The COVID-19 pandemic, declared by the WHO in March 2020, prompted Italy to implement a strict nationwide lockdown. This unprecedented event presented a unique opportunity for social science research to investigate the impact of these public health measures on the Italian population. Italy was among the first countries severely affected by the virus, experiencing a high number of cases and deaths in the initial phase of the pandemic. The lockdown, implemented on March 9th, 2020, involved the closure of non-essential businesses, social activities, schools, and universities. Movement restrictions were enforced, with exceptions permitted only under specific circumstances and requiring self-declaration. This study aimed to understand the impact of these measures on everyday life, explore people’s perceptions of the measures, and investigate their views on the public health challenges associated with the emergency. Previous research has examined the pandemic's impact on mental health and daily life disruption, and also investigated risk perception and behavior linked to adherence to public health measures. However, fewer studies integrated the public health perspective by exploring responses to the measures and views on public health management and challenges. This study utilized a qualitative approach, employing semi-structured interviews to gather in-depth insights. The study also acknowledges the researchers' personal experiences with the lockdown as shaping the research design and questions.

Existing literature examined the social impact of the pandemic and public health measures through various approaches, including studies focusing on mental health, the psychological impact of lockdown, and its effect on daily life in several European countries. Research in Italy similarly explored the lockdown’s impact on mental health and daily life disruption. Other studies concentrated on perceptions of public health measures, linking risk perception to behavior and adherence. Some studies included a wider timeframe to analyze the long-term effects of the lockdown and responses to public health measures. This study builds on this existing research by integrating the public health perspective, exploring both the impact on daily life and views on public health management and challenges during the early phase of the pandemic in Italy. The study's methodology, like many others conducted during the pandemic, shifted to an online approach due to the restrictions imposed.

This study employed a qualitative design using semi-structured interviews. The interview guide, developed through team brainstorming, focused on three main dimensions: daily life during the lockdown, relationships with others, and public health issues. Specific questions explored daily routine changes, advantages and disadvantages of the lockdown, shifts in priorities, changes in social relationships, perceptions of others, the perception of public health measures, hypothetical criteria for accessing scarce critical care resources, and the role of media and information during the pandemic. The final interview guide included nine questions, with follow-up questions used for clarification. Purposive sampling was used to recruit 18 participants, aiming for a balanced sample across age, gender, education, and geographical region in Italy. Recruitment was facilitated by mediators within the researchers' network, contacting potential participants from their social circles. The data was analyzed using qualitative content analysis. The sociodemographic data on the respondents is presented in Table 1 which shows details about the gender, age group, education and area of residence of the respondents.

The lockdown significantly altered participants' daily lives, impacting routines, work arrangements, and social interactions. Many adapted to the new circumstances by creating new routines and finding positive aspects like increased family time and reduced stress. However, challenges included difficulties in rearranging work spaces and routines, especially for those working from home. The pandemic led to a polarization between "us" and "them," with respondents reporting both engaging in and being subject to social control and judgment regarding adherence to public health measures. Trust in others' responsible behavior decreased. While many positively evaluated public health measures as necessary, they also reported feelings of uncertainty, fear, and confusion due to unclear guidelines and communication. The pandemic revealed existing inequalities, with the lockdown’s burden unevenly distributed among different socioeconomic groups. When asked about criteria for allocating scarce intensive care resources, respondents struggled, often avoiding direct answers and raising ethical concerns. They suggested various criteria, including age, likelihood of survival, societal role, and past behavior. However, many rejected age as a primary criterion, highlighting relational and sentimental considerations. Media and information played a crucial role, with respondents reporting confusing and sensationalistic coverage, leading to a heightened critical approach to information sources.

The study's findings highlight the dynamic and multifaceted impact of the early COVID-19 lockdown in Italy. The process of adapting to the lockdown was gradual, involving personal sensemaking and strategies for managing the challenges presented by the restrictions. The “us vs. them” dynamic observed reflects the psychological impact of a crisis situation, characterized by social control and uncertainty. The perceived ambiguity of public health guidelines, the revelation of existing social and economic inequalities, and the difficulties in defining criteria for resource allocation in critical situations underline the complexities of managing a public health emergency. The renewed critical engagement with media and information reflects the need for reliable and transparent communication during such events. The study's findings resonate with existing research on pandemic fatigue and the difficulties in maintaining adherence to public health measures over time. The study contributes to a deeper understanding of the social dimensions of public health emergencies, revealing the importance of clear communication, addressing social inequalities, and transparent ethical decision-making when implementing public health interventions.

This study offers valuable insights into the complex social impact of the early COVID-19 lockdown in Italy. The findings emphasize the need for nuanced public health policies that account for the dynamic nature of individual and societal responses to crises. Future research could explore the long-term impacts of the lockdown, investigate the evolution of social dynamics and attitudes towards public health measures, and further examine the ethical dilemmas related to resource allocation during public health emergencies. The study's qualitative approach offers a rich understanding of the lived experiences during this unprecedented time.

As an exploratory qualitative study, this research does not claim generalizability to the broader Italian population or other contexts. The relatively short timeframe of data collection, around two months after the lockdown began, may have limited the capture of long-term changes in attitudes and behaviors. The sample, while aiming for balance, may not fully represent the diversity of experiences within the Italian population. The reliance on mediators for recruitment could introduce biases.