matériel, but fear it could soon be surrounded, trapping a large number of Ukrainian troops.

Mr. Michta wrote for Politico.

“For the first time in the modern era,” he wrote, “it would force Moscow to come to terms with what it takes, economically and politically, to become a ‘normal’ nation-state.”

Reporting was contributed by Andrew E. Kramer and Valerie Hopkins from Kyiv, and Thomas Gibbons-Neff from Lysychansk, Ukraine.

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Silvio Berlusconi Angles for Italy’s Presidency, Bunga Bunga and All

ROME — Early this month, Silvio Berlusconi sat at a dining room table in his mansion with his girlfriend, more than a half-century younger, and an old political ally. As they feasted on a pumpkin souffle and truffle tagliatelle, the 85-year-old Italian former prime minister and billionaire made hours of phone calls, working his way down a list of disaffected lawmakers he hoped to persuade to elect him president of Italy next week.

“‘We are forming the Bunga Bunga party and we want you with us,’” Christian Romaniello, a lawmaker formerly with the anti-establishment Five Star Movement, recounted Mr. Berlusconi as saying, referring to the sex-fueled bacchanals that Mr. Berlusconi has deemed merely “elegant dinners.” According to Mr. Romaniello, Mr. Berlusconi then added, “‘But I’ll bring the ladies.’”

The Italian presidency, the country’s head of state, is a seven-year position usually filled by a figure of unimpeachable integrity and sobriety whose influence flows from moral authority. The current holder, Sergio Mattarella, is a quiet statesman whose brother was murdered by the mob. Another contender is Mario Draghi, the prime minister and a titan of European politics who has led the country to a period of unusual stability.

Then there is Mr. Berlusconi, who despite his recent bad health, waxen appearance and weakened political standing, is making an unabashed push to win a career-culminating position that he hopes will wash away decades of stains — his allies say unjustly thrown mud — and rewrite his legacy.

mob links and bribing lawmakers; the tax fraud conviction; the ban from office; the sentence to perform community service in a nursing home; his use of his media empire for political gain; his use of the government to protect his media empire; the wiretapped conversations of his libertine party guests regaling the Caligulan extent of his bunga bunga debaucheries; his close relationship with the Russian president, Vladimir V. Putin, who gifted Mr. Berlusconi a large bed; his appraisal of Barack Obama as “young, handsome and sun tanned”; his comparing a German lawmaker to a concentration camp guard; his second wife’s divorcing him for apparently dating an 18-year-old.

It’s an unorthodox résumé.

Mr. Berlusconi’s conflicts of interest, judicial problems and past behavior made him less than an excellent candidate, said Emma Bonino, a veteran Italian politician and civil rights activist who once ran for the office herself. “I don’t think he would give a good image of our country in the world,” she said.

Mr. Berlusconi declined to comment for this article. But he and his team of longtime advisers are selling him as a moderate, pro-European champion of democracy and can-do capitalism. “I think Silvio Berlusconi can be useful to the country,” Mr. Berlusconi, speaking of himself in the third person, said in October.

In usual fashion, he is using all the levers at his disposal to reach the requisite majority of 505 votes in the secret balloting for the presidency among lawmakers that starts on Monday.

read the headline) and published an insert on his qualities (“hero of liberty”). Weeks ago, lawmakers opening their mailboxes found a photograph of Mr. Berlusconi, arms up and bathing in adoration, on the cover of an anthology of his speeches.

the great-grandfather has remained the father figure of the center-right, which now has — if united — the largest bloc of lawmaker electors in Parliament and a strong desire to choose the next president.

But Mr. Berlusconi’s insistence has caused a major headache for Matteo Salvini, the leader of the nationalist League party, both at work and at home. Mr. Salvini’s girlfriend is the daughter of Denis Verdini, one of Mr. Berlusconi’s closest advisers, who is publicly applying pressure — from house arrest after his conviction in a bankruptcy fraud case — to elect Mr. Berlusconi.

