Northern Italian here, from the fringes of the first red zone. Basically the two areas which where hit hardest, Bergamo and Codogno, where hit along political lines.

Codogno has an "hospital" which is basically a glorified asylum (and is often considered one of the worst asylum in Italy). It was not equipped to deal with anything serious and basically it was considered and hospital only in order to avoid spending money on other infrastructures.

Bergamo, on the other hand, is one of the economical centers of the country and the regional government delayed action under the pressure of the industrial establishment, until national government stepped in.

Many citizens of Lombardy knew that our healthcare system (which is regional competence) was a disaster waiting to happen and still suspect our regional government is lying in order to cover their failures.

Probably the closest comparison would be the US to the whole European Union. Similar sized population, a broad a mix of left/right leaning states, some more affluent than others, that are largely operating independently.

About two weeks ago the EU was around 800k cases and 57k deaths, the US is there now and at 40k deaths - so maybe doing better, but possibly could have been a lot better if the Fed Gov had taken charge early.

But we don't know precisely how many non-hospital deaths have occurred in either case. They estimated the UK was out by 40%, and Wuhan added 50% to their total recently.