As Britain struggles to prepare for what is predicted to be the peak of the Covid-19 virus in mid-to-late April, many people fear the country will suffer horrors on the scale of those endured by Italy in recent weeks. However, that country and its Covd-19 experience should not necessarily be seen as a predictive model for the UK. It could well be that Italy, or at least northern Italy, suffered a kind of perfect storm, with several factors that are particular or even unique to that country contributing to the lethal damage wrought by the disease.

That Italy has the world’s second oldest population (more than 25% of Italians are over 65) is well-known. So is the fact that Italy enjoys an extremely high number of multi-generational households by European standards, with many grandparents living with their children and grandchildren. Both factors have made a contribution to Italy’s apparently high mortality rates from the disease.

There is also a third, less well-known possible reason for Italy’s particularly acute crisis, and specifically for the way that the impressive Italian healthcare system was overwhelmed by Coronavirus in mid-February and March.

Italian authorities initially thought that the disease might have been unwittingly imported by a pair of Chinese tourists who became sick in Parma after travelling from Wuhan in January, but its arrival and swift spread may have had more to do with the leather and textile industry of northern Italy. 

Over the last two decades, that industry has become dependent on large numbers of often poorly-paid Chinese guest workers, many of them brought over by partially Chinese-owned textile companies. According to a March 2018 article in  the New Yorker magazine more than thirty thousand Chinese workers live and work just in the Tuscan city of Prato. More recent estimates have put the number at 50,000, which would make it the largest Chinese community in Europe apart from Paris. There are at least 150,000 Chinese workers based in other textile cities of the region. 

Many of the Chinese guest workers and migrants who toil in the notorious sweatshops of Prato and other textile towns come from the city of Wenzhou in eastern China, which has a direct daily flight to several cities in northern Italy. Wenzhou is 900 km from Wuhan where the pandemic began, but it had the highest number of infections of any Chinese city outside Hubei province. It was locked down by the Chinese authorities in mid-February. 

The virus had apparently been brought to Wenzhou by workers returning from Wuhan. The people of Wenzhou are famous in China as travellers and entrepreneurs; its enormous diaspora includes 170,000 Wenzhou citizens living in Wuhan city, many of whom fled home as quarantines were initiated there.

In the days following the Chinese New Year on January 29, thousands of Chinese workers flew back to northern Italy from Wenzhou and elsewhere in China. Less than three weeks later, there was an explosion of Coronavirus cases in Lombardy. 

It is possible that the speed and size of the north Italian outbreak and the large population arriving from the epicentre of the pandemic were not causally related. However, this seems unlikely, even though many of the returning workers self-isolated on their arrival from China.

After all, Iran suffered a similarly explosive outbreak at exactly the same time – two to three weeks after thousands of Chinese labourers working on the new high-speed railway between Qom and Tehran flew back into the country after the New Year holiday (Qom is a destination for Shia pilgrims, and the latter then brought the disease to certain cities Afghanistan and Pakistan). 

There may well have been additional geographically and culturally specific reasons for the speed of the north Italian epidemic and its lethality. Some observers suspect it might have been worsened by the prolific kissing and hugging that graces Italian social life, by the density of tourism from China and elsewhere in Italy’s crowded ancient cities, or perhaps by the high pollution levels in northern cities. We still know too little about Covid-19 at this point to understand why or how it spreads more quickly in some places than others.

In any case, by mid-February, the virus had spread to the region’s ski resorts, where crowded cable cars, bars and chalets aided the rapid spread of the virus among holidaymakers from around Europe, and in particular the UK (the borough of Kensington and Chelsea in London became the UK’s initial Covid-19 hotspot apparently thanks to the return of skiers from resorts in Italy and Austria). 

Lombardy’s hospitals are at least as modern and efficient as those in the UK, but their facilities and heroic staff were overwhelmed by the sheer number of infected and seriously ill patients arriving at the same time. The closing of the region’s schools – the very measure called for with such moralistic fury by Twitter opinion in the UK – seems to have caused a massive second wave of serious infections among the elderly, ensuring that the system is still overwhelmed. 

Finally, there was the fact that Italy has, especially among the older generation, very high numbers of smokers and ex-smokers. It is not in the current interest of governments and health authorities to go public with any correlation between severe reactions to the virus and tobacco-damaged lungs, lest they stigmatise Coronavirus sufferers or diminish the general fears of the public and prompt it to cease social-distancing, but there seems to be the kind of correlation you would expect with a disease that primarily affects the lungs. 

Fortunately, none of these four factors in Italy’s catastrophe apply strongly in the UK. On the other hand, the UK may well have some vulnerabilities that Italy did not.

For example, the UK population includes unusually large numbers of people whose health is severely compromised by obesity (many of the younger people who have died from the disease have obesity-related conditions). Nor is it impossible that even now the UK’s hospitals may still be less prepared than Italy’s were in terms of ventilators, intensive care beds, and personal protective equipment for medical staff.

There are many reasons for this, some more blameworthy than others. But the overall long-term inadequacy of emergency preparation in the UK is such that Britons should be grateful that there has never been a major terrorist attack involving chemical, biological or nuclear weapons. It seems clear now that British cities including London would have been helpless in the face of even a small “dirty bomb” detonation, their hospitals and police lacking adequate supplies of even the most basic emergency equipment.

There will be and should be debates about whether or not the British government has made the right decisions, whether panic inspired by social media has distorted policy, whether the lockdown was too late, too early, perfectly timed or a dangerous mistake, and whether Britain might have been better off following the Singaporean or South Korean examples, with their reliance on boots-on-the-ground mass testing rather than computer modeling based on problematic data. But it is important to remember that Britain is not Italy nor South Korea nor Spain nor Sweden; it has its own peculiar cultural, demographic, institutional and political advantages and disadvantages in the confrontation with Coronavirus. We all have to hope that when added together the result comes out in our favour.