Italy’s extended quarantine restricting the movement of people in its industrial northern heartland have provoked panic among residents and accentuated the country’s north-south divide.

Prime Minister Giuseppe Conte signed a decree on Sunday imposing restrictions to the movement of people in the northern region of Lombardy — the epicenter of the outbreak in Italy — and 14 other provinces across the north, until April 3. The measures (an extension of a preexisting lockdown of 11 towns in Lombardy and Veneto) now affect more than 16 million people, banning them from moving in and out of those areas.

The publication of a draft decree Saturday afternoon by a newspaper revealing the forthcoming, wider quarantine measures prompted panic among residents trying to get out before the restrictions came into force after midnight.

Media reports said bars and restaurants emptied and thousands of people tried to leave the region in cars and trains, where there were reports of shoving and pushing by passengers.

Violent protests have broken out in 27 Italian prisons against coronavirus restrictions with many inmates asking for an amnesty due to the virus emergency, news agency ANSA reported Monday, citing local sources.

Some 20 inmates had managed to break out of Foggia prison in Puglia during a riot Monday morning, ANSA said citing local sources.  Shop keepers in the area were told to close their shops in the vicinity of the prison.

Prison unrest broke out in a prison in Modena Sunday after inmates were informed that visits from relatives had been banned to prevent the spread of infection. In the south, relatives of detainees in a Poggioreale prison in Naples clashed with police against the government ban.

Italian stocks on the blue-chip FTSE MIB initially failed to open Monday along with other European markets. When the index did open, stocks were trading down around 2,290 points, or around 11% lower, and by late afternoon the index was down around 9.5%.

Italy now has 7,375 confirmed cases of the virus and 366 deaths. The outbreak has been concentrated in Italy’s wealthiest northern regions of Lombardy (where there are 3,372 confirmed cases), Emilia-Romagna (with 1,097 cases) and Veneto and has highlighted Italy’s north-south economic and cultural divide.

The presidents of the southern regions of Campania, Puglia and Calabria — which have far few cases of the virus — have pleaded with their own inhabitants studying or working in the north not to bring the virus back down south, telling people “don’t come down here.”

Those regions, as well as Basilicata and Molise, have signed decrees ordering anyone who does arrive from the affected northern regions into a self-imposed quarantine for two weeks. Puglia’s president said those who ignored the order were committing a crime and could be prosecuted.

La Repubblica newspaper quoted Jole Santelli, the governor of Calabria, as telling people that “returning from the north in an uncontrolled way puts our country in danger. … Don’t do it, stop!”

“The government must block an exodus to Calabria, which risks triggering a disastrous bomb,” said Jole Santelli, the president of Calabria.

Economists predict that Italy’s economy, weak before the outbreak, will go into recession and the government has already announced that it will spend billions of euros to try to mitigate the economic impact of the virus on businesses and to help the north’s beleaguered health-care system.

President Donald Trump sought to play down the plunging price of oil and the global spread of the new coronavirus as markets tanked Monday, saying that lower gas prices were good for consumers and comparing COVID-19 to the common flu.

“Good for the consumer, gasoline prices coming down!” Trump wrote in one of a series of posts on Twitter. In another, he wrote that the flu killed 37,000 Americans last year, compared with 22 known deaths from COVID-19, the disease caused by the coronavirus.

The market slid Monday amid an all-out oil price war and fears over the economic pain to come from the coronavirus. The sell-off triggered market “circuit breakers” shortly after trading opened, after the major indexes fell by 7% in less than 15 minutes.

Oil prices were down more than 20% after Saudi Arabia announced major price cuts and production increases. The Saudi move came after Russia rejected a proposal by OPEC to cut 1.5 million barrels of production per day.

Trump said the collapse was caused by Saudi Arabia and Russia “arguing over the price and flow of oil.”

“That, and the Fake News, is the reason for the market drop!” Trump tweeted. “Nothing is shut down, life & the economy go on,” he said.

The president’s downplaying of the coronavirus comes even as other parts of his administration signaled that containing the disease was his top priority.

“The American people should know President Trump is leading a whole of government approach,” Health and Human Services Secretary Alex Azar told Fox Business on Monday. “It is the number one priority of this administration.”

