COVID-19 hit Italy in February 2020 after its outbreak in China at the beginning of January. Why was Italy first among the Western countries? What are the conditions that made Italy more vulnerable and the first target of this disease? What characteristics and diffusion patterns could be highlighted and hypothesized from its outbreak to the end of March 2020, after containment measures, including a national lockdown, were introduced? In this paper, we try to provide some answers to these questions, analyzing the issue from medical, geographical and planning points of view. With reference to the Italian case, we observed the phenomenon in terms of the spatial diffusion process and by observing the relation between the epidemic and various environmental elements. In particular, we started from a hypothesis of the comparable economic, geographical, climatic and environmental conditions of the areas of Wuhan (in the Hubei Province in China, where the epidemic broke out) and the Po Valley area (in Italy) where most cases and deaths were registered. Via an ecological approach, we compared the spatial distribution and pattern of COVID-19-related mortality in Italy with several geographical, environmental and socio-economic variables at a Provincial level, analyzing them by means of spatial analytical techniques such as LISA (Local Indicators of Spatial Association). Possible evidence arose relating to COVID-19 cases and Nitrogen-related pollutants and land take, particularly in the Po Valley area.
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