Italy is about to bring in the strictest COVID-19 measures in Europe

Despite violent protests in Rome this weekend over new COVID-19 requirements for workplaces, Italy is moving ahead with the strictest measures against COVID-19 in Europe.

Late Saturday, some 10,000 protesters marched through the streets of Rome. Several hundred broke off to storm the headquarters of Italy's largest union, breaking windows and equipment. Dozens more protesters, also members of a neo-Fascist group, smashed windows in the emergency entrance of a hospital where one of their fellow protesters who had been arrested was being treated as a patient. Four health-care workers were injured and police arrested 12 people, including the head of a far-right group.

Yet on the same day the violent protests erupted, Italy quietly reached a goal it set in March to fully vaccinate 80 per cent of the population over the age of 12, with 85 per cent having received at least one dose.

As countries around the world look for ways to motivate people to get vaccinated and impose restrictions and mandates to reduce spread of the coronavirus, observers say Italy — the European Union country hit first and hardest with more than 131,000 deaths — has struck something of a fine balance resulting in high vaccination rates and little political resistance. 

Italy's tough new green pass rules

Starting Oct. 15, Italy will become the first European country to require the so-called green pass — the digital or paper proof of vaccination, immunity or a negative test in the past 48 hours — in all places of work, both private and public. It's a step short of fully mandating vaccines, something Prime Minister Mario Draghi openly considered a month ago.

The new workplace green pass requirement is still one of the toughest in the world, giving workers five days of "unjustified absence," after which their salary can be suspended, though they can't be fired. Employees found inside the workplace without a green pass will face fines of up $2,100 Cdn; for employers who don't check workers' green passes, as much as $1,400 Cdn.

The Italian government first introduced the pass in June for international travel, then extended it to indoor restaurant dining and theatres, gyms and pools. In early September, it was extended further, to long-distance train rides, interregional buses and ferries, domestic flights and parents entering schools.

Italy's Health Minister Roberto Speranza appears regularly on television, soft selling the green pass and expressing understanding about the fear felt by vaccine-hesitant people, all the while trying to gently coax them toward getting inoculated.

"In political terms, the Draghi government is acting pragmatically. It's gradually driving up the vaccinated numbers, but without imposing a full vaccine mandate, which would risk triggering a backlash," says Lorenzo Pregliasco, head of polling company YouTrend.

"By slowly widening the number of activities where a green pass is required, you leave very little space for non-vaccinated people." 

Employers worry about enforcement 

Yet just days before its full implementation, many workplaces expressed frustration at the lack of information about implementation and enforcement.

Cristiana Liguori, the legal head at national cleaning company Mast, which employs more than 1,000 cleaners nationwide, considers the workplace green pass "an absolutely positive measure."

But she and her brother, CEO Domenico Liguori, say they have yet to receive finalized instructions from the government.

Instead, they have followed guidelines of Confindustria, Italy's employers' federation, sending out forms to workers to gauge how many already have passes and urging those with health exemptions to gather the documentation to prove it.

They're also unsure how much extra time and effort it will take to enforce the measures.

"If it's a question of scanning everyone as they arrive at work, we're talking about a few extra minutes each day," said Cristiana. "But if we have to deal with a technical problem or with people who kick up a fuss or finding workers to replace those who object and rejigging scheduling, well, that's when things get complicated."

Sally Silvers, a tax attorney based in Rome for more than 35 years, says she's exasperated by the lack of government support and information for small businesses.

"Big companies have an office to deal with this, but small businesses don't," she said. "So don't give us just the penalties, give us some practical stuff in how we're supposed to deal with it."

Hitting a vaccine ceiling

While the explicit rationale for the new green pass requirement is to make workplaces safer, the implicit goal is to put pressure on more people to get vaccinated, something Italy's COVID Emergency Commissioner Francesco Figliuolo says has happened.

In the week after the mid-September announcement of the pending workplace requirement, he reported that vaccination appointments rose between 20 per cent and 40 per cent from previous weeks.

YouTrend's Pregliasco says there may have been a slight initial spike in vaccinations, but data show first doses actually decreased after the announcement — not because it turned people off, but because as vaccination coverage rises, it eventually hits a ceiling of those fully willing to get a shot.

That leaves 10 to 15 per cent or so of the population that is anti-vaccine or vaccine hesitant, or that can't be vaccinated for health reasons. This results in a much slower daily roll out of vaccinations.

"It's possible the government announcement put a brake on the decrease in first vaccinations," said Pregliasco. "But without a control group, it's impossible to know."

'I may have to pay fines'

Among those in Italy who are anti-vaccine or vaccine hesitant is an unvaccinated wine producer in Tuscany who says she doesn't trust what is in the vaccine. CBC News has agreed not to name her because she said she feared a possible "witch hunt" against her.

She says for people in her situation there is little wiggle room, which prompted her to hire a lawyer to help follow the law. She says that of her nine employees, five are unvaccinated and she's encouraging them to work from home. For those who want to come in, she says the company will cover the cost of the required tests each week — a sum of about $65 per person.

She says it's a price worth paying, at least until the end of the year when the law expires.

"I follow all the regulations, mask wearing and social distancing inside the office. But as an employer, I don't feel like imposing health decisions on each and every employee," said the wine producer, 54.

"In our small town, several thousand people aren't vaccinated and we only have one pharmacist to handle the COVID testing. So, I'll do my best to make sure my staff is tested, but I may have to pay fines." 

But not all people in Italy who are against vaccination or vaccine hesitant are coming up with legal ways to deal with the green pass requirement — some say they have obtained fake versions of the digital pass. 

Experts say the number of fake green passes is likely negligible and that, while Italy's handling of the green pass roll out may not be perfect, the government strategy of avoiding shaming rhetoric combined with the incremental expansion of laws requiring the pass has been, on the whole, highly effective.

"Since COVID, my fellow cleaners and I have worked incredibly hard to make sure the spaces we clean are properly sanitized," says Stefania Chisté, a Mast employee who helps clean Rome's Castel Sant'Angelo monument near the Vatican.

"The green pass gives me extra reassurance. But we also need it to finally get out of this chaos. Until more people get vaccinated, we'll never leave it behind."