Spain versus Italy and Japan in the coronavirus crisis: this is what the two countries have done and this has been the case

The numbers of infected by coronavirus of yesterday were eloquent. Too eloquent, perhaps: the data from Spain almost perfectly coincided with the Italian data from ten days before. However, the political measures of one country and another could not be more different. At the time, Italy had not only created an isolated "red zone" with more than 50,000 people, but had expanded the restrictions to six regions of the country. Today, Spain begins to close schools in Álava.

We review the measures that the two countries have taken and compare their infection rates to try to understand to what extent Italy is a foretaste of what will happen in Spain in the coming days. In addition, to complete the overall picture, we compare the Spanish evolution against Japan, a country that is considered one of the success stories in the management of the epidemic.

Spain vs. Italy

First cases In both Italy and Spain, some cases directly related to the Chinese outbreak were identified throughout January and the first part of February. In Italy the first two cases were detected in Rome on January 31 at the same time as Spain. We would have to wait two weeks, in both countries, for cases to start to rise and, now, with a much closer focus.

The epidemic in Italy

Civil Protection in the city of Padua

However, it was on February 21 with the appearance of 16 new cases (14 in Lombardy and 2 in Veneto) when the authorities recognized that there is an outbreak in the country and the "uncontrolled community contagion" is a fact. Work is started to identify the epidemiological chain and control the possible infected, but unfortunately they are not successful. Patient zero, the one who introduced the virus into the country, cannot be identified by leading the country to a "mitigation scenario".

That same day [20 cases], the Ministero della Salute issued an ordinance that provided for the mandatory quarantine of all those who had been in contact with people positive for viral infection (and active surveillance and home quarantine for all those who had been in areas of risk the previous two weeks). However, the outbreak shows no signs of being controlled.

On the 22nd [79 cases], the Italian Consiglio dei Ministri announces a decree that quarantines more than 50,000 people in 11 municipalities in the north of the country.It comes into force the following day and involves the suspension of public and private events of any kind; in addition to the closure of schools, museums, cultural centers and commercial activities (except for the sale of basic necessities). The stops of the train lines that cross the red zone are suppressed.

The first problems and resistance from citizens trying to escape from the municipalities despite the sanctions are also beginning to be seen. Given this, the Government mobilizes the army and the police by creating 35 checkpoints.

On February 25 [320 cases], a decree of the President of the Council of Ministers extends the restrictive measures to the regions of Emilia Romagna, Friuli-Venezia Giulia, Lombardy, Veneto, Piedmont and Liguria. Schools, museums, and judicial offices in those regions are closed until March 15 and companies are asked to implement telework policies. Along these lines, sporting events in the new area are suspended (although some matches are allowed behind closed doors).

On March 1 [1,694 cases], a decree was finally approved that reorganized the Italian health system, harmonized all the local regulations that had arisen in those days, and zoned the country according to risk criteria. On March 4 [3,089 cases] all schools and universities in the country, sports stadiums are closed and access restrictions to hospitals, nursing homes and prisons are introduced

On March 7 [5,883 cases] the draft of a decree is filtered that will prevent the exit and entry of the Lombardy region and 14 provinces of the north central part of the country (Modena, Parma, Plasencia, Reggio Emilia, Rimini, Pesaro and Urbino, Alessandria, Asti, Novara, Verbano-Cusio-Ossola, Vercelli, Padua, Treviso, Venice). A total of 16 million people would be quarantined, causing the "flight" of many people to the south of the country. On March 8 [7,375] the decree was approved, while the difficulties in applying it increased.

The epidemic in Spain

Fernando Simón, Director of the Coordination Center for Health Alerts and Emergencies of the Ministry of Health

In Spain, on the other hand, the increase in cases begins on the 25th [8 cases] as a consequence of the importation of cases from the Italian focus. However, on February 26 cases begin to appear that do not have a direct link with Italy. As of that moment, the figures climb rapidly, but the Ministry continues to maintain that, with 90% of the cases perfectly affiliated, there is no evidence that an "uncontrolled community contagion" is taking place and there is no need to go on stage. mitigation.

