Italy: experiences of multi-level governance with the COVID-19 crisis

Italy has been the first European country to be dramatically affected by COVID-19. As of June 2020, the epidemic counts almost 240,000 cases and a staggering number of over 34,000 deaths. The central government established a progressive and harsh lockdown of all non-essential social and economic activities, prioritizing health issues. Given their established co-responsibility on health policy and the uneven spread of the virus throughout the country, regional authorities undertook further prevention actions independently and often in an uncoordinated way. Most of the policy decisions were shown to be informed by clinical experts, who assumed a great visibility with the public since the early phases of the crisis. Public healthcare managers were much less visible but took relevant decisions in very short timespans, filtering a multitude of policy inputs and communication noise. More particularly, they provided a space for action, coordinated multiple stakeholders and professionals of different backgrounds, and played a crucial role in service redesign, human resource management and logistics.