After years of promising Mr. Berlusconi that he would back his candidacy for president, Mr. Salvini sent a stinging message to Mr. Berlusconi this week, saying that, “We must verify if Berlusconi has the numbers before the start of voting next week.” Mr. Salvini indicated that he had somebody else in mind.

Giorgia Meloni, the hard-right leader of Brothers of Italy, the third party in the center-right alliance, spoke on Tuesday of the possibility of Mr. Berlusconi’s stepping aside, prompting speculation that he might drop out.

the cover of Espresso magazine.

For all Mr. Berlusconi’s seeming unsuitability to fill the role of head of state, his allies argue that Italians elected him multiple times, that political considerations motivated the magistrates who hounded him for decades and that he was a self-made and brilliant businessman who built an empire.

But his outsize appetites and self-interested use of power fueled a backlash that seeded and grew the enormous anti-establishment Five Star Movement, co-founded by the comedian Beppe Grillo, who once derided Mr. Berlusconi as a “psychotic dwarf.”

Five Star took power in 2018 as Italy’s leading party, and Mr. Berlusconi’s support dwindled. He took a back seat to the rising nationalists, first Mr. Salvini and then Ms. Meloni, and railed against Five Star as incompetent good-for-nothings and a threat to democracy. He mocked their trademark universal welfare plan as a joke. He called their power structure communist.

Five Star has since imploded and scattered members into a mixed group of lawmakers desperate to avoid new elections that would almost certainly cost them their jobs and pensions. Mr. Berlusconi has explicitly promised to keep the legislature going as president, has called the universal income plan good for the poor and showered gifts on former rivals.

Luigi Di Maio, the Five Star leader who once refused to join any government with Mr. Berlusconi, this Christmas accepted a centuries-old oil painting of Venice from the mogul’s collection, according to a person close to Mr. Di Maio, who declined to comment.

As Mr. Berlusconi worked the phones alongside his girlfriend, who is also a member of Parliament in his political party, he sat next to Vittorio Sgarbi, one of his former ministers and a lawmaker and television personality who is well liked by many Five Star members.

When Mr. Sgarbi called Mr. Romaniello, the former Five Star lawmaker, who was interrupted while making Carnevale masks with his two small children, he jokingly introduced Mr. Berlusconi as “a Grillo-following friend.”

In an interview, Mr. Romaniello said that he was flattered by the call and added that friends contacted by Mr. Berlusconi also respected the former prime minister’s phone banking and “positive charisma.” But Mr. Romaniello said that he still considered himself, politically, “an adversary,” adding that Five Star had been born “as the antithesis of Berlusconi.” A phone call, he said, would not win his vote.

By Tuesday, even Mr. Sgarbi had bailed on Mr. Berlusconi and was urging him to be a kingmaker.

“I don’t think he can do it,” he said in an interview, saying that the duo had only persuaded about 15 lawmakers to back him, far short, even if he had a base of about 450 conservative supporters, to win the election. “It’s useless to try if you don’t have the numbers.”

On Wednesday, as Mr. Berlusconi’s lawyers in Milan successfully argued for a delay in a bribery trial related to his bunga bunga tribulations until after the presidential vote, his team snapped back and vowed that he would persist and, as always, speak for himself.

“I will not disappoint those who have trusted me,” Mr. Berlusconi said.

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Italy Ponders a New Role for Draghi. Let the Politicking Begin.

The secrecy, and self-interested nature, of the vote makes it ripe for influence peddling. In recent days, opening gambits took the form of government-collapsing ultimatums, with Mr. Berlusconi saying that he would pull his party out of government if Mr. Draghi became president.

Secret negotiations between the nationalist League, led by Matteo Salvini, and the center-left Democratic Party, are already underway, with the aim of avoiding new elections, possibly by keeping Mr. Draghi as prime minister of a government consisting of political leaders rather than technocrats.

Many, though perhaps not Mr. Draghi, are hoping that after sufficient votes fail to materialize for presidential hopefuls in opening ballots, a reluctant Mr. Mattarella, 80, can be persuaded by a broad alliance to serve another term, or at least to stick around for a couple more years and leave a new term early.

