Why coronavirus hits Italy, Spain hardest in Europe

There is still no verifiable scientific explanation for why two Mediterranean countries -- Italy and Spain -- have become the epicenter of the COVID-19 pandemic in Europe. These two European Union (EU) nations have seen the fastest growth in coronavirus cases in terms of both infections and deaths.

It is also not understood yet why 70 percent of the fatalities in Italy were men and just 30 percent women. The explanation could be sociological rather than medical, and this could also go some way to explaining the similarities between Spain and Italy and also the differences between countries and regions.

The fact that Italy's Sicily Island has only seen a handful of deaths from the coronavirus is itself intriguing. Perhaps Sicily being an island is a factor here, but there may be other reasons, such as the locals' social characteristics, such as family life.

Scientists will have to consider non-medical factors, such as the Spanish habit of living an extensive social life out in the streets, in bars and restaurants. People in Spain spend relatively little time at home, and this may explain the rapid spread of the coronavirus.

In the countries of northern Europe, people tend to be homebodies partly because of the cold and wet climate, which makes staying indoors more attractive than going outside.

Spain's case is worthy of study, given that the epidemic appears to be spreading faster there than in Italy, with over 47,000 confirmed cases by Wednesday. One difference between Spain and Italy is that while in Italy coronavirus infections are concentrated in three regions, in Spain the number of cases is increasing across the whole country, with the capital Madrid being the epicenter.

Within just five days, Spain's number of coronavirus deaths jumped from just under 1,000 to 3,434 by Wednesday and the infections are projected to reach their peak in the coming days.

Some experts claim that the Spanish government should have curtailed the freedom of movement earlier, since March 12 and 13 (just before the "state of alarm" was imposed) saw many people leave their homes in the country's biggest cities to visit their families in the villages or to go to the coast.

Sporting and political events were also allowed to be held in Spain up to and including March 8, with 110,000 people taking part in the International Women's Day celebration in Madrid and in similar marches throughout Spain. On the same day, the right-wing Vox party organized a rally with 9,000 participants in Madrid, attended by the party's Secretary General Javier Ortega Smith, who tested positive for the coronavirus two days later.

That weekend also saw a full round of sporting fixtures, with thousands of fans attending football matches. On March 11, 2,500 Atletico Madrid fans traveled to Liverpool for a Champions League game.

Opposition groups have criticized Prime Minister Pedro Sanchez for waiting until March 14 before declaring a "state of alarm".

Spain has also struggled to source the sanitary equipment needed to protect its medical workers, who currently make up over 10 percent of all confirmed coronavirus cases in the country, according to local media reports.

This despite the government's 48-hour deadline for private companies to inform the Ministry of Health if they had items such as face masks, protective suits, rubber gloves and hand gels at their disposal for distribution to the nation's hospitals.

Despite donations of protective equipment from China, by companies such as Inditex and Huawei, as well as individuals, Spain still faced a dire shortage of protective gear. On Wednesday, the Spanish government finally announced a massive order of face masks, ventilators and rubber gloves from China.

It is clear that not having the capacity to produce the required amount of such equipment in Spain has been a problem since the start of the crisis. Meanwhile, the public health service's capacity to react has also been affected by the cutbacks it suffered between 2011 and 2018 under the economic austerity policies of the previous Spanish government.

The pattern of mortality rate for COVID-19 is little different in Spain than in other countries, hitting the elderly and people with pre-existing medical conditions the hardest.

According to the Spanish Ministry of Health, the mortality rate for people aged 80 or older is 17.91 percent, dropping to 5.34 percent for those aged between 70 and 79 and 2.16 percent for those aged between 60 and 69. Meanwhile, death rate among those aged 60 or younger is 0.64 percent.