COVID-19 in Italy. A new culture of healthcare for future preparedness

Italy was the first Western country hit by the COVID-19 pandemic, with tremendous impact. Several factors contributed to this, many still under investigation, including macroeconomic flows of goods and people, environmental and social conditions, a weakened national health system (NHS) and severe unpreparedness for a pandemic. As a “limit situation”, the pandemic made explicit the impact of market-oriented reforms in undermining the capacity of the NHS to perform its biopolitical duties of health promotion. It also made explicit the cultural values informing national health policy: the pandemic was mainly dealt with at the hospital level, with an infective and virologic approach rather than a public health one. Although it was mainly through lockdown, i.e. people's social behavior, that the virus spread began to be contained, the NHS did not act through its community-based local articulations. Rather, lockdown was a top-down measure, without consideration of the social conditions of its lived experience. In this chapter, we explore these elements to critically highlight what might be needed to build real preparedness: a global health approach capable of acting locally by involving community participation, based on a broader health concept that legitimizes forms of knowledge not strictly bound to the biomedical field