Greece learned from Italy’s and Spain’s mistakes and used rapid response to keep its virus deaths low

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If there were any country in Europe least capable of dealing with the novel coronavirus pandemic, you might think it would be Greece.

Here was a country with one of Europe’s oldest populations, a frail health care system and little financial firepower to fight the disease caused by the virus. The recipient of three sovereign bailouts since the 2008 financial crisis, Greece had spent almost all of the past decade mired in deep recession and crushing unemployment.

Yet today, two months after the pandemic hit the continent, Greece, so far, has been spared the disasters that have hit Italy, Spain, Britain and other European countries. As of Tuesday, it had recorded 2,170 COVID-19 cases and 101 deaths. Two countries of comparable size, Belgium and Netherlands, had recorded 4,167 and 2,945 deaths, respectively. Italy continues to have the highest death toll in Europe, with 21,067 fatalities by Tuesday night, followed by Spain (18,056), France (15,729) and Britain (12,107).

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Greece was able to keep its death count down by listening to its scientists and moving much faster than most other countries to lock down the economy. The government had ample political support to do so.

Greece’s new government, led by Prime Minister Kyriakos Mitsotakis, has mustered enormous political and popular support to put his virus-fighting agenda into action, said Takis Pappas, a Greek political scientist at the University of Helsinki who has written about Greece’s response to the coronavirus crisis.

“Mitsotakis went into the crisis with several advantages and was able to move very fast,” he said in an interview. “He made the case for a common response and there was no room for the Opposition to slow him down.”

The centre-right New Democracy government, elected with a majority last summer, knew it could not take chances when the pandemic hit. After years of cutbacks, the entire health care system was left with just 560 intensive care unit beds. Relative to its population of 10.7 million, the number of beds was one of the lowest in Europe, equivalent to about one-fifth of the German tally.

Speed – not widespread testing – was the crucial factor in preventing COVID-19 illnesses from overwhelming Greek hospitals. Mr. Pappas created a timing response table to measure Greece’s lockdown performance against those of Italy and Spain (Greece’s first positive coronavirus case was reported on Feb. 26; the first death came on March 12).

All Greek schools were closed within 13 days of the first positive test. Italy did not shut its schools until 33 days after its first positive; Spain took 43 days. Greece’s schools were closed on the day the country reported its first coronavirus fatality. Italy waited 11 days and Spain 30 days. Non-essential shops were closed in Greece within four days of the first fatality. Italy waited 18 days and Spain 30 days.

Mr. Pappas said Spain’s slow response was alarming, since the disease in Europe hit Italy first, giving Spain some time to formulate an effective response. It didn’t. “Spain was reluctant to learn from Italy,” he said.

At first, Spain appeared not to take the COVID-19 threat seriously. “We are going to have only a handful of cases,” Fernando Simon, the epidemiologist who serves as the emergency health co-ordinator for Spain’s Ministry of Health, said on Feb. 9, a little more than a week after Spain’s first coronavirus case was confirmed.

But the number of cases and fatalities exploded in Spain, partly because the quarantine measures came so late. For instance, on March 8 – three weeks after Spain’s first COVID-19 death – Madrid allowed more than 100,000 people to march through city streets to celebrate International Women’s Day. Political squabbling and infighting in the fragile coalition government of Prime Minister Pedro Sanchez helped to ensure the