Italians in seven regions headed to the polls Sunday for two days of voting shaped by the COVID-19 pandemic.

Voters were required to wear masks and maintain social distancing as they cast ballots in regional contests originally scheduled for the spring but delayed due to the pandemic. Italy's outbreak has claimed more than 35,600 lives — the second-worst confirmed death toll in Europe after Britain — and stricken 296,500 people since February.

Click to Gallery

A woman waits to vote at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

Italians in seven regions headed to the polls Sunday for two days of voting shaped by the COVID-19 pandemic.
A woman walks past a poster showing how to avoid the spreading of COVID-19 as she arrives to vote at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

Once inside, voters may lower their masks just long enough to confirm their identity against voting cards and ID documents. And in a change, voters leaving the voting booths will place the ballots inside the boxes themselves, instead of turning them over to poll workers.
A woman with her dog leaves after voting at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

The other races are considered a test of the strength of the right-wing opposition, led by League leader Matteo Salvini, against the ruling parties of the 5-Star Movement and the Democratic Party. The toughest contest is expected in Tuscany, where Salvini is betting his candidate can oust the Democratic Party from the left-wing stronghold.
A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities.(AP PhotoAndrew Medichini)

Regional presidents “are quite powerful and people understand this,’’ said Cristina Fasone, a professor at Rome’s LUISS University. "I think even more so after we experienced the first months of the pandemic.’’
A friar leaves after voting at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities.(AP PhotoAndrew Medichini)

Polls will close at 3 p.m. on Monday.
A friar arrives at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A friar arrives at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)
A voter with his dogs leaves a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A voter with his dogs leaves a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)
A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)
A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)
More Images
A woman waits to vote at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

Italians in seven regions headed to the polls Sunday for two days of voting shaped by the COVID-19 pandemic.

A woman walks past a poster showing how to avoid the spreading of COVID-19 as she arrives to vote at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

Once inside, voters may lower their masks just long enough to confirm their identity against voting cards and ID documents. And in a change, voters leaving the voting booths will place the ballots inside the boxes themselves, instead of turning them over to poll workers.

A woman with her dog leaves after voting at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

The other races are considered a test of the strength of the right-wing opposition, led by League leader Matteo Salvini, against the ruling parties of the 5-Star Movement and the Democratic Party. The toughest contest is expected in Tuscany, where Salvini is betting his candidate can oust the Democratic Party from the left-wing stronghold.

A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities.(AP PhotoAndrew Medichini)

Regional presidents “are quite powerful and people understand this,’’ said Cristina Fasone, a professor at Rome’s LUISS University. "I think even more so after we experienced the first months of the pandemic.’’

A friar leaves after voting at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities.(AP PhotoAndrew Medichini)

Polls will close at 3 p.m. on Monday.

A friar arrives at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A friar arrives at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A voter with his dogs leaves a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A voter with his dogs leaves a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

For the first time, voters over 65 will have preferential access and will be guided to the front of any line by volunteers from Italy’s civil protection agency.

A woman waits to vote at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A woman waits to vote at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

Once inside, voters may lower their masks just long enough to confirm their identity against voting cards and ID documents. And in a change, voters leaving the voting booths will place the ballots inside the boxes themselves, instead of turning them over to poll workers.

Veneto Gov. Luca Zaia of the right-wing League party is expected to win his third mandate handily after helping Veneto avoid the worst of the pandemic through targeted testing early on and protocols that took the pressure off intensive care wards.

In the region of 5 million people centered around Venice, confirmed virus deaths have numbered 2,158, compared with 16,917 in Lombardy, the epicenter of Italy’s epidemic with a population of 10 million.

A woman walks past a poster showing how to avoid the spreading of COVID-19 as she arrives to vote at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A woman walks past a poster showing how to avoid the spreading of COVID-19 as she arrives to vote at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

The other races are considered a test of the strength of the right-wing opposition, led by League leader Matteo Salvini, against the ruling parties of the 5-Star Movement and the Democratic Party. The toughest contest is expected in Tuscany, where Salvini is betting his candidate can oust the Democratic Party from the left-wing stronghold.

Regional leadership is also being decided in Liguria, Le Marche, Campania, Puglia and Valle d’Aosta. Mayoral races also were being held in 1,000 towns and cities.

Despite the complications presented by coronavirus, analysts are projecting a strong turnout, as the pandemic emphasized the significance of local and regional leadership. In Italy, health care is administered at a regional level.

A woman with her dog leaves after voting at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A woman with her dog leaves after voting at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

Regional presidents “are quite powerful and people understand this,’’ said Cristina Fasone, a professor at Rome’s LUISS University. "I think even more so after we experienced the first months of the pandemic.’’

Italians also are voting on a referendum to reduce the number of national lawmakers, backed by the 5-Star Movement, which has made reforming Italy’s often moribund institutions a central political plank. The move would cut lower house lawmakers from 630 to 400 and those in the Senate from 315 to 200. The 5-Stars, which have the most members of any party in the lower house after the 2018 election, say the move will save 500 million euros ($580 million) each five-year legislative period.

Most parties back the constitutional reform, which has already been passed by parliament but without the two-thirds majority that would have avoided a referendum. Still, many top political voices say they are voting ‘’no'' as the move would reduce regional representation.

A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities.(AP PhotoAndrew Medichini)

A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities.(AP PhotoAndrew Medichini)

Polls will close at 3 p.m. on Monday.

Follow AP’s pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

A friar leaves after voting at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities.(AP PhotoAndrew Medichini)

A friar leaves after voting at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities.(AP PhotoAndrew Medichini)

 A friar arrives at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A friar arrives at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

 A voter with his dogs leaves a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A voter with his dogs leaves a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

 A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

 A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)

A man casts his ballot at a polling station, in Rome, Sunday, Sept. 20, 2020. On Sunday and Monday Italians are called to vote nationwide in a referendum to confirm a historical change to the country's constitution to drastically reduce the number of Members of Parliament from 945 to 600. Eighteen million of Italian citizens will also vote on Sunday and Monday to renew local governors in seven regions, along with mayors in approximately 1,000 cities. (AP PhotoAndrew Medichini)