fac-
tories and large buildings, re-
cently broke ground on a 16 mil-
lion euro ($19 million) expansion
at a factory in southern Germany.
“If we wait to invest until the
market recovers, that’s too late,”
said Peter Fenkl, the company’s
chief executive. “There are bil-
lions of dollars in the market
ready to be invested and just wait-
ing for the signal to kick off.”
The euro has gained more than5 percent against the dollar so far
this year, according to FactSet.
European markets have been
lifted by international money
flowing into so-called exchange-
traded funds that purchase Euro-
pean stocks. The Stoxx 600, an in-
dex made up of companies in 17
European countries, appears set
for a second straight month of
gains outpacing the S&P 500.
The French oil giant Total saw
demand for its products in Europe
drop by nearly one third in the sec-
ond quarter of the year, but a pow-
erful recovery has been gaining
momentum, said the company’s
chairman and chief executive,
Patrick Pouyanné.
“Since June, we have seen a re-
bound here in Europe,” he said
during a call with analysts. “Activ-
ity in our marketing networks is
back to, I would say, 90 percent of
the pre-Covid levels.”
France, Europe’s second larg-
est economy, has been buttressed
by aggressive government spend-
ing. President Emmanuel Macron
has mobilized more than 400 bil-
lion euros ($476 billion) in emer-
gency aid and loan guarantees
since the start of the crisis, and is
preparing an autumn package
worth another €100 billion.
Those funds paid businesses
not to lay off workers, allowing
more than 14 million employees to
go on paid furlough, stay in their
homes, accumulate modest sav-
ings and continue spending. De-
layed deadlines for business taxes
and loan payments spared compa-
nies from collapse.
In the second quarter, when
France was still partly lockeddown, the country’s economy con-
tracted by nearly 14 percent. Tour-
ism, retail and manufacturing, the
main pillars of the economy,
ground to a halt.
But services, industrial activity
and consumer spending have
shown signs of improvement. The
Banque de France, which had ex-
pected the economy to shrink
more than 10 percent this year, re-
cently forecast less damage.
In Spain, a sense of recovery re-
mains distant. Its economy
shrank by nearly 19 percent from
April to June. The nation’s unem-
ployment rate exceeds 15 percent,
and it could surge higher if a wage
subsidy program for furloughed
workers is allowed to expire in
September.
Spain officially ended its coro-
navirus state of emergency on
June 21, but it has since had an in-
crease in infections. The economic
effects have been compounded by
Britain’s decision to force trav-
elers returning from Spain to
quarantine for two weeks. Tour-
ism accounts for 12 percent of
Spain’s economy.
Italy is also highly exposed to
tourism. Its industry is concen-
trated in the north of the country,
which had the worst of the coro-
navirus. The central bank expects
the Italian economy to contract by
nearly 10 percent this year.
But exports surged more than
one-third in May compared with
the previous month. That left
them below pre-pandemic levels,
yet on par with German and
American competitors, according
to Confindustria, an Italian trade
association.“We are starting to slowly re-
cover after the most violent down-
fall in the last 70 years,” said Fran-
cesco Daveri, an economist at
Bocconi University in Milan.
Europe’s fortunes appear on the
mend because its people are more
likely to trust their governments.
Denmark acted early, imposing
a strict lockdown while paying
wage subsidies that limited unem-
ployment. Denmark suffered far
fewer deaths per capita than the
United States and Britain.
With the virus largely con-
trolled, Denmark lifted restric-
tions earlier, while Danes heeded
the call to resume commercial life.
The Danish economy is expected
to contract by 5.25 percent this
year, according to the European
Commission, with a substantial
improvement in the second half of
the year.
In the United States, people
have wearied of bewildering, con-
flicting advice from on high
against a backdrop of more than
150,000 deaths.
President Trump first called the
virus a hoax and then treated it as
an emergency befitting wartime
mobilization, and then urged
states to reopen to spur the econ-
omy. He encouraged protesters
who portrayed wearing masks as
an affront to civil liberties.
The result has been record
surges of new cases along with a
syndrome likely to persist: an
aversion to being near other peo-
ple. That spells leaner prospects
for retail, hotels, restaurants and
other job-rich areas of the Ameri-
can economy.THE CONTINENT’S COMEBACK
Europes Flashes Signs of Hope Amid Plunge, in Contrast to Struggles of the U.S.
From Page ALiz Alderman reported from Paris.
Reporting was contributed by
Emma Bubola from Milan, Ra-
phael Minder from Madrid, and
Stanley Reed and Eshe Nelson
from London.