Updated report: The COVID-19 Long-Term Care system situation in Italy

Sara Berloto, Elisabetta Notarnicola, Eleonora Perobelli and Andrea Rotolo (Observatory on Long Term Care, Cergas SDA Bocconi School of Management)

This updated report provides new figures on the impact of the pandemic and reviews the measures adopted to support care homes in 9 Italian regions. The full report is available here:

Key findings:

• The Italian government acted late on the Covid-19 outbreak management in nursing homes. The first operational guidelines were released after the country’s total lockdown on March 9^th, only requiring care homes to suspend visitations. An update of the operational guidelines dedicated to nursing homes was released by the Ministry of Health only on March 25^th. The first Covid-19 case registered in Italy dates to January 30.
• Regions own the responsibility for the LTC sector operational regulation: after the outbreak, they enacted late and different responses without a clear guidance from the national legislator.
• Italy faced a massive shortage in PPE: nursing homes were not prioritized for receiving new procurements. Workers and users have not been sufficiently protected from the Covid-19 spread.
• The National Institute of Health (Istituto Superiore di Sanità) launched a survey to investigate the incredibly high numbers of deaths registered in elderly residential centres, after national press raised the attention on the possible sharp underestimation of Covid-19-related deaths in care homes. Preliminary results confirm that the actual number of Covid-19 related deaths might be much higher than the one reported in official documents.
• Coordination with health care actors (mainly acute care but also general practitioners) has been limited and poorly implemented, mainly relying on professional linkages between single professional and without a regional or national framework.
• Response to Covid-19 emergency has been left to the initiative of each Nursing Home alone, relying on their capacity and willingness to cope with extraordinary conditions while having poor support from institutions.