Italy’s response to the Covid-19 pandemic was “improvised” and “chaotic” according to a World Health Organisation report that was taken down from the body’s website just hours after publication in May.

The assessment titled “An unprecedented challenge, Italy’s first response to Covid-19” was completed by a group of pan-European WHO scientists led by Venice-based Francesco Zambon.

It was published on the WHO’s website on May 13, including an introduction written by Europe’s WHO director, Hans Kluge, but was removed the next day. The WHO issued no public statement at the time to indicate that it had withdrawn the report or explain why.

According to the 102-page document, seen by the Financial Times, Italy’s decentralised approach to public health policy, as well as delays in testing and tracing potential Covid-19 infections, contributed to worsening the outcome of the first phase of the pandemic.

“Unprepared for such a flood of severely ill patients, the initial reaction of the hospitals was improvised, chaotic and creative,” the report said.

In a written response to the FT, the WHO said the document was removed by the WHO’s European Office because it contained “factual errors in some of the data and statistics” but declined to provide specific details.

“While it was offline, a decision was taken to instead use a new mechanism created in the early months of the pandemic aimed at helping member states conduct intra-action reviews and assess their Covid-19 responses,” the WHO said. “The document was, therefore, not republished.”

Mr Zambon, the lead author of the report, challenged the WHO’s statement that errors in the assessment meant it had to be withdrawn. “Never in nine months was I told that the report . . . has inaccuracies and inconsistencies,” he said in a written statement to the FT. “Before publishing even a short piece for the internet there are several tiers of approvals [at WHO] and rounds of comments to grant technical soundness and corporate consistency.”

Italy was the first country outside China to be hit by the pandemic, with the death toll topping 35,000 during the first wave of the outbreak. The report, financed by a grant from Kuwait, was intended to provide guidance to countries that had not been affected at the time.

According to three WHO officials, who asked not to be identified, the report was formally approved by the institution before publication, at a meeting in Geneva on May 11 chaired by Sylvie Briand, the WHO’s director of global infectious hazard preparedness. Ms Briand did not respond to a request to comment made via the WHO.

The document, the existence of which was first reported by the Italian television programme Rai Report, also says that the Italian government’s pandemic response plan had only been “reconfirmed” in 2016. Italian government officials had previously said the plan had been fully updated that year.

Ranieri Guerra, who as the Italian health ministry’s chief medical officer from 2014 to 2017 was responsible for the plan, is now one of 14 WHO assistant-director generals. He is also currently a member of the Italian government’s scientific task force on Covid-19. Mr Guerra declined to comment for this article, referring all questions to the WHO.

Prosecutors in Bergamo, the epicentre of Italy’s Covid-19 outbreak during the first wave, are already investigating whether mistakes on both a local and national level contributed to the catastrophic impact of the pandemic in the area.

Mr Guerra was interviewed by prosecutors in Bergamo last month but other WHO officials, including authors of the report, have not yet complied with court orders to appear.

“National authorities recently informed WHO about court orders issued by the office of the prosecutor in Bergamo. We have formally requested additional information,” the WHO told the FT.

Mr Guerra had spoken to prosecutors “in his personal capacity” before the official court orders had been received, the WHO said. “To preserve its objectivity and independence, WHO does not normally become involved in legal matters at the national level,” it said.