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ROME — If hospitals in the wealthy Lombardy region of Italy are on the brink of collapse as a result of the coronavirus outbreak, in the south of the country the national health care system doesnt stand a chance of coping with a similar scenario.

In poorer southern regions, limited resources, mismanagement and poor infrastructure have put a strain on hospitals for over a decade. An epidemic would be the last straw, which is why the Italian government is working to limit the virus spread southward. “Its a race against time,” according to one senior health ministry official who pointed a finger at years of cost-cutting and hospital closures.

On Tuesday, new rules banning people from moving from where they are located — including to join their families or return to their domicile — came into force. Fines for people who dont comply were raised from €400 to €3,000. Also on Tuesday, the Sicilian regional governments decision to close off the island from anyone traveling from mainland Italy sparked chaos as hundreds of people, including truck drivers transporting food products, were stranded in the port of Villa San Giovanni, on the tip of Italys boot, waiting to board ferries to Sicily.

“These people will not set foot in my city,” said Cateno De Luca, the mayor of Messina, the closest city to the mainland.

Sicily, Apulia, Campania (which contains Naples) and Calabria — the biggest southern regions with a total population of 16 million — had less than 1,000 critical care beds combined before the coronavirus outbreak. Throughout the country, the number of total places for critical patients was only 5,200. The national government said the figure needs to increase by 40 percent.

“If Lombardy is struggling, imagine what could happen down south where they have a fraction of doctors and vital medical instruments compared to the north,” said Filippo Anelli, president of the National Medical Association, earlier this month.

Regional governors have repeatedly voiced concerns over the thousands of people who left Lombardy to join their families or to spend the lockdown in their vacation homes. As soon as the containment measures were implemented, two weeks ago, tens of thousands of people travelled south, according to official data from regional authorities.

Within 24 hours from the shutdown of Lombardy on March 8, more than 9,300 people had self-declared their presence in Apulia, said Governor Michele Emiliano. By March 20, over 35,000 people had reached Sicily from other regions.

“Our health care system cannot face a situation like Lombardys, were not up to it,” said Jole Santelli, Calabrias newly elected governor and a member Silvio Berlusconis Forza Italia, in a video posted on social media. The region has almost 2 million inhabitants and fewer than 150 critical care beds. Almost 10,000 people arrived there from the north this month.

“Our health care system cannot face a situation like Lombardys, were not up to it” — Jole Santelli, governor of Calabria

Though 80 percent of the regional budget in Calabria goes to the public health care system, much of it is siphoned off by criminals and corruption.

Its not an isolated problem in the area: the massive presence of criminal organizations like the Sicilian Mafia and the Neapolitan Camorra have diverted public funds needed to renovate hospitals, buy medical devices and hire specialists in Sicily and Campania.

To complicate matters further, thousands of health care workers migrated away from poorer southern regions in recent years because of job cuts and low salaries. And now it is proving complicated to convince doctors and nurses to return.

According to the manager of a hospital in Palermo, who spoke on condition of anonymity because he was not authorized to talk to the media, “its extremely hard to find specialists and nurses who want to come back here, essentially risking their lives, because we cant offer any reassurances for the future.”

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