The EconomistMarch 14th 2020 International 47
2 home. But if these limitations fail to slow
rapidly and substantially the rate at which
infections are increasing, Italy may be-
come a role model.
Italy’s national lockdown was
prompted by its apparent success using
comparable measures on a regional level.
The government tested similar restrictions
in two “red zones” around a handful of
small towns in the northern part of the
country where, in late February, it found its
first big clusters of covid-19 cases. On
March 8th Silvio Brusaferro, the president
of Italy’s national public health institute,
said the number of new infections in both
areas was falling.
But that is no guarantee the national
quarantine will lead to similar results. The
efficacy of the shutdown depends on two
things: the extent to which people comply
with the rules; and the length of time the
rules can be left in place, given their vast
social and economic costs. For those
watching Italy, the crucial question is
whether they need to go to similar lengths,
or whether a more modest set of restric-
tions will slow the epidemic.
Italy is following the example set by
China, which got a raging covid-19 epide-
mic in Hubei province under control and
prevented outbreaks elsewhere by impos-
ing stringent mass quarantines. Millions
have been mostly stuck inside for weeks. In
some cities, such as Wuhan, where the out-
break began, people have been prevented
from leaving their homes for more than a
month. The lockdown has been strictly en-
forced by neighbourhood committees and
building managers, though restrictions are
now being loosened as China’s new cases
have dwindled. In Italy, by contrast, the im-
plementation of the travel restrictions de-
pends on the public’s co-operation. Au-
thorities and doctors are imploring people
to stay at home. But at checkpoints drivers
need only show a self-certified form stat-
ing their reasons for travelling.
So far Italians seem to be adhering to the
new rules. There have been exceptions. A
hospital porter who tested positive for the
virus and should have been in self-quaran-
tine was found shopping in a supermarket
at Sciacca in Sicily. He risks being charged
with spreading an epidemic, which carries
a maximum penalty of 12 years in jail. Peo-
ple were still gathering in bars and
clubs—in at least one case, to watch a foot-
ball match—before the strictest measures
came into effect. But in Caserta near Na-
ples, where a handful of infractions were
reported on the first full day of police
checks, a senior officer said: “Members of
the public are starting to be aware that it’s
in the interests of their health to keep their
movements to a minimum.”
The extent to which people continue to
comply with demands that they keep their
distance from friends, colleagues and the
general public depends in large part on
how long they are required to do so. Social-
distancing measures work best when they
are put in place early, before an epidemic
takes off, says Elias Mossialos from the
London School of Economics. In China cit-
ies that imposed restrictions on mass gath-
erings and transport before identifying
their first covid-19 case had fewer infec-
tions in the first week after that milestone
than places that acted later.
In Britain, however, the government is
worried about introducing such restric-
tions too soon. The country, which is at an
earlier stage of its covid-19 outbreak than
many others, has not yet banned mass
gatherings, nor has it closed schools or in-
structed people to work from home. The
scientists advising the government are
concerned that if such measures come
now, compliance fatigue may set in just as
the epidemic is taking off. But tougher re-
strictions are almost certainly on the way.
Sometime in the next two weeks everyone
with symptoms of a cold will be asked to
stay at home for seven days because at that
point many such cases will be assumed to
be covid-19 infections.
The experience of South Korea, which
has seen one of the largest outbreaks of co-
vid-19, suggests that scientists in Britain
may be right to worry. Outside the city of
Daegu, where most of the country’s co-
vid-19 cases have been identified, the gov-
ernment has not introduced any manda-
tory restrictions—hoping instead that
people will voluntarily follow advice to
stay at home and to take precautions dur-
ing gatherings that they cannot avoid.In
Gyeonggi province, which surrounds
Seoul, mourners at funerals have been told
Hubei
67,773
5,000
20,000
1
Peopleinfected
Shareofcasesthat
occurredinthepast
week,%
10
50
90
100
0
What a pandemic looks like
Source: Johns Hopkins CSSE
Confirmed covid-19 cases, to March 11th 2020
1
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