Italy has adopted seemingly draconian measures to stop the outbreak of COVID-19 that had killed 463 people in the country as of Monday and forced a further 733 into hard-pressed intensive care units.

Some 17 million people are now in quarantine in the northern region of Lombardy and in 14 other provinces, including Venice. The government has also closed down public spaces such as gyms and pools in these areas, and severely restrained the use of bars and restaurants. Theaters, cinemas and museums will be shut across the country.

These steps, which follow an earlier decision to close down schools across the country, are the harshest in Europe, reflecting the magnitude of the outbreak in Italy. Yet they still fall short of the measures China took in January to contain an outbreak in the city of Wuhan and the surrounding region of Hubei. This shows the limits of how far a democratic state can go to constrain the liberties of its citizens when dealing with a medical emergency — and raises questions about how effective the measures will be.

The Italian government issued a decree last weekend, saying that people who live in an area that spans the north and the center of the country must remain within it until April 3. These citizens have been told to stay at home and only go out to work or to fulfill their basic needs. Shops can stay open — alongside public offices — but they must make sure there’s enough space for people to be sufficiently far from each other.

The main reason for these measures is to slow down and contain the virus, which has infected more than 9,000 individuals. The outbreak is putting a serious strain on hospitals and, in particular, intensive care units in Lombardy — which has one of the best health care systems in the country. The fear is that the size of the epidemic will become impossible to manage, and that the outbreak will move decisively south, where hospitals are less well-equipped. The hope is to replicate the success of China, which managed to constrain the spread of COVID-19 in Wuhan thanks to a range of extremely strict measures. These included very severe travel restrictions and limitations of movement within the city.

However, Italy’s steps are less limiting than one might have anticipated. The government is letting people move around the affected areas, and even to leave them, for work- or health-related reasons. Rome says it will fine or arrest those who break the rules, but it will be difficult to patrol such a vast area. Individuals will only need a written statement to prove that they’re traveling for work — a system that’s open to abuse.

These difficulties point to the fundamental problem in keeping in check such a dangerous epidemic in a democratic country that values fundamental liberties such as the freedom to move around. The government also wants to protect the nation’s economy, which is already suffering from a sharp contraction in domestic and foreign demand — hence the openness to employment travel and the decision to let people keep going to work as usual.

The decree appears to be more of an instrument to try to persuade people to find ways to stay at home as much as possible, rather than as a list of enforceable prescriptions. This makes it very different — and potentially much less effective — than China’s crackdown in Wuhan.

As the outbreak hits other western countries, including the United States, Germany, France and Britain, they too will face the same dilemma as Italy. For all their persuasive powers, governments will need substantial collaboration from their citizens to be able to slow down the virus and return to a normal life. Democracies trust their citizens, now it’s time for us to earn that trust.

Ferdinando Giugliano writes columns on European economics for Bloomberg.

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