In theory, that would allow Mr. Draghi to defer his dream job until after the vital recovery fund programs have been put in place. But a year or two is an eternity in constantly evolving Italian politics.

Mr. Draghi, no political neophyte, has added his own pressure, asking the political parties if it was at all imaginable for a government that splinters on the choice of a president — be it him or anyone else — to “come back together magically” to run the country.

But even Mr. Draghi has not been untarnished by the political sniping. His backers say that he has become a more politically cautious broker between the bickering parties than their firm leader. In his most recent news conference, the prime minister sounded defensive, insisting that he was the one really making decisions. His honeymoon period seems to have ended.

“There is a lot of noise in the system because of this presidential race,” Mr. Colao said, nevertheless acknowledging that political pressure had “on the margins” increased the urgency of getting modernizing projects into the pipeline.

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Biden Eases Fray with France and Savors Meeting with Pope as Europe Trip Begins

ROME — After a six-week diplomatic uproar over a scuttled submarine deal and accusations of American duplicity, President Biden made a one-on-one effort Friday to mend fences with President Emmanuel Macron of France by admitting that, yes, the matter could have been handled better.

“What we did was clumsy,” Mr. Biden told reporters hours after arriving in Italy to attend a summit with other world leaders. “It was not done with a lot of grace.”

By delivering an in-person mea culpa to the leader of one of America’s oldest allies, Mr. Biden signaled that he was ready to move on from an embarrassing spat that grew from a secretive American agreement with Britain and Australia to supply Australia with nuclear-powered attack subs, effectively canceling out a lucrative and strategically important French contract.

“I was under the impression that France had been informed long before that the deal was not coming through,” Mr. Biden said, effectively inviting his negotiating partners to shoulder some of the blame after weeks of weathering French ire. Later in the day, the two issued a joint statement that confirmed Mr. Biden’s support for America’s European allies to develop a “stronger and more capable European defense” as a compliment to NATO.

global agreement to set minimum levels of corporate taxation, aimed at stopping companies from stuffing income into tax havens. He will also prod other countries to assist in uncorking supply chain bottlenecks, announce a global task force to fight the coronavirus and urge investments to curb global warming.

But his trip began with a private audience with Pope Francis at the Vatican, a diplomatic meeting that the president, who was grinning broadly as he emerged from his presidential limousine, seemed to enjoy.

After spending about 90 minutes with Francis in the Vatican’s Apostolic Palace, Mr. Biden told reporters that the pope had called him a “good Catholic” who should keep receiving holy communion.

The apparent show of support would mark the first time the pope has explicitly pushed back against a campaign by conservative bishops in the United States to deny Mr. Biden, a fellow Roman Catholic, the sacrament because of his support for abortion rights. Asked if the two had spoken about abortion, the president said no, but that the topic of receiving the sacrament had come up.

“We just talked about the fact he was happy that I was a good Catholic,” Mr. Biden told reporters, “and I should keep receiving communion.”

have become common targets of powerful conservative American bishops seeking to undercut them.

Massimo Faggioli, a theology professor at Villanova University and author of “Joe Biden and Catholicism in the United States,” said there was “no question” that American bishops would be angered by the pope’s encouragement, and wondered whether the president had cleared his decision to speak publicly about it with the Vatican.

The heavily edited footage released by the Vatican appeared to underscore the warm bond shared by the two leaders. Mr. Biden clasped the pope’s hand and called him “the most significant warrior for peace I’ve ever met.”

After their private talk they exchanged gifts, and Mr. Biden gave the pope a presidential challenge coin that featured Delaware, his home state, and Beau’s Army National Guard unit. “I know my son would want me to give this to you,” he said.

As Francis showed Mr. Biden and Jill Biden, the first lady, to the door, Mr. Biden was in no rush to leave.

He unspooled a folksy yarn that referred to both he and the pope ascending to their positions later in life. In a nod to their ages — he is 78 and Francis is 84 — he relayed a story about Satchel Paige, the legendary Black player who pitched the majority of his career in the Negro Leagues, and who was allowed to join the Major Leagues only in his 40s.

