Italians locked down: people’s responses to early COVID-19 pandemic public health measures

SARS-CoV-2 spread rapidly worldwide from late 2019, with the WHO declaring a public health emergency of international concern on January 30, 2020 and a pandemic on March 11, 2020. Italy declared a state of emergency on January 31, 2020 and, as one of the earliest and hardest-hit countries, implemented stringent nationwide measures: closure of non-essential activities, schools and universities; severe restrictions on movement with self-declaration; and classification of heavily affected areas as red zones. On March 9, 2020 these measures were extended nationally, initiating a lockdown (phase one) that lasted until May 18, 2020, followed by gradual easing. Against this backdrop, the study aimed to explore how laypeople experienced and responded to public health measures during the first wave of COVID-19 in Italy, focusing on daily life, social relationships, and perceptions of public health management and challenges. Given the exceptional and evolving context, the study employed in-depth semi-structured interviews conducted remotely to capture nuanced, process-oriented experiences shortly after the lockdown’s implementation.

Contemporary studies across Europe examined mental health impacts and disruptions to daily life during lockdowns, as well as adherence to and perceptions of public health measures. In Italy, research focused on mental health and everyday life disruption, perceptions of measures, and links between risk perception and compliance. Some studies tracked changes over time across broader collection windows. Methodologies varied (semi-structured interviews, surveys, questionnaires, diaries), often shifting to online data collection due to pandemic constraints. This study aligns with Italian work on everyday impacts while adding a public health perspective by exploring views on pandemic management, challenges (e.g., resource scarcity), and the informational environment.

Design and setting: A qualitative, exploratory design employing remote, single, semi-structured interviews conducted during the Italian COVID-19 lockdown. The research team reflexively acknowledged how their own lockdown experiences informed the study’s conceptualization, research questions, and interview guide. Interview guide: Developed via team brainstorming to operationalize two main dimensions: (1) daily life during lockdown (changes, coping, priorities, relationships, perception of others); and (2) public health response and challenges (perceptions of measures; hypothetical criteria for ICU access under scarcity). A question on media and information was included for context. The guide comprised nine questions with probes; it was piloted once with no subsequent changes, and the pilot data were included in analysis. Recruitment and sampling: Purposive sampling aimed for balance by age, gender, education, and geographic area (North, Center, South and Islands). Recruitment used mediators identified through researchers’ networks. Mediators were briefed on aims and asked to identify and contact potential participants within their social circles, then facilitate contact with the research team for consenting, scheduling, and interviewing. Participants: N = 18 Italian residents (7 female; 11 male) with varied ages, educational levels (6 higher education; 12 secondary education), and residence (Center 7; North 6; South and Islands 5). Data collection: Semi-structured interviews were conducted online/remotely during the lockdown period, shortly after lockdown implementation. Analysis: Interviews were analyzed using qualitative content analysis to identify themes and patterns regarding daily life changes, social relationships, perceptions of public health measures, ICU resource allocation views, and media/information navigation.

• The lockdown reshaped daily routines, work arrangements, and social relations. Participants described an initial phase of disruption, followed by understanding, acceptance, and progressive adjustment to new routines, which helped manage stress and anxiety.
• Work-from-home adaptations reduced commuting stress and enabled more family time and engagement in hobbies; some experienced reduced stress from fewer in-person social demands.
• Social polarization emerged: respondents reported heightened social control and blame dynamics (“us vs. them”), both observing and experiencing censure regarding adherence to rules (e.g., mask-wearing, visiting restrictions). While some blamed noncompliers, others criticized excessive policing by “balcony sheriffs.”
• Relationships: close relationships were also affected; some participants reported discomfort with newly revealed attitudes, prompting reflection on the meaning of friendship and valued ties. Positive notes included strengthened existing bonds, solidarity, and framing mask use as respect for others.
• Public health measures were generally seen as acceptable, adequate, necessary, and sometimes perceived as overdue. However, they also generated uncertainty, fear, and confusion, particularly around what was permitted (e.g., work attendance), revealing tensions between public health goals and economic interests.
• Health system strain and inequities: respondents perceived inadequacy and lack of coordination across regional/national levels, resource scarcity, and highlighted socioeconomic disparities (e.g., housing, access to outdoor space, remote work feasibility) affecting how bearable restrictions were.
• ICU resource allocation: many struggled to articulate selection criteria and distanced themselves from such decisions, often deferring to healthcare professionals. Criteria mentioned included age (often prioritizing younger), likelihood of survival, societal role (e.g., prioritizing health professionals and researchers), and in some cases excluding those acting against the collective (e.g., rule transgressors), though such punitive criteria raised fairness concerns.
• Information and media: participants reported confusion, sensationalism, and conflicting messages, eroding trust and increasing uncertainty. Many adopted more critical information practices (cross-checking sources, evaluating provenance) to navigate the “infodemic.”
• Sample statistics: N = 18; Gender: 7 female, 11 male; Education: 6 higher education, 12 secondary education; Area: Center 7, North 6, South and Islands 5. Age groups reported included 25–34 (5), 35–44 (7), 45–54 (3), 55–64 (4), 65–74 (1), 75–84 (1).

Participants experienced lockdown as a dynamic process, moving from disruption toward adaptation via time/space reorganization and coping strategies. Social polarization and blame narratives accompanied rule adherence and enforcement, reflecting tensions captured in concepts like “covidiots” and pandemic fatigue. While measures were broadly accepted as necessary, respondents perceived trade-offs with economic interests and highlighted how the pandemic exposed and amplified existing socioeconomic inequalities. The ICU scarcity scenario was ethically challenging for laypeople; views overlapped with professional triage principles (e.g., maximizing benefits, considering age and survival likelihood) but also raised concerns about transparency and fairness. Prioritization of healthcare workers and researchers was seen as instrumental to resolving the emergency rather than compensatory. Regarding information, participants navigated an infodemic with heightened critical scrutiny, seeking reliable sources amid perceived sensationalism and contradictions. These findings illuminate how public perceptions, trust, and social dynamics shape the lived experience of emergency measures and have implications for communication strategies, equity-focused policy design, and transparent triage protocols during health crises.

This qualitative study captured Italian residents’ early responses to stringent COVID-19 public health measures, highlighting substantial reshaping of daily life and relationships, general acceptance of restrictions alongside uncertainty and stress, ethical discomfort with ICU triage decisions, and a shift toward more critical consumption of information. Insights into social dynamics (e.g., polarization, social control), perceived health system strain, and inequities can inform public health preparedness and policy-making in future emergencies. Policymakers and researchers can benefit from integrating qualitative evidence on public attitudes and experiences, improving risk communication and transparency, and addressing structural inequities that shape the feasibility and burden of restrictions. Future research should examine longer-term social and behavioral changes and how evolving evidence and policies interact with public trust and compliance over time.

As an exploratory qualitative study with purposive sampling and a small sample (N = 18), findings are not representative or generalizable to the broader population. Data were collected during the lockdown and relatively soon after measures were implemented, capturing early-stage experiences that may evolve over time. The short timeframe limits assessment of longer-term mindset and behavioral changes. Remote data collection and reliance on mediators may have influenced participation and perspectives. Privacy/ethical constraints limit public data sharing.