Health governance of COVID-19 in Milan and Toronto: long-term trends and short-term failures

Abstract In this paper, we examine a crisis in the governance of health and care that characterized the regions of Milan and Toronto, which the COVID-19 pandemic impacted substantially—both in early 2020 when SARS-CoV-2 first hit and later in the fall and winter when the disease entered its second and third waves. We analyze restructuring in health and care in both regions, and, where necessary, in national contexts. We make the case that restructuring and implementing welfare and health policy, including long-term care, in Toronto and Milan in the context of long-standing tendencies of health governance restructuring that were part of a more general rescaling of the regional welfare state be held responsible for the toll COVID-19 levied. This paper is part of the SPE Theme on the Political Economy of COVID-19.