“Usually, pitchers lose their arms when they’re 35,” Mr. Biden said to the pope, who seemed a little lost by the baseball reference. “He pitched a win on his 47th birthday.”

As Mr. Biden explained it, reporters asked the pitcher: “‘Satch, no one’s ever pitched a win at age 47. How do you feel about pitching a win on your birthday?’” and the pitcher responded: “‘Boys, that’s not how I look at age. I look at it this way: How old would you be if you didn’t know how old you were?’”

The pope looked at Mr. Biden.

“You’re 65, I’m 60,” the president said. “God love ya.”

Jim Tankersley contributed reporting from Rome, and Ruth Graham from Dallas.

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France Arrests Former Members of Italian Extremist Group

PARIS — The French police on Wednesday arrested seven former members of Italian left-wing extremist groups who had been convicted of terrorism crimes in Italy decades ago, but were given refuge in France.

A court will now decide if the militants, arrested at the request of the Italian authorities, can be extradited to Italy, a decision that could take several years depending on appeals.

Dozens of Italian leftist extremists were given refuge in France decades ago by the socialist government at the time if they agreed to renounce violence, a move that long poisoned the diplomatic relationship between France and Italy.

The government’s announcement of the arrests on Wednesday signaled an easing of that troubled relationship, with Prime Minister Mario Draghi of Italy and President Emmanuel Macron of France managing to establish closer ties in recent months.

Lotta Continua, which translates as “Continuous Struggle,” was also detained in France. Mr. Pietrostefani was sentenced to 22 years in prison for murdering the police chief of Milan, Luigi Calabresi, in 1972.

François Mitterrand, the former socialist president of France, instituted a policy in the 1980s when he was in office of granting asylum to leftist Italian militants — much to the anger of the Italian government, which requested their extradition — providing they renounced violence and were not wanted in Italy for murder or other “crimes of blood.” Some of the militants, like Mr. Pietrostefani, however, had been implicated in such crimes.

One of the beneficiaries of the so-called Mitterrand Doctrine who was arrested on Wednesday was Marina Petrella, a former Red Brigades member who fled to France in 1993 after being convicted of involvement in several murders.

In 2008, President Nicolas Sarkozy rejected a request from the Italian government to extradite Ms. Petrella, citing humanitarian reasons as her health was deteriorating. The refusal provoked outrage in Italy and revived dormant tensions between the two countries.

The French presidency said in its statement Wednesday that the arrests “fall strictly within the framework of the Mitterrand doctrine, since they are blood crimes.”

In 2019, Matteo Salvini, Italy’s interior minister at the time, said that he would “appeal to the French president to return to Italy some fugitives who do not deserve to drink champagne under the Eiffel Tower, but deserve to rot in jail in Italy.”

strategic alliance with Mr. Macron at the European level and Wednesday’s decision testified to this new working relationship.

Marta Cartabia, Italy’s justice minister, said she met with her French counterpart, Éric Dupond-Moretti, and that he had shown a “particular sensitivity” to the case and “decisive will to cooperate.”

Mr. Dupond-Moretti said he hoped the arrests “will allow Italy to turn a bloody and tearful page of its history after 40 years.”

Benedetta Tobagi, an Italian journalist and daughter of Walter Tobagi, a reporter who was killed in 1980 by a left-wing terrorist brigade, welcomed the decision in an editorial in the Italian daily La Repubblica on Wednesday.

But she added, “the anomaly is not the arrests, but the unreasonable persistence of the Mitterrand doctrine, the fact that it took so many years, and so much effort, to unblock the situation.”

Gaia Pianigiani contributed reporting from Rome.

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Young Italians Are Accused of Jumping the Line for Vaccines

Last year, in the worst days of the pandemic in Italy, old people died in record numbers. Now, as the country rolls out its vaccination campaign, national authorities have uncovered a rash of line-cutting by younger people and accused them of depriving the elderly and the most vulnerable of their shots.

