A network model of Italy shows that intermittent regional strategies can alleviate the COVID-19 epidemic

Abstract
The COVID-19 epidemic hit Italy particularly hard, yielding the implementation of strict national lockdown rules. Previous modelling studies at the national level overlooked the fact that Italy is divided into administrative regions which can independently oversee their own share of the Italian National Health Service. Here, we show that heterogeneity between regions is essential to understand the spread of the epidemic and to design effective strategies to control the disease. We model Italy as a network of regions and parameterize the model of each region on real data spanning over two months from the initial outbreak. We confirm the effectiveness at the regional level of the national lockdown strategy and propose coordinated regional interventions to prevent future national lockdowns, while avoiding saturation of the regional health systems and mitigating impact on costs. Our study and methodology can be easily extended to other levels of granularity to support policy- and decision-makers.

An ongoing global debate concerns effective and sustainable lockdown release strategies in the current pandemic. Here, the authors implement a network model at healthcare-relevant spatial scale to show that coordinated local strategies can be effective in containing further resurgence of the disease.

Introduction
Regionalism is an integral part of the Italian constitution. Each of Italy’s twenty administrative regions is independent on Health and oversees its own share of the Italian National Health service. The regional presidents and their councils can independently take their own actions, strengthening or, at times, weakening national containment rules. Previous studies have modelled the spread of the epidemics and its evolution in the country at the national level1–5, and some have loo