ROME — The coronavirus was already a disaster for Meorina Mazza. In March, it sickened her brother, killed her cousin and prompted officials in Italy’s southern region of Calabria to quarantine her seaside town of San Lucido.
But the lockdown also cut her off from her off-the-books shifts as a kitchen hand and made it harder to apply for welfare. Now she is relying on donations of flour to feed her daughters, but still has no money to pay her electricity bills.
“We are really headed toward total desperation,” said Ms. Mazza, a 53-year-old mother of two.
Italy’s coronavirus epidemic, among the deadliest in the world with more than 24,000 deaths, first exploded in the country’s wealthy north, where it stretched one of Europe’s most sophisticated health care systems to the limits. But it is the country’s poorer, less developed south that has loomed over the entire crisis and figured prominently in the government’s decision to lock down all of Italy last month.
Now, with the Italian government’s plan to begin a gradual reopening of the country on May 4, some southern leaders remain so fearful of the potential of the virus to devastate their regions that they have suggested they would ban northerners if they rushed to lift the lockdown.
Southern Italians are already fighting a war on two fronts, facing both the rampages of the virus as well mounting economic carnage not seen since the period immediately following World War II.
The widespread eruption of the virus in Calabria “would have been a catastrophe,” said Jole Santelli, Calabria’s president, who took the drastic step of sealing off the entire region in March, helping prevent a disastrous outbreak. But the economic damage, she said, “will be enormous.”
That toll is already apparent, even as the south has generally avoided the worst of the pandemic.
The poor, used to scraping by on jobs in the informal economy, are increasingly dependent on handouts. Troubling, if scattered, reports of social unrest have punctured the Italian narrative of patriotic sacrifice. Officials are concerned that organized crime is exploiting the crisis by stepping in as providers of loans and, in some cases, food.
The coronavirus has been the great revealer of the weaknesses of governments, systems and societies everywhere it goes across the world. In Italy, it wasted no time laying bare the country’s most confounding and enduring problem: the economic and social inequality between the north and south.
Italy’s unification, in the mid-19th century, has been interpreted by many scholars as a conquest of the feudal south by the north’s Savoy kingdom in what was essentially a civil war.
Over the next 150 years, the armed guards for the south’s vacant landowners slowly usurped influence, developing into the powerful organized crime bosses who helped complicit politicians develop a system that exchanged votes for services. All of this corruption and violence helped keep the south poor.
Health care, in particular, remains one area where a mix of political patronage, bad management and the influence of organized crime has left the south far behind.
Even before the virus struck, some of the hospitals in the region were so deeply in debt, they had to be put under external administration, and southerners often traveled north for medical procedures.
“The health system in the south cannot hold a candle to the northern one,” said Giovanni Rezza, director of the infective illness department at the National Health Institute.
Ms. Santelli, whose office is similar to that of an American governor, said she had closed off Calabria for fear that infected workers returning from the north would break a “rather weak” hospital system.
In the region’s Cetraro hospital, the appearance of a single coronavirus patient forced the entire emergency room to be closed and completely sanitized because administrators had not set up a distinct path to avoid contamination.
“If the wave they had up north arrived here,” said Dr. Pino Merlo, 60, a doctor at the Cetraro, “we wouldn’t be able to withstand it.”
At least for now, the south is holding out against the virus. In the south, there have been about 1,500 deaths attributed to the virus, compared with more than 20,000 in the north.
But as the south keeps the virus at bay, the threat has become economic.
In San Lucido, Ms. Mazza’s brother spent more than a month in the hospital as she used flour to make a breakfast cake that her daughters ate throughout the week.
Sergio Malito, who works in the town hall, said the dread of contagion was morphing to fear that the stores would not reopen, that the fishing wouldn’t restart, that the tourists wouldn’t come. “We will be ruined,” he said.
That feeling is widespread. A video of desperate residents shouting outside banks in the southern city of Bari, on the opposite coast, went viral.
Those fears are compounded by the economic troubles that were prevalent even before the virus arrived. Unemployment in the south hovers around 18 percent, almost triple that of the north, while its youth unemployment rate is around 50 percent, according to Eurostat.
More than 3.5 million workers in Italy operate off the books, accounting for about 12 percent of the country’s G.D.P., according to Italy’s National Institute of Statistics. Much of that activity is in the south, an area of about 20 million people that encompasses the six regions and two southern islands south of Rome.
But even for those in the mainstream economy, hardships can multiply exponentially, like the contagion itself, once their lives have been sideswiped by the virus.
In Naples, Arianna Esposito spent days trying to get her mother hospitalized but health workers repeatedly told her that her mother wasn’t sick enough to be tested.
When her mother’s condition deteriorated, dispatchers on the coronavirus emergency line said she didn’t sound out of breath enough. Her lips turned purple and the ambulances finally came, but she died en route to the emergency room. Her father died in an intensive care ward days later.
They left behind a shuttered store that sold detergent and cleaning products.
“Now we can use what is left in the house to eat, but we don’t have much,” said Ms. Esposito, 27, whose parents had provided a home and the only income for her and her year-old son. “Now we are even more scared because we know that nobody helps you.”
The boy’s father worked off the books in another shop that has closed, too.
The region’s widespread use of off-the-books workers constituted a vibrant “street economy,” said Luca Bianchi, director of an association for industry development in southern Italy. But it meant that when the lockdowns came, those workers were hit hardest because they had no access to government relief packages.
The Campania region’s president, Vincenzo De Luca, said he had prepared a nearly billion-euro relief package, or $1.09 billion, for workers.
“No one will die of hunger,” he said. “This I can absolutely guarantee.”
But he said he had urged the federal government to find a way to address the “big problem” of motivating the thousands who make a living off the books to come out of the black market’s shadows and ask for help. Otherwise, he said, “they could never declare themselves illegal, or declare the businesses that they work for as illegal.”
Mr. De Luca worries that the local mob, the Camorra, may seek to exploit the crisis, and said one reason the region had put together an ambitious relief package was “to close the door to organized crime.”
Already in Naples, the Italian media has reported that the Camorra is using the pretext of delivering food to be on the streets to sell drugs, or to shake down shop owners for donations to the poor.
Michele Emiliano, the president of the region of Puglia, and a former prosecutor, told reporters recently that mob bosses were most likely meeting via teleconferences like other businesses.
Mr. Emiliano dismissed reports of a brewing rebellion in the south as “nonsense.” But he said he thought Italy was making a “strategic error” by not focusing on reopening the south before the north. If the smaller outbreaks in the south are eliminated, he said, it could create hospital space for sick northerners, and also allow for the relocation of production from the north.
Other southern leaders consider the notion of attracting the north’s business a fantasy, and argue that the regions need to focus on keeping the virus out and the people fed.
“These are the new poor of the coronavirus,” said Cateno De Luca, the mayor of the Sicilian city of Messina.
Mr. De Luca has become well known in Italy for trying to personally turn back mainlanders arriving on the island. He has insulted government ministers critical of his actions and argued that given the state of the Sicilian health system — doctors, he said, are forced to “wage war with toothpicks in their hands” — even a small rise in infections would be fatal.
So, he said, would a failure to begin planning an economic recovery.
“We don’t start from zero,” he said. “We start from less than zero.”
Emma Bubola contributed reporting from Milan.