Neglecting nursing homes: the management of the pandemic crisis in Italy

This chapter examines the profound impact of the COVID-19 pandemic on the residential care sector in Italy, focusing mainly on Lombardy, the region most affected during the first wave. It highlights the structural and institutional weaknesses that exacerbated the crisis, including chronic underfunding, fragmented governance, and inadequate preparedness in long-term care (LTC) systems. Key failures included delayed lockdown measures, insufficient testing and personal protective equipment (PPE) provision, and a lack of integration between healthcare services and care homes. The absence of coordinated policies and the neglect of nursing homes in early national and regional responses left residents highly vulnerable, with nursing homes accounting for 32 per cent of COVID-19 related deaths during the first wave. While the vaccination campaign eventually reduced mortality, systemic issues in LTC persisted. The chapter underscores the need for a comprehensive reform of the Italian LTC system, including increased public investment, regulatory improvements, and better integration with healthcare services to address the challenges of an ageing population and future crises.