Spain and Italy ease Covid-19 lockdown but Russia hits daily high

Photograph: Miquel Benitez/Getty Images

Spain and Italy, two of the European countries hardest hit by coronavirus, are beginning to emerge from lengthy and strict lockdowns as Russia and Afghanistan reported their biggest one-day rises in new infections.

In Spain, where 217,466 cases of Covid-19 and 25,264 deaths have been confirmed, adults were allowed back on to the street to exercise for the first time in seven weeks this weekend.

Epidemics of infectious diseases behave in different ways but the 1918 influenza pandemic that killed more than 50 million people is regarded as a key example of a pandemic that occurred in multiple waves, with the latter more severe than the first. It has been replicated – albeit more mildly – in subsequent flu pandemics.

How and why multiple-wave outbreaks occur, and how subsequent waves of infection can be prevented, has become a staple of epidemiological modelling studies and pandemic preparation, which have looked at everything from social behaviour and health policy to vaccination and the buildup of community immunity, also known as herd immunity.

Is there evidence of coronavirus coming back elsewhere?

This is being watched very carefully. Without a vaccine, and with no widespread immunity to the new disease, one alarm is being sounded by the experience of Singapore, which has seen a sudden resurgence in infections despite being lauded for its early handling of the outbreak.

Although Singapore instituted a strong contact tracing system for its general population, the disease re-emerged in cramped dormitory accommodation used by thousands of foreign workers with inadequate hygiene facilities and shared canteens.

Singapore’s experience, although very specific, has demonstrated the ability of the disease to come back strongly in places where people are in close proximity and its ability to exploit any weakness in public health regimes set up to counter it.

What are experts worried about?

Conventional wisdom among scientists suggests second waves of resistant infections occur after the capacity for treatment and isolation becomes exhausted. In this case the concern is that the social and political consensus supporting lockdowns is being overtaken by public frustration and the urgent need to reopen economies.

The threat declines when susceptibility of the population to the disease falls below a certain threshold or when widespread vaccination becomes available.

In general terms the ratio of susceptible and immune individuals in a population at the end of one wave determines the potential magnitude of a subsequent wave. The worry right now is that with a vaccine still months away, and the real rate of infection only being guessed at, populations worldwide remain highly vulnerable to both resurgence and subsequent waves.

Peter Beaumont

Small shops, such as bookshops, hardware stores and hair salons were due to reopen on Monday, serving customers by appointment, along with restaurants for the collection of takeaways.

The prime minister, Pedro Sánchez, has announced that the wearing of face masks will be mandatory on public transport, and that 14.5m masks will be handed out across the country.

Sánchez also confirmed that his coalition government would be seeking MPs’ approval this week to extend the state of emergency declared on 14 March until 24 May.

“We’re winning the battle against the epidemic, but the cost in lives and sacrifices has been very high,” he said on Saturday.

“The virus isn’t going anywhere. It’s still there, lying in wait, and so we have to be prepared to react and, logically, to be able to manage this transition towards a new normality.”

On Sunday, Spain reported 164 deaths, the lowest single-day death toll in six weeks, while the number of new overnight cases was 838.

From Monday, people in Italy will be able to travel within regions to visit relatives – provided they wear masks – but schools, hairdressers, gyms and many other commercial activities will stay closed.

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Cafes and restaurants will offer takeaways only, and all travel between regions will be banned except for work, health or emergency situations. Restrictions on funerals have been relaxed, with a maximum of 15 mourners allowed to attend, but the celebration of mass and weddings will have to wait.

The virus has claimed almost 29,000 lives in Italy to date, and has infected more than 205,000 people.

“We must maintain social distancing, maximum hygiene levels, and masks,” said Italy’s special commissioner for the virus emergency, Domenico Arcuri.

“We’ve done our bit to the best of our ability. From Monday, it’s up to you.”

Italy coronavirus deaths - graph

Portugal, meanwhile, ended its state of emergency on Saturday night and some small shops are reopening as it, too, begins a phased de-escalation.

The country, which has reported 25,190 cases and 1,023 deaths, moved swiftly to contain the virus and declared a state of emergency on 18 March, when it had confirmed 448 cases and two deaths.

On Saturday, France – which is set to lift parts of its lockdown on 11 May – extended the health emergency by two months until late July as it reported 166 new deaths, its lowest single-day toll in more than five weeks.

The health minister, Olivier Véran, said the date of 11 May was an objective but warned it could be put back if people did not respect the rules.

“If the lockdown is well-respected right to the end, the lid will have been put on the saucepan of the epidemic and we can progressively end the lockdown in the best conditions,” he told Le Parisien newspaper.

“In the opposite case, and if the number of new cases is too high, the date of the lifting of the lockdown could be in doubt and will be weighed up according to each department.”

Russia recorded its highest daily rise in confirmed Covid-19 cases on Sunday, with 10,633 new cases listed. It brings the overall number to 134,686. A further 58 deaths have been reported by the country’s coronavirus crisis response centre, increasing the total fatalities to 1,280.

In Moscow, the centre of Russia’s outbreak, about 2% of the population is infected by Covid-19, according to officials. “The threat is apparently on the rise,” said the Moscow mayor, Sergei Sobyanin.

View photos

Vehicles wash the streets in Moscow. Photograph: Mikhail Metzel/Tass

Afghanistan has confirmed 235 new coronavirus cases in the last 24 hours, marking its biggest one-day rise of new infections, and 12 patients died overnight – bringing the total number of infections to 2,704 and deaths to 85.

The rise came as a third of 500 random tests in the capital, Kabul, came back positive, raising fears of widespread undetected infections in one of the world’s most fragile states.

Kabul is the country’s worst-affected area and authorities have implemented a lockdown in a bid to contain the spread of the virus.

The disease may cause huge collateral damage among Afghanistan’s many vulnerable citizens. Save the Children has already warned that lockdowns – which are being widely ignored – have put 7 million children at risk of hunger. Six new polio cases were also reported in the country on Sunday.

More than 250,000 Afghans have returned home from neighbouring Iran since the beginning of the year, fanning out across the country without being tested or quarantined. Anecdotal reports have emerged of dozens of returnees dying of coronavirus.

Iran has said it will reopen schools and mosques in some locations, even though the nation has been the regional centre of the pandemic since mid-February.

The Guardian