In 2020, governments across the globe faced the challenge of balancing the protection of their citizens’ health with the need to contain the economic consequences of the COVID-19 pandemic. In this study, we examine public opinion preferences for different strategies factoring in economic and health costs, in Italy. We embedded a discrete choice experiment in an online survey administered between April 24 and 28, 2020. Respondents were randomly assigned to receive two alternative scenarios (re-opening vs. lockdown) with different health and economic consequences. We show that, in general, containment measures were preferred to re-opening, and that Italians were mostly concerned about minimizing deaths from COVID-19. We then test the differential impact of sociodemographic, ideological and attitudinal profiles, including populist attitudes, in explaining these preferences.