DONALD TRUMP’S mercifully short and atypical experience of Covid-19 does rather demonstrate that when you have access to the most expensive healthcare system in the world, top-class doctors, whatever drugs they prescribe and urgent need to contest an election, that the only thing to do is blow dry your hair, tuck in your tummy and put a smile on your face.

He was a bit unsteady, with a slight glaze on his scrubbed visage, but the Commander-In-Chief — the one who didn’t actually go to war — put on a brave face. Displaying symptoms suggestive of “steroid euphoria” he appeared ready for a fight. Steroids plus an outsize ego and we have a jet-powered POTUS. For a while, possibly.

The train crash that is the US response to the pandemic is a good demonstration of the role that ideology plays in public policy. A private-insurance-based health system that excludes millions of people from healthcare and puts expensive medical treatment beyond the incomes of millions more inevitably leaves a big space for infections like Covid-19 to spread.

But the stories that emerge from the White House, not least from correspondents working in there, reveal that mask-wearing is rare and that a cavalier approach to social distancing is rampant. This has inevitably led to an outbreak of infection.

The dominant private good/public bad ideology among the elite has predictable effects on the US public-health system, but within those broader social circles that take Trump’s prognostications seriously the absence of sensible precautions means that the rate of infection is magnified beyond the level that neglect and social exclusion have engendered.

If we set aside the alternative conspiracy theory that this is a contrived “fake news” operation designed to enhance his electoral prospects, the surprise is not that Trump went down with the infection, but rather that it took so long to happen.

Here in Italy there has been a rise in infection, most recently in Calabria in the South, which so far has been spared the high levels that placed such a big strain on the health system earlier this year in the northern regions of Lombardy, Piedmont and Veneto.

But Italy’s handling of the coronavirus has been remarkably successful and has earned plaudits from sources as diverse as the World Health Organisation and that august journal of Cold War convention, the Foreign Affairs magazine.

Notably the latter downplayed the contribution of Chinese, Russian and Cuban health teams that offered an early reinforcement of Italy’s hospitals in such stark contrast to the EU.

Earlier this year Covid-19 imposed a deathly grip on Italy’s health system, particularly in the North.

The sight of military convoys trundling through deserted streets laden with corpses, the exhausted medical personnel, the empty streets and deserted piazzas, the downturn in production and the slow pace of economic activity added to a picture of despondency and real fear.

Six months later and the infection rate is down to levels comparable with the nominally better-organised societies like Germany or some of the Nordic countries.

My neighbour, like many people here in the Alte Langhe, combines the management of his family hazelnut farm with another profession – in his case a responsible job as an economist in Turin.

Between the rather disappointing hazelnut harvest and the Eurozone’s problems you might think him despondent. But he says he feels quite optimistic with Italy’s handling of the coronavirus and mischievously remarks that where Italy is traditionally presented as governed in chaos by incompetents, that mantle has now passed to Britain.

Italy’s test-and-trace system is rooted in its local public-health administration. Where people are tested positive for Covid-19 they are isolated and their contacts are traced and tested. Like any system it isn’t perfect but it is fit for purpose and it works.

Compare this to Britain’s chaotic, private-sector system, which is convulsed by the latest discovery that 50,000 people who should be in isolation but whose data from the test sites fell out of the Excel spreadsheets because they apparently exceeded the capacity of the software.

A failure to appear in statistics is one problem, but people who tested positive a fortnight ago are self-isolating while their contacts are off the radar. This has resulted in an uncontrolled and unmonitored infection problem that now is impossible to sort out.

The government predictably will blame Public Health England but the totality of the problem is rooted in the failure to mobilise the existing framework of public-health administration. This has a robust and long-standing network that integrates regional and local administration.

With the ready availability of tens of thousands of GP practices and local health centres that already have the most extensive databases of the real live human beings who are the subject of any test-and-trace programme, we have a resource of great resilience

But gripped by the ideology of the market and an overweening urge to centralise power and patronage, the government has dispensed billions to a strikingly incompetent collection of private firms in a spending binge that sets new standards in political corruption.

Britain is well on the way to becoming the sickest nation in Europe.

By contrast Italy’s reputation is rather unjustified. It started this crisis with more intensive-care beds per 100,000 people than Britain. There is a strong streak of social solidarity, a powerful political tradition of collective values, resilient family structures and a distinct trend in public life that celebrates civic values.

This is helped along by an extraordinarily diffused system of local government with even the smallest commune in possession of real authority and control of its own money coupled with an effective localised public-health administration.

The politics of the Covid-19 crisis quickly exposed the ideological vulnerabilities of Italy’s right-wing parties, most particularly the Lega which met the pandemic with a confused mixture of rhetoric and mismatched regional policies where it rules in the North.

Having left the government alliance with the Movimento Cinque Stella (M5S) earlier, in the expectation of forcing a general election which polls suggested might make his party the largest in the Assembly, Matteo Salvini was out-manoeuvred when the M5S teamed up with the Partito Democratica (PD) to form a government with the nominally non-partisan Giuseppe Conte as premier.

Conte has emerged with a measure of credit for Italy’s effective response to the crisis but perhaps with less confidence that Italy’s economic problems can so effectively be tackled.

Last month’s elections in a clutch of the country’s powerful regions were a setback for Salvini, with only a victory for his semi-fascist allies, Fratelli di Italia (Brothers of Italy), in the eastern region of Marche. He expected to defeat the PD, mostly running separately from M5S, in the central belt and Puglia but failed when a broad centre-left unity triumphed, albeit narrowly.

The coronavirus crisis has heightened the gap between a growing popular criticism of the European Union and the seemingly unshakeable grip that loyalty to the institutions of the EU has on the thinking of the centre-left party leaders.

The PD senses an opportunity as M5S sheds some of its right-leaning popular support to become more the junior partner in the governing alliance.

PD itself is somewhat more coherent now that a Blairite tendency led by former leader Renzi has become a separate entity, and some of the more left-wing tendencies — those still influenced by a certain connection to the PD’s communist origins — have returned to the fold.

PD leader Nicola Zingaretti told a gathering of his mayors from the traditionally red central regions that the co-operation with M5S was strengthening, but his main message was centred on what to do with a 37 billion euro stash from the European Stability Mechanism.

Somewhat imprecise was Zingaretti’s assertion that the health system was in need of radical reform with more health facilities and “a massive de-hospitalisation.”

There is no such thing as a free gift in the EU and the conditions attached to any cash will be to carry through the kind of structural reforms that inevitably accompany the neoliberal market model that the EU treaties make conditional.

Meanwhile, in an encyclical entitled Fratelli Tutti (Brothers All), Pope Francis — whose family origins lie in Piedmont — refused to meet US Secretary of State Mike Pompeo (whose family origins are in Abruzzo). He went on to condemn the “perverse” global economic system, which consistently keeps the poor on the margins while enriching the few.

Rejecting the concept of an absolute right to property for individuals, he stressed instead the “social purpose” and common good that must come from sharing the Earth’s resources.

The coronavirus pandemic has subverted “magic theories” of the market: “Neoliberalism simply reproduces itself by resorting to magic theories of ‘spillover’ or ‘trickle’ — without using the name — as the only solution to societal problems,” he wrote. “There is little appreciation of the fact that the alleged ‘spillover’ does not resolve the inequality that gives rise to new forms of violence threatening the fabric of society.”

Trusting neither to heavenly intervention nor to Trumpian theories, Italians have, spontaneously and independent of edict, tightened up their mask discipline.

Nick Wright blogs at 21century manifesto.