The outbreak in Italy seems to be quickly spiraling as officials reported 100 new cases in a single day, raising the official number to 322. The real number, however, might already be higher.

Just as it seemed we were reaching peak coronavirus and the outbreak was plateauing, it’s starting to strike elsewhere in the world. In addition to Japan and South Korea, which are struggling with their own potential outbreaks, the virus now seems to have taken a foothold in Iran and Italy, where the number of cases is rising quickly. Italy has confirmed 322 cases of the virus, the Italian civil protection agency said Tuesday.

However, the numbers don’t exactly add up. Italian authorities have also reported 11 fatalities caused by the virus. But the observed case fatality of the virus seems to be around 2% in Hubei, where the outbreak originated — and closer to 1% in other parts of China. Having 11 fatalities for 322 cases would make for a fatality rate of 3.4%, which is unlikely. This could mean that there several more unreported cases, health officials fear.

Italian authorities were quick to point out that they are taking measures to contain the virus, and Italian Prime Minister Giuseppe Conte has said he is confident in his country’s ability to do this.

“Our health system is excellent, our precautionary measures are of the utmost rigor and we trust that, by virtue of the combined provisions […] we will promote a containment effect,” Conte told reporters on Tuesday.

In a separate interview with Italian TV Sky TG 24, Conte emphasized that he is not taking the outbreak lightly, and is confident.

“I cannot say that I am not worried, I don’t want anyone to think that we are underestimating this emergency. But I can say that with the measures we have enforced, I am faithful that we will have a containment effect in the coming days.”

Post-China Coronavirus

Several cities in northern Italy (where most cases have been reported) are on lockdown, with schools, theaters, and museums being closed, and people being banned from entering or leaving affected areas. Effectively, 100,000 people are under quarantine, and several cities are basically ghost towns.

“The concern is palpable, people are worried, partly because of what they hear on television, information, on social media,” said Davide Passerini, the mayor of Fombio, one of the Lombardy towns under lockdown. “Life is like it is in other isolated villages: Everything is shut, people go out just to do their shopping.”

However, Walter Ricciardi (a member of the World Health Organization’s executive committee, who also advises the Italian government) admitted that enforcing measures at the regional level, where it is most needed, has proven very difficult.

“The measures that have been taken recently, that the Prime Minister and all ministers are currently discussing with the regions, are going in the right direction,” he told journalists Tuesday.

“But all the organization and management mechanisms are entrusted to the regions, unlike other countries that have a single command line, and so it is no coincidence that they currently have fewer cases than we do.”

Furthermore, Italian authorities still don’t know where the outbreak started — Patient Zero in the country is still a mystery. Initially, a businessman returning from China was thought to be the source, but he turned out to not be infected at all.

The rapid spread of the virus and lack of information has sparked fears that the contagion might spread across the European Union, where Italian citizens can travel freely. The EU’s Schengen Area allows people in most member states to move freely between countries without any border checks. Already, there are signs that the disease is starting to spread from Italy to other parts of the world.

A hotel in Tenerife is on lockdown after a doctor from Italy visiting the hotel tested positive for the virus. Several countries (Austria, Croatia, Switzerland, Algeria) have reported their first cases — all of which involve people who had been to Italy.

It’s unclear what this means for the potential containment of the coronavirus. For now, the situation in Italy is still unfolding and it remains to be seen whether the number of cases will be stabilized or whether the virus will continue to surge and push beyond the country’s borders.