ABSTRACT
Background: The COVID-19 pandemic appears to have struck Italy in two waves.Objective: To analyse the differences between the first (W1) and the second wave (W2).Methods: Our analysis was based on weekly data retrieved from the Official Bulletin of the Italian Civil Protection Department from 1 March 2020 to 21 January 2021.Results: W1 lasted about 23 weeks, from March to 15 August 2020. W2 started on 16 August and was still underway on 21 January 2021.W2 is much more severe than W1 in terms of positive cases and deaths, and its decay is much slower.We have identified at least six different causes of these differences: the colder season, the impact of seasonalinfluenza, viral mutation, the lack of a plan to tackle viral resurgence, poor care of elderly people, and lack of oralhygiene as an important preventive measure. Moreover, in an attempt to give the best possible informationthrough the media, the experts have instead caused feelings of uncertainty and fear.Conclusions: There are several reasons for the differences between W1 and W2: the start of the colder seasonduring W2, poor care of elderly people, the delay in providing seasonal influenza vaccination, the lack of anational plan against COVID-19 resurgence, confusion over the lockdown measures, lack of information aboutoral hygiene, and confusing information given through the media.