Monday’s market turmoil contributed to several weeks of chaotic financial declines spurred by concerns that efforts to contain the flu-like respiratory infection, which emerged late last year in China, will hamper global growth. The president is expected to meet with his economic team later Monday to review options to stem the impact of the disease on the economy.

Some economists have speculated that declines in the price of oil and historically low rates, including for the popular 30-year fixed mortgage, could boost consumer sentiment in the short term. But those factors could be overwhelmed by negativity around the spread of the coronavirus, they cautioned.

“The question is whether the fear factor attributable to the virus will overwhelm any positive impact from lower gasoline prices and lower mortgage rates,” Edward Yardeni, president of Yardeni Research, told CNBC over the weekend.

Earlier Monday, Trump tweeted that  Vice President Mike Pence, who is leading the government’s coronavirus task force, was doing a great job. Trump also boasted that his administration’s travel restrictions on China, which were announced in January, saved lives.

“The BEST decision made was the toughest of them all – which saved many lives,” Trump tweeted. “Our VERY early decision to stop travel to and from certain parts of the world!”

Some of the president’s posts on Monday were more in line with his ordinary preoccupations.

Despite the precipitous market drop, Trump spent some of his morning directing fury at the news media — “So much FAKE NEWS!” — former Vice President Joe Biden, the front-runner for the Democratic nomination, and the Democratic Party, which he accused of attempting to “smear” Biden’s rival Sen. Bernie Sanders.

— CNBC’s Eamon Javers and Kevin Breuninger contributed to this report. 

Dr. Amy Compton-Phillips recalled the day the first U.S. patient infected with COVID-19, a 35-year-old man from Snohomish County in Washington state, had taken a “turn for the worse.”

“He was day nine in his course and he actually started going downhill, started getting worse,” said Compton-Phillips, chief clinical officer of Providence St. Joseph Health, where the patient was treated.

At first, the patient only had common cold-like symptoms, Compton-Phillips said. But very quickly he began to have shortness of breath and a cough, she said. His X-ray also showed viral pneumonia. He needed supplemental oxygen and had to be put on an experimental antiviral treatment.

The patient has recovered and has been released from the hospital.

Since the patient landed at Seattle-Tacoma International Airport on Jan. 15 from the outbreak’s epicenter in Wuhan, China, the virus has spread to at least 75 other people in Washington state, killing 14 in the U.S. so far — 13 in Washington and one in California, according to Johns Hopkins University.

At least five of those deaths have been traced to a skilled nursing facility, Life Care Center, in Kirkland, according to Washington state and local health officials. On Saturday, county health officials said about 50 residents and employees of the nursing care facility in the Seattle suburb were ill with “respiratory symptoms or hospitalized with pneumonia or other respiratory conditions of unknown cause” and were being tested for COVID-19.

Public health officials have identified at least 233 cases in the U.S. so, a fraction of the more than 100,600 infections across the world. But epidemiologists and state officials say the actual number of COVID-19 patients in the U.S. is likely in the thousands, maybe even tens of thousands, since testing here has been limited by a lack of kits and stringent criteria set by the Centers for Disease Control and Prevention.

Compton-Phillips said the doctors, nurses and other front-line workers watching the outbreak in real time are all saying “this is coming.”

“It’s not if, it’s when. And we better get ready now,” she said.

World health officials are turning their attention abroad and away from China, where businesses have started reopening operations and the growth in COVID-19 cases have slowed over the last two weeks. Last week, WHO increased its risk assessment of the coronavirus to “very high” at a global level — its highest warning.

Outside China, 14,768 cases across at least 74 countries had been confirmed as of Thursday morning — up from four cases in three countries on Jan. 21, according to the World Health Organization.

“We are on the highest level of alert or highest level of risk assessment in terms of spread and in terms of impact,”  Dr. Mike Ryan, executive director of WHO’s health emergencies program, said during a press briefing on Feb. 28. “This is a reality check for every government on the planet: Wake up. Get ready. This virus may be on its way and you need to be ready. You have a duty to your citizens, you have a duty to the world to be ready.”

