Letter from Rome: facing the third wave

As of March 15, 2021, Rome and much of Italy, has been declared a “Covid-19 Red Zone” for the next three weeks — the government has a system that classifies different regions of the country as white, yellow, orange and red according to indicators including infection and transmission rates, and the situation in hospitals and intensive care units. The imposition of a Red Zone means that all kindergartens, schools and colleges are closed, as are coffee bars, restaurants, gyms, barber shops, shopping malls and museums, and all non-essential activities. There are severe restrictions on people’s movements both within the city and between cities and regions. Those moving around may be stopped by the police or the army and may be fined if they are out without an adequate explanation.

The new restrictions come a year after the first lockdown in March 2020. I had just returned from Pakistan and it was bizarre to see the normally bustling Roman square and piazzas fall silent and deserted. There was fear in the air with long silent queues outside supermarkets and pharmacies. There was also confusion and disorganisation — with not enough beds in the ICU, not enough coffins for the dead, and not enough personal protection equipment for hospital staff. Even face marks were not easy to find and we had to plead with our local pharmacy to call us as soon as any became available. 

But there was also optimism in the air. People put up signs saying, “All Will be Fine”, and there were wonderful moments of solidarity when people would come out on their balconies every evening to sing or play music. By May 2020, the worst seemed to be over and the government gradually eased restrictions. By mid-June, the daily death toll was less than 50 and over much of July and August below 10 a day. People went on summer holidays convinced that the pandemic was over and things could now return to normal. Restaurants, bars, hotels and seaside resorts did unexpectedly good business. Even discotheques opened and young people flocked there.

But unbeknown to all, bad things were round the corner. As people started returning from holidays, they brought the virus with them and infection rates rose. By mid-October, a second wave of Covid-19 was in full swing. New infections soared to 40,000 cases per day, and the daily death rates reached almost 1,000 — higher than the peak during the first wave.  Restrictions and partial lockdowns, including over Christmas, were imposed in attempts to reverse the trend.

But this time the disease abated much slowly. This was because the lockdown restrictions were not as severe and many people, tired of restrictions, were lax about following the SOPs, particularly on social distancing. The death rates edged down but remained around 200 per day in February. But again, there were reasons for optimism — particularly related to the arrival of vaccines.

But as of March 1, 2021, the death toll started to rise sharply for the third time. Other indicators also took a turn for the worse. The number of daily new cases rose to around 25,000, the death rate to 400, and positivity rate to 8.5%. The transmission rate shot to over 1.3 in the region of Rome. ICUs came under pressure despite the huge improvements made in the last year. Most new cases were the “English variant” which is more infectious and also infects younger people who were less at risk to the original virus. These factors triggered the reclassification of the region directly from yellow to red. And so here we are struggling to contain the third wave. 

Despite the economic, social and psychological damage that will be caused by the new lockdown, there is still hope pinned on vaccination. But the process is slow. So far almost eight million people, of a total population of 60 million, have been vaccinated of which about 2.5 million have received both doses. The programme has so far covered older people and those exposed such as health workers, police forces and teachers.

The major problem has been a lack of supplies. Italy relied largely on supply contracts negotiated by the EU and the process hit several hitches.

To add to this there have been concerns about possible side effects especially with the AstraZeneca vaccine. Fears peaked when a young naval officer in top physical form, and subsequently a teacher in his early 50s, died a few hours after receiving the vaccine. It then turned out that several others had also died but as they had pre-existing conditions and deaths were several days after receiving the vaccine, they did not make headlines. 

These deaths led to the temporary suspension of the AstraZeneca vaccine which accounts for 25% of all supplies in Italy. Several European countries such as France, Germany and Spain also suspended use of the AstraZeneca vaccine. These suspensions were subsequently lifted as the European Medical Association (EMA) ruled that the AstraZeneca vaccine “is not associated with an increased overall risk of blood clotting disorders” and is safe and effective. Nevertheless, despite the reassurances many Italians continue to harbour doubts about the safety of vaccinations. It is worth noting that EMA’s Safety Committee also stated that “there remain some concerns” in younger patients. These may play a role as the vaccination programme is further rolled out. It may even put in doubt the government target of having 80% of Italians vaccinated by September end — coverage necessary to ensure herd immunity.

So, what is the mood now? On the one hand people are frightened and concerned. No one expected the problem to continue for so long. Shops and other enterprises continue to close at an alarming rate. The government is pumping money into the economy to sustain demand. But people are apprehensive about spending, and much of this extra money is ending up as savings. Bank deposits have soared. There are fears related to the level of national debt which jumped from 130% of GDP to 160%, and about inflation which could surge once people start spending.  

On the other hand, there is immense compliance fatigue, especially among young people.  Students are demonstrating to go back to school. Football fans of two rival teams in Milan got together in large numbers outside the stadium while a crucial match was being played. And many youngsters insist on their regular Friday and Saturday evening “aperitivo” with complete disregard for rules on masks or social distancing.

To add to the country’s woes this has been a period of substantial political instability.  Parliamentary shenanigans by some smaller parties brought down the last government. A new government, headed by a technocrat as prime minister, has been patched together but relies on a strange mix of left- and right-wing parties with incompatible agendas.

Spring and early summer is a period of glorious weather in Italy, especially in Rome. It is warm, the flowers are in bloom, and ski resorts and beautiful beaches are within two hours’ drive from the city. 

But for the second year in a row very few will be enjoying this time.