Outside Mainland China, some cruise ships were quarantined after passengers developed symptoms or tested positive for 2019-nCoV. The Costa Smeralda was quarantined on 30 January off Civitavecchia in Italy, after passengers developed flu-like symptoms – the quarantine was lifted when tests for the virus came back negative. Two further ships were quarantined on 5 February: Diamond Princess in the Port of Yokohama, Japan and World Dream, which returned to Hong Kong after being refused entry to Kaohsiung, Taiwan. In both cases, passengers and crew tested positive and the ships remained quarantined as of 6 February.
On 31 January 2020, Italy closed all passenger air traffic between Italy and China and Taiwan. The Italian Civil Aviation Authority NOTAM says that effective 31 January, all passenger flights from China, including the special administrative regions of Hong Kong and Macau, and Taiwan are suspended until further notice, on request of the Italian health authorities. Aircraft that were flying to Italy when the NOTAM was published, was cleared to land. On the same day, the WHO declared that the number of infected cases is 9826 and 213 confirmed death case
The Lombardy outbreak came to light when a 38-year-old Italian tested positive in Codogno, a comune in the province of Lodi. According to his wife, he had met an Italian friend who had returned from China on 21 January, who subsequently tested negative. On 14 February, he felt unwell and went to a doctor in Castiglione d'Adda. He was prescribed treatments for influenza.
On 16 February, as the 38-year-old man's condition worsened, he went to Codogno Hospital, reporting respiratory problems. Initially, there was no suspicion of COVID-19, so no additional precautionary measures were taken, and the virus was able to infect other patients and health workers. Later, the patient, his pregnant wife, and a friend tested positive. Three more cases were confirmed on the same day after the patients reported symptoms of pneumonia. Thereafter, extensive screenings and checks were performed on everyone that had possibly been in contact or near the infected subjects.
The Ministry of Health announced new guidelines for reporting cases on 27 February in response to the previous blanket testing that caused case numbers to surge and inflamed public panic. It would no longer report asymptomatic cases (swabs taken from patients which tested positive but were not showing symptoms) which counted as 40 to 50% of all reported cases at the time. These people would undergo isolation at home and would be followed up with new tests until they were negative.
On 9 March, Giovanni Malagò, president of the Italian Olympic Committee, announced that all sports events in Italy would be canceled until at least April 3. The ban does not cover Italian clubs or international games.
As of 4 April, there were 119,827 confirmed cases, 14,681 deaths, and 19,758 recoveries in Italy, with the majority of those cases occurring in the Lombardy region. A CNN report indicated that the combination of Italy's large elderly population and the inability to test all who have the virus to date may be contributing to the high fatality rate.