On March 3 [169 cases], after having to put almost 200 Basque health personnel in quarantine and in view of the imminence of certain matches against Italian teams, the Ministry of Health suspends all medical congresses and training days and orders that certain parties (which could involve the displacement of people from risk areas) are held behind closed doors.

Given the growth of the numbers and the appearance of cases in various residences in Madrid, the Community orders the closure of 213 day centers and Health orders the quarantine of thirty families in Haro (La Rioja), mobilizing the Civil Guard to ensure its fulfillment. Finally, on March 9 [999 cases] Vitoria canceled classes in several municipalities in the province and the Ministry announced new measures for Madrid and the Basque Country that would be taken throughout the day.

Similar figures, similar answers?

As can be seen in the graph, Italy took much more aggressive measures with fewer infections than Spain. For this reason, we have contacted the Ministry of Health to try to clarify what differentiates us from the Italian situation a few days ago. Health explains that "the Italian response to the crisis is marked by a very important factor. From minute one in Italy there was an 'uncontrolled community contagion', something that to date there is [no evidence that] has occurred in Spain" .

That would be the key factor that would lead to a jump from the "containment scenario" (in which the virus has not yet moved freely around the country and can be contained) to that of "mitigation" (in which the virus is already circulating and requires more aggressive measures). From Health they also insist that "the cases that are appearing fit in the forecasts that were had from the Ministry" and, therefore, they do not suppose a surprise nor they modify the road map of the country.

Spain vs. Japan

We also wanted to compare the Spanish case with the Japanese one. Throughout the crisis, Japan has set itself the example of a country that took action quickly and has managed to keep the numbers of infections surprisingly low. And, in effect, between January 31 and February 1, with less than 20 cases diagnosed in the country, the Japanese government began the procedures to repatriate the Japanese who were in the province of Hubei, while applying restrictions to denying entry to the country to all foreigners who had been in the province two weeks before.

However, the determining factor was the arrival of the Diamond Princess at the port of Yokohama. On February 4, they tested positive for 10 on the ship, and the government quarantined the cruise ship and its 3,700 passengers. From that moment, Japan begins an ambitious control plan that seeks to perform coronavirus tests on the entire population of the country as a way to control it.

However, on February 23, during the panel of experts of the Japanese executive, it is assumed that it will be impossible to stop the virus and recommends starting to test only people with a "high risk of complication." Two days later, the Government decides to advance the vacations of 12.8 million students in approximately 34,800 educational centers across the country. On February 28, the island of Hokkaido decides to declare a state of emergency.

In addition to these measures, the Government has asked citizens for prudence since, constitutionally, it lacks legislative instruments to limit citizens' mobility rights. Since then, the figures have maintained very low growth (compared to the exponential growth of other countries) and this, in places like South Korea, has raised suspicions about a possible manipulation of them in order to avoid the cancellation of the games Olympians.

Things start to change in Spain

In essence, the idea with which he worked at the Ministry of Health was, on the one hand, that there was no "Spanish outbreak", but that Spanish cases were part of the Italian outbreak. While this was the case, measures should be taken taking into account the Italian ones and in coordination with Europe, but they should not be copied because the situation is structurally different. On the other hand, unlike the Japanese case, they assumed that the outbreak could still be controlled.

This situation has begun to change. Because in his press conference on March 9, Fernando Simón, director of the Coordination Center for Health Alerts and Emergencies of the Ministry of Health, recognized that there is an “obvious community transmission” in two autonomous communities: Madrid (which has doubled the cases in 24 hours and total 469 cases) and Euskadi (with 149). This forces the State to start implementing mitigation measures at the regional level and makes it clear that the crisis in Spain has entered a new phase whose measures, at this time, have yet to be decided.

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