The national military police, the Carabinieri, are fielding hundreds of reports of vaccine cheating, including by teenagers and people in their early 20s, and the prime minister has felt compelled to weigh in.

“Stop vaccinating people under 60. Stop vaccinating young people,” Prime Minister Mario Draghi said in a news conference last week.

“How can people in all conscience jump the line?” Mr. Draghi added. “Knowing that they leave exposed a person who is over 75 to a risk, a concrete risk of dying, or a fragile person?”

fined for flying to a remote town in order to get vaccinated.

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How Mario Draghi Has Made Italy a Power Player in Europe

ROME — The European Union was stumbling through a Covid-19 vaccine rollout marred by shortages and logistical bungling in late March when Mario Draghi took matters into his own hands. The new Italian prime minister seized a shipment of vaccines destined for Australia — and along with them, an opportunity to show that a new, aggressive and potent force had arrived in the European bloc.

The move shook up a Brussels leadership that had seemed to be asleep at the switch. Within weeks, in part from his pressing and engineering behind the scenes, the European Union had authorized even broader and harsher measures to curb exports of Covid-19 vaccines badly needed in Europe. The Australia experiment, as officials in Brussels and Italy call it, was a turning point, both for Europe and Italy.

It also demonstrated that Mr. Draghi, renowned as the former European Central Bank president who helped save the euro, was prepared to lead Europe from behind, where Italy has found itself for years, lagging behind its European partners in economic dynamism and much-needed reforms.

In his short time in office — he took power in February after a political crisis — Mr. Draghi has quickly leveraged his European relationships, his skill in navigating E.U. institutions and his nearly messianic reputation to make Italy a player on the continent in a way it has not been in decades.

denied her a chair, rather than a sofa, during a visit to Turkey last week, saying he was “very sorry for the humiliation.”

In his debut in a European meeting as Italy’s prime minister in February, Mr. Draghi, 73, made it clear that he was not there to cheerlead. He told an economic summit including heavy hitters like his European Central Bank successor, Christine Lagarde, to “curb your enthusiasm” when it came to talk about a closer fiscal union.

That sort of union is Mr. Draghi’s long-term ambition. But before he can get anywhere near that, or tackle deep economic problems at home, those around him say Mr. Draghi is keenly aware that his priority needs to be solving Europe’s response to the pandemic.

Italian officials say his distance from the contract negotiations, which were completed before he took office, gave him a freedom to act. He suggested that AstraZeneca had misled the bloc about its supply of vaccine, selling Europe the same doses two or three times, and he immediately zeroed in on an export ban.

“He understood straightaway that the issue was vaccinations and the problem was supplies,” said Lia Quartapelle, a member of Parliament in charge of foreign affairs for Italy’s Democratic Party.

On Feb. 25, he joined a European Council videoconference with Ms. von der Leyen and other European Union leaders. The heads of state warmly welcomed him. “We owe you so much,” Bulgaria’s prime minister told him.

Then Ms. von der Leyen gave an optimistic slide presentation about Europe’s vaccine rollout. But the new member of the club bluntly told Ms. von der Leyen that he found her vaccine forecast “hardly reassuring” and that he didn’t know whether the numbers promised by AstraZeneca could be trusted, according to an official present at the meeting.

He implored Brussels to get tougher and go faster.

Ms. Merkel joined him in scrutinizing Ms. von der Leyen’s numbers, which put the Commission president, a former German defense minister, on the back foot. Mr. Macron, who had championed Ms. von der Leyen’s nomination but quickly formed a strategic alliance with Mr. Draghi, piled on. He urged Brussels, which had negotiated the vaccine contracts on behalf of its members, to “put pressure on corporations not complying.”

At the time, Ms. von der Leyen was coming under withering criticism in Germany for her perceived weakness on the vaccine issue, even as her own commissioners argued that responding too aggressively with a vaccine export ban could hurt the bloc down the road.

