Portugal’s ‘worst-case scenario’ response has kept COVID-19 caseload low

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The Portuguese government has attributed the country’s low coronavirus caseload to a swift, flexible “worst-case scenario” response and to the early closure of schools and universities on 16 March. The Guardian reports that despite the fact that around 22% of Portugal’s 10.3m people are aged 65 or over, making them particularly vulnerable to the virus, the country has so far registered just over 20,000 cases and 714 deaths – far fewer than its neighbours.

Spain has recorded more than 195,000 cases and more than 20,000 deaths, Italy 176,000 cases and more than 23,000 deaths, and France 153,000 cases and around 20,000 deaths. Portugal’s coronavirus mortality rate is around 3%, compared with 13% in the UK and Belgium and 10% in Spain.

The report quotes António Sales, the secretary of state for health in Portugal’s socialist minority government, as saying that the administration had “taken the right measures at the right time” after monitoring the spread of the virus from the end of January. Sales said that the decision to close all schools and universities in mid-March – when the country had logged 112 cases and no fatalities – had proved pivotal.

“Anticipating the spread of the infection and community transmission, the government decided to close educational institutions in order to limit the contact of a large amount of people in a confined place,” he said. Six days after the country’s educational establishments were shut, Portugal declared a state of emergency and moved into full lockdown after recording 448 cases. Spain had gone into lockdown on 14 March after logging more than 6,000 cases.

He added that Portugal’s rapid reaction had been helped by five years of sustained investment to bring the national health service back to pre-austerity levels. Many health workers across the border in Spain argue that its response to the pandemic has been hampered by a lack of investment in health services – especially in Madrid, the region hit hardest by the virus.

Inês Fronteira, an assistant professor of epidemiology at the institute of hygiene and tropical medicine at Lisbon’s Nova University, said in the report that Portugal’s centralised health system and cross-party support for the emergency measures had also helped. In Spain, healthcare is the responsibility of the country’s 17 autonomous regional governments and the response was not brought under the control of the central government until the state of emergency was declared.

According to Fronteira, the pandemic underscores the need for proper preparation. “That’s going to be crucial to the next stage of the epidemic as we start discussing whether to loosen the measures or not,” she said. “It’s important to take one step at a time because you need to have time to measure the impact of each of the measures. For this type of response, you also need to have social and political cohesion to effectively implement public health measures.”

Sales said in the report that while it was to soon to start drawing conclusions, “We are constantly learning with our outbreak and with other countries’ experiences. We will be better prepared for the next time, for sure.”

Full report in The Guardian

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