Persistently high levels of coronavirus cases in Milan are complicating Prime Minister Giuseppe Conte’s plans to restart the Italian economy. Even as growth in new cases nationally has slowed in recent weeks, Milan has experienced a late wave, becoming the province with the highest number of infected people. In the 30 days to April 16, the growth rate for new cases in Milan was 30% higher than the national level, while total fatalities in the metropolitan area nearly doubled in March compared to the year before. Earlier this month, the city was forced to halt cremation rites for non-residents.

Wealthy Milan, which prides itself on northern European levels of industriousness and efficiency, has also been rocked by a scandal at its largest nursing home, where hundreds of patients have died in recent weeks. Conte is preparing to at least partially open the country up starting May 4, but he’s been under pressure from industrialists and regional politicians in Lombardy, the region with Milan as its capital, for a quicker return to business as usual. Italy reported a slight drop in new coronavirus cases on Friday even as a record number of people were tested, though experts warn the virus is not yet in check.

Local leaders have argued that the grave situation in Milan and the surrounding area argues for caution.