Mr. Draghi, with his direct talk during the February meeting, tightened the screws. So did Mr. Macron, who has emerged as his partner — the two are dubbed “Dracon” by the Germans — pushing for a more muscular Europe.

Behind the scenes, Mr. Draghi complemented his more public hard line with a courting campaign. The Italian, who is known to privately call European leaders and pharmaceutical chief executives on their cellphones, reached out to Ms. von der Leyen.

Of all the players in Europe, he knew her the least well, according to European Commission and Italian officials, and he wanted to remedy that and make sure she did not feel isolated.

Then, in early March, as shortages of AstraZeneca’s Covid vaccine continued to disrupt Europe’s rollout and increase public frustration and political pressure, Mr. Draghi found the perfect gift for Ms. von der Leyen: 250,000 doses of seized AstraZeneca vaccine earmarked for Australia.

“He told me that in the days before he was on the phone a lot with von der Leyen,” said Ms. Quartapelle, who spoke with Mr. Draghi the day after the shipment freeze. “He worked a lot with von der Leyen to convince her.”

The move was appreciated in Brussels, according to officials in the Commission, because it took the onus off Ms. von der Leyen and gave her political cover while simultaneously allowing her to seem tough for signing off on it.

The episode has become a clear example of how Mr. Draghi builds relationships with the potential to yield big payoffs not only for himself and Italy, but all of Europe.

On March 25, when the Commission became suspicious over 29 million AstraZeneca doses in a warehouse outside Rome, Ms. von der Leyen called Mr. Draghi for help, officials with knowledge of the calls said. He obliged, and the police were quickly dispatched.

In the meantime, Mr. Draghi and Mr. Macron, joined by Spain and others, continued to support a harder line from the Commission on vaccine exports. The Netherlands was against it, and Germany, with a vibrant pharmaceutical market, was queasy.

When the European leaders met again in a video conference on March 25, Ms. von der Leyen seemed more confident in the political and pragmatic advantages of halting exports of Covid vaccines made in the European Union. She again presented slides, this time authorizing a broader six-week curb on exports from the bloc, and Mr. Draghi stepped back into a supportive role.

“Let me thank you for all the work that has been done,” he said.

After the meeting, Mr. Draghi, however modestly, gave Italy — and by extension himself — credit for the steps allowing export bans. “This is more or less the discussion that took place,” he told reporters, “because this was the issue originally raised by us.”

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Italy Pushes Back as Health Care Workers Shun Covid Vaccines

ROME — Giulio Macciò tested negative for the coronavirus and spent weeks receiving treatment for emphysema in a sealed-off hospital under the care of doctors and lung specialists — and a nurse who had refused to be vaccinated. On March 11, he unexpectedly died. A post-mortem swab found that he had contracted the virus, as had 14 other patients and the unvaccinated nurse who spent her shifts in his midst.

“It makes no sense that a person whose job is to heal the sick gives them Covid and kills them,” said Mr. Macciò’s son, Massimiliano Macciò, who filed a complaint against the San Martino hospital in the northern Italian city of Genoa. He believes that the nurse, one of an estimated 400 who have refused vaccination against Covid-19 at the hospital, infected his father, who died unvaccinated at 79.

As vaccination rollouts build momentum, businesses everywhere are grappling with whether they can require the inoculation of their employees, raising thorny ethical, constitutional and privacy issues around Europe and the United States. But that quandary becomes all the more urgent when the person is your health care worker.

In Italy, the original Western front in the war against Covid, a rash of outbreaks in hospitals where medical workers have chosen not to be inoculated has raised fears that their stance is endangering public health. It has also prompted a forceful response from an Italian government that is struggling to get vaccinations on track.

pronouncement by Italy’s data protection authority that the vaccination status of health workers should be unknown. “But this right exists until it does not limit another person’s right,” Mr. Petralia said.

made some vaccinations compulsory for children, including for measles, and barred the unvaccinated from attending school — a decision backed by Italy’s constitutional court because it also safeguarded public health. In the northern city of Belluno, a court ruled in mid-March that a nursing home that employed several health care workers who chose not to get vaccinated could force them to take paid leave.

