Their eyes are tired. Their cheekbones rubbed raw from protective masks. They do not smile.

The doctors and nurses on the front lines of the coronavirus pandemic in Italy are almost unrecognisable behind their masks, scrubs, gloves and hairnets – the flimsy battle armour donned at the start of each shift as the only barrier to contagion.

Italy surpassed China in total confirmed cases and stands behind only the United States. But the National Institutes of Health also said there had been a slowing of infections in recent days, suggesting that a national lockdown was starting to show an effect after two and a half weeks.

For medical staff, any letup from the chaotic crush that marked the initial stage of the virus’s spread in Italy is welcome. But they know they are nowhere near the end of the emergency.

“What we are living through is like a tattoo,” said Daniela Turno, an ICU nurse at the Humanitas Gavazzeni hospital in Bergamo. “It will remain forever.”

Sometimes hospital workers do not drink water or any liquids during their 8-, 10-, or 12-hour shifts so they do not have to go to the toilet and disrobe. They follow strict protocols while taking off their hazmat suits, gloves and masks, knowing that one wrong move could mean they, too, will catch the virus.

Already, more than 7,100 healthcare workers around the country have been infected. They are sent home to recover and report back to work when they test negative. Their absences are sorely felt, creating more work for those left standing. More than 50 doctors never recovered and are counted among the dead.

The stress levels in ICU wards is palpable, the silence deafening. Sometimes all you can hear are helicopters taking off and landing outside, transporting another critical patient to a hospital that is not quite as full.

The heroes of Italy’s pandemic are not just treating the sick with respirators and oxygen. They are standing in for sons and daughters, brothers and sisters, who under normal circumstances would be able to visit, hold the hands of sick loved ones and offer a word of encouragement.

COVID-19 patients must be isolated, and their family members quarantined.

“These are patients who are starving for air,” said Dr Gabriele Tomasoni, head of ICU at the public Civic Hospital in Brescia. He said his team provides not only life-saving help with machines, but something else, more human.

“We know these are elderly patients. They need closeness. Tenderness.”