The management of the Sars-CoV-2 pandemic in Italy, lessons earnt and reflections for the future

The management of the Sars-CoV-2 pandemic in Italy, lessons earnt and reflections for the future


  • Manuel Maffeo University of Milan, Italy
  • Antonio Azara Department of Medical, surgical and experimental sciences, University of Sassari
  • Enrico Di Rosa Local public health office, ASL ROMA 1
  • Luigi Bertinato Scientific secretariat to the President Head of Office , National Institute of Health, Italy
  • Claudio Garbelli Italian hygiene and preventive medicine society (SITI)
  • Silvana Castaldi Università degli Studi di Milano


Sars-CoV-2; Covid-19; Preparadness; Public Health


Background: Italy and especially Lombardy region was the first European Country hit by the covid 19 pandemic, without a proper preparedness plan. Italy’s health-care service is a regionally based National Health Service (NHS) that provides universal coverage, largely free of charge at the point of service. Aim of this paper is to analyse the national and especially the regional strategies put in place to face the pandemic, focusing on the impact of the overlap of the political and health competences among national and regional authority. Methods: Italian hygiene and preventive medicine society (SITI) realized a questionnaire submitted to National Institute for Health and regional stakeholder to investigate the response to the epidemic analysing the strategies and actions put in place both by the national and regional governments and the regional health authorities. Results: The national survey highlighted several critical points in the management of the covid 19 pandemic in the different regional contexts such as lack of personnel in preventive departments and preparadness. Conclusions: Lessons learnt during the pandemic should shape the future of the Italian health service. (

Author Biography

Silvana Castaldi, Università degli Studi di Milano

professore associato Dipartimento di Scienze Biomediche per la Salute



Perico L, Tomasoni S, Peracchi T, et al. COVID 19 and Lombardy: Testing the impact of the first wave of the pandemic: The prevalence of SARS-CoV-2 infection in norther Itlay. EbioMedicine 2020, 61, 103069 DOI:

Rivieccio BA, Luconi E, Boracchi P, et al. Heterogeneity of COVID-19 outbreak in Italy. Acta Biomed 2020; Vol. 91, N. 2: 31-34 DOI: 10.23750/abm.v91i2.9579

Ferre, F, de Belvis AG, Valerio L, et al. Italy: health system review. Health Syst. Transit. 2014, 16, 1–168

Italian Government Law n. 833, 23 December 1978

Italian Government Law n. 502, 30 December 1992

Italian Government Law n. 517, 7 December 1993

Italian Government Law n. 229, 19 June 1999

Tuscany Region Law n. 40, 24 February 2005

Emilia-Romagna Region Law n. 29, 23 December 2004

Lombardy Region Law n. 31, 11 July 1997

National Institute for Health Monitoring Covid-19 Available online:

Cartabellotta, N.; Cottafava, E.; Luceri, R.; Mosti, M. 4° Report on sustainability of the national health system. 2019. GIMBE Evidence for Health

Castaldi S, Luconi E, Rivieccio BA, et al. Are health indicators able to describe the ability to cope of Health Systems with COVID-19 epidemic? Risk Management and Healthcare Policy 2021:14 2221-2229. DOI

WHO. List of blueprint priority dieseases. 7 February 2018

The European Parliament Council Decision No 1082/2013/EU of the European Parliament and of the Council of 22 October 2013 on serious cross-border threats to health and repealing Decision No 2119/98/EC. Off. J. Eur. Union 2013, 1–15.

Conferenza permanente per i rapporti tra lo Stato le Regioni e le Province autonome di Trento e Bolzano National prevention plan 2014-2018, 13 November 2014

Ministery of Health. Preparedness Plan for Pandemic Influenza. 2016

Italian Government President Decree 4th March 2020

Italian Government President Decree 1st March 2020

ALTEMS Analysis of the organization models for the response to COVID-19. December 2020

Italian Government Law decree n.14 9 March2020

National Institute for Health. National Survey on covid 19 in the residential homes. 5 May 2020

National Institute for Health. Indicazioni ad interim per la prevenzione ed il controllo dell'infezione da SARS-CoV-2 in strutture residenziali sociosanitarie e socio assistenziali 24 agosto 2020.

National Institute for Health. Indicazioni ad interim per la gestione dei rifiuti urbani inrelazione alla trasmissione dell'infezione da virus SARS-CoV-2. Maggio 2020

European Centre for Disease Prevention and Control. Resource estimation for contact tracing, quarantine and monitoring activities for COVID-19 cases in the EU/EEA (ECDC Technical Report). 2020, 1–9.

Ministry of education Decree n. 1136 15 September 2020.

Intelligence, D.O.E.A.; Health, F.A.I. Understanding the Infodemic and Misinformation in the Fight Against COVID-19 Available online:

Castaldi S, Romanò L, Pariani E, Garbelli C, Biganzoli E. COVID-19: the end of lockdown what next? Acta Biomed 2020; Vol. 91, N. 2: 236-238 2020; DOI: 10.23750/abm.v91i2.9605







How to Cite

The management of the Sars-CoV-2 pandemic in Italy, lessons earnt and reflections for the future. Acta Biomed [Internet]. 2021 Nov. 3 [cited 2024 Jun. 17];92(5):e2021388. Available from:

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