Mr. Macciò, whose father died in Genoa, said it made no sense that the people entrusted to care for his father were allowed to potentially harm him. He said he had complained to the doctors, who told him their hands were tied because the nurses were protected by privacy rules.

But amid Italy’s frustration, and the new decree, something appears to be changing. Mr. Macciò said the police had asked for his help in identifying the nurses he saw when going to pick up his father’s belongings.

“I hope some good comes of it,” he said of his father’s death. “These people should change their job.”

Emma Bubola contributed reporting.

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Why Supply Isn’t the Only Thing Stymying Europe’s Coronavirus Vaccine Rollout

On Wednesday, Mr. Draghi said that differing approaches by the regions to vaccinating people over the age of 80 was unacceptable, adding that some “neglect their elderly to favor groups who claim priority based probably on some contractual power.”

In Tuscany, a region usually admired for its health care system, only about 6 percent of people over the age of 80 have been fully vaccinated, prompting a public letter from leading citizens.

“Inefficiency,” they wrote, “produces deaths.”

Matteo Villa, a researcher at the Italian Institute for International Political Studies who has studied the coronavirus pandemic, said that Italy’s strategy of first vaccinating only health care workers had resulted in a bottleneck that made the virus more deadly.

“When the delays came,” he said, “we still had a lot of elderly people to vaccinate.”

Guido Bertolaso, the former head of Italy’s civil protection agency who is now in charge of the vaccine campaign in Lombardy, said the country had failed to act on emergency footing.

He blamed pharmaceutical companies not making good on their promised deliveries for Italy’s problems. “When you plan, you must know where you get the vaccine, at what time, which amount, on a weekly basis,” he said. In any case, he added, “In Italy with planning, we are not very good.”

Avoidable organizational and logistical problems have slowed the rollout and infuriated Italians. In Lombardy, a wealthy northern region at the center of Italy’s outbreak, intensive care wards are still packed with older and dying Italians, making it an emblem of Italy’s missteps.

“Every time the phone rings, I hope it’s them,” said Ester Bucco, 84, from Castiglione Olona, in the Lombardy region, who registered two months ago to get vaccinated but has yet to get an appointment. She walks around the house carrying her home phone and said she had started taking anti-anxiety pills to cope. “I really want to see my grandchildren.”

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Supply Isn’t the Only Thing Stymying Europe’s Vaccine Rollout

On Wednesday, Mr. Draghi said that differing approaches by the regions to vaccinating people over the age of 80 was unacceptable, adding that some “neglect their elderly to favor groups who claim priority based probably on some contractual power.”

In Tuscany, a region usually admired for its health care system, only about 6 percent of people over the age of 80 have been fully vaccinated, prompting a public letter from leading citizens.

“Inefficiency,” they wrote, “produces deaths.”

Matteo Villa, a researcher at the Italian Institute for International Political Studies who has studied the coronavirus pandemic, said that Italy’s strategy of first vaccinating only health care workers had resulted in a bottleneck that made the virus more deadly.

“When the delays came,” he said, “we still had a lot of elderly people to vaccinate.”

Guido Bertolaso, the former head of Italy’s civil protection agency who is now in charge of the vaccine campaign in Lombardy, said the country had failed to act on emergency footing.

He blamed pharmaceutical companies not making good on their promised deliveries for Italy’s problems. “When you plan, you must know where you get the vaccine, at what time, which amount, on a weekly basis,” he said. In any case, he added, “In Italy with planning, we are not very good.”

In Lombardy, a wealthy northern region at the center of Italy’s outbreak, intensive care wards are still packed with older and dying Italians, making it an emblem of Italy’s missteps.

“Every time the phone rings, I hope it’s them,” said Ester Bucco, 84, from Castiglione Olona, in the Lombardy region, who registered two months ago to get vaccinated but has yet to get an appointment. She walks around the house carrying her home phone and said she had started taking anti-anxiety pills to cope. “I really want to see my grandchildren.”

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