Spain is rapidly catching up to Italy in terms of both COVID-19 confirmed case and death counts.  It has already claimed the top spot as the hottest country in the world with 0.20% of its population infected vs Switzerland at 0.19% and Italy at 0.17%.  What is surprising is that Spain did not learn anything from the Italian example and try to avoid the same tragic fate. 

Both countries encountered their first confirmed cases on the same day on Jan 31st. Both had several weeks to prepare before the virus took off on its exponential growth but neither was prepared to roll out test kits quickly and widely.  The Italians were about 10 days ahead in experiencing exponential growth of the virus. For example, Italy counted 650 cases on Feb 27th, a level above that which led China to quarantine Wuhan, 10 days before Spain crossed a similar threshold on March 8th.  Both countries began to institute some travel restrictions then but neither as strong as those imposed on Wuhan.  It was not until March 8th that Italy moved to restrict travel nationwide and not until March 23rd that it recommended that non-essential businesses close nationwide.  For Spain, these same milestones lagged Italy’s by about a week.  This is one reason why Italy is beginning to see early signs of deceleration and possible bending of the curve by next week; while for Spain the confirmed case count is still accelerating and bending of the curve will not happen for at least 2 more weeks. 

Perhaps the Spaniards got lulled into thinking that their younger population relative to Italy’s (median age of 42.7 vs 45.5yrs) will save them from the worst of Italy’s tragedy? Certainly, they should not have been complacent about their equally poorly prepared medical systems.  Spain’s younger population has allowed them to keep their coincident mortality rate at 8.8% below the horrendous 11.7% observed now in Italy.  However, Spain’s slow and weak response could still make them lose more lives than the 12,428 already lost in Italy.  Spain’s Prime Minister Pedro Sánchez, hobbled after forming a minority government, did not want to rock the boat and allowed many large events to go forward in March that spread the disease like wildfire.

The lesson here for the US is clear:  slow and tepid response will lead to more American deaths than if the President took immediate and strong action to restrict domestic travel.  The imposition of incremental travel restrictions is not the answer when slow testing has failed to reveal the true scope of the infection.