Compton-Phillips said some front-line workers had been saying “if” when talking about the virus becoming widespread in the U.S. — until two weeks ago, when cases suddenly cropped up in Iran and Italy with no known connection to China.

Then, “we started saying, ‘when,’” she said.

The health system will need to think where it can source essential products such as gowns, masks and gloves, Compton-Phillips said. She said they’ve started putting masks for patients “behind the counter,” to help conserve them.

“The boxes of masks were walking away,” she said.

WHO officials said panic buying and hoarding medical supplies is putting lives at risk and causing a “severe and mounting disruption” to the world’s stockpile of protective gear. “Shortages are leaving doctors, nurses and other front-line workers dangerously ill-equipped to care for COVID-19 patients, due to limited access to supplies such as gloves, medical masks, respirators, goggles, face shields, gowns, and aprons,” WHO said in a statement Tuesday.

When that first patient in Washington state presented himself for testing, Compton-Phillips said the hospital took an “overkill” approach.

“We will presume it’s COVID-19 until proven otherwise, so we’ll put a mask on them and put them in an isolation room,” she said. She added that when transporting that first patient to an appropriate isolation room, “we had him in this special gurney with plastic around it, so he wouldn’t contaminate anything.”

But that was over a month ago. Since then, the number of confirmed cases in the U.S. has risen to 233 across at least 17 states as of Friday morning, according to Johns Hopkins’ data. For weeks, most of the U.S. cases could be traced to travel in Wuhan, the Diamond Princess cruise ship, which was quarantined off the coast of Japan, or close contact with those people.

That’s all changed since last weekend. There are now well over two dozen cases in the U.S. of person-to-spread, many of which are proving to have been transmitted openly in the community, and it appears to be getting worse, according to state health officials.

State and local health have confirmed community transmission cases in California, Washington state, New York and North Carolina — where a woman contracted the virus on a trip to Washington state in what appears to be the nation’s first domestic travel-related infection.

Part of the problem, Compton-Phillips said, was the CDC’s delay in getting testing kits to local health agencies and its reluctance to test patients who hadn’t traveled to Wuhan, China.

“We had real challenges initially. … I think it’s one of the reasons we’re seeing these hot spots pop up around the country is because we simply didn’t know this had already hit our shores,” she told CNBC, adding that cases will rise as testing is expanded and labs discover new cases that were previously hidden. “I do think that this virus has been circulating now for several weeks in the U.S. … Until now, it’s been circulating unchecked.”

Some hospitals still haven’t instituted strict isolation protocols for everyone being tested, and some state officials are even starting to relax hospital quarantine rules for patients who test positive. One woman in New York is under self-quarantine at her home in Manhattan. State health officials said a California patient was not under quarantine as doctors appealed to the CDC to test her. Since she hadn’t been to Wuhan, or been in contact with anyone who was, she was out and about in her community.

One patient in New Hampshire under self-quarantine broke protocol by attending a private event Friday night, state officials said Tuesday. In Texas, the CDC mistakenly released a Prince Cruise passenger who was under mandatory quarantine who later tested positive for the virus.

Last week, California Gov. Gavin Newsom said the state was monitoring more than 8,400 people for the coronavirus. As the magnitude of the emerging virus grew in the U.S., federal officials have loosened guidelines that restricted local clinicians from testing patients and led to delays.

The CDC sent test kits earlier in the outbreak to public health labs around the country, but those kits were problematic, CDC officials have since said, and potentially inaccurate. Because local clinicians can’t depend on the test kits, some have had to ship samples to a laboratory with the ability to run the tests, like the CDC laboratory in Atlanta.

“Some of our tests are getting sent to CDC in Atlanta, and it’s taking a while to get them back,” Compton-Phillips said. “The first couple [of] patients it was only taking a day or two. And now it seems to be taking about a week to get the test results back.”

Those delays, Compton-Phillips said, means doctors and nurses need to treat patients as if they have the virus until the results come back, which can be taxing for patients and health-care providers alike.

On Feb. 28, however, Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, announced that the agency is rolling out new tests. She said the move will improve the country’s ability to quickly identify and treat COVID-19 patients. Private labs Quest Diagnostics and Lab Corp. will be able to test specimens next week.

“Our goal is to have every state and local health department online, doing their own testing,” she said.