Some nations that crushed COVID now see cases rise
Israel, Spain and France all fought the coronavirus into abatement in the first months of the pandemic with tough measures that won international praise. But the three countries now share a painful distinction: Their infection rates have shot past the United States, even though Americans never got the virus under control.
The experience of these three nations demonstrates the difficulty of keeping the virus at bay, experts and officials say, and how reopening too quickly and other missteps can undermine successful national policies. For countries with more chaotic approaches, such as the United States, the challenge may be even greater.
“We are going into a worsening situation,” Hans Kluge, the World Health Organization’s top official in Europe, told reporters Thursday. He said the rising numbers on the continent should serve as “a wake-up call for all of us” to be more vigilant about the transmission of the disease.
Israel, meanwhile, entered a new three-week lockdown Friday, a particularly bitter blow because it coincides with the beginning of the Jewish High Holy Days.
U.S. death rate worse
Taking into account population, a handful of countries have higher rates of COVID-19 diagnoses than the United States does. But Israel, Spain and France — all similarly positioned to the United States, in that they are democracies with advanced medical systems and deep pockets — stand out for having made dramatic progress against the health menace before seeing gains reversed.
Israel used an aggressive trace-and-quarantine program to keep its death rates lower than many of its peers. Spain, which was so overwhelmed by death that it had to turn a Madrid ice rink into a morgue, forced citizens to stay inside their homes for six weeks with few exceptions. French residents needed signed attestations that they were doing necessary errands during the hour they were allowed out of their homes every day.
By early June, after months of lockdown, each of these countries had managed to push cases down to lower than 10 per 100,000 people over a two-week period, according to figures from the European Center for Disease Prevention and Control.
Israel now has one of the worst infection rates in the world given its population: Over the past week, it has reported an average of 47 cases per day per 100,000 residents. Spain, which has averaged 22 cases per day per 100,000 people, and France, which has averaged 13, have also been setting daily records.
The United States registered an average over the past week of 12 cases per day per 100,000 people.
The comparisons are imperfect, since testing availability differs from country to country, and some may be undermeasuring. The death rate in the United States remains the worst of the four countries: adjusted for population, its deaths are nearly one-and-a-half times Israel’s, double that of Spain, and five times that of France.
“The USA is still tackling their first major peak, and will see further down the line some very similar challenges that a number of European countries are facing now,” said Catherine Smallwood, a senior emergency officer at the WHO Health Emergencies Program.
Rush to reopen
Some Spanish experts say that the rigidity of their lockdown may have led to a rush to reopen.
“The lockdown in Spain was fantastic. It was probably the country that did the best. It was very serious,” said Rafael Cantón, the head of microbiology at the Ramón y Cajal University Hospital in Madrid. “But probably because of these months of very strict lockdown, when we opened it was very quick, unfortunately. There was a background of virus that was in the population.”
Most of Spain’s new cases are mild and concentrated among younger, more resilient people, experts say, although hospitalization numbers are shooting up, as are deaths.
Public health officials blame the increase in cases on a virus-friendly cocktail. Vacation season spread the virus across the country. Families reunited, sometimes breaking size limits on gatherings. Teenagers embraced late-night drinking sessions, also ignoring rules on public gatherings. Pandemic policymaking was largely delegated to regional governments, which led to sharply divergent rules and strategies. And testing and tracing failed to keep pace with the rise in cases.
Now, strict lockdowns are set to be reimposed on especially hard-hit parts of Madrid this weekend.
“We don’t know for the time being whether we’re at the top of the wave or whether we’re facing more weeks of increases,” said Antoni Trilla, dean of the University of Barcelona Medical and Health Sciences School.
In France, a strict spring lockdown also produced an early-summer payoff.
After cases skyrocketed in March and April, overwhelming emergency rooms and ICU wards, the coronavirus seemed close to disappearing from France altogether by mid-May, when the government lifted the lockdown.
France’s reopening was more gradual than in Spain or Israel. But then came the long, hot summer.
Infections slowly started increasing in late July.
The resurgence has alarmed the French government, although for now it has held back from imposing significant new lockdown measures.
Schools are open, and attendance is compulsory. Many restaurants are crowded. And the government is encouraging people to return to work.
“The virus is still here for several more months,” French Prime Minister Jean Castex said. “We have to succeed in living with it without letting ourselves slip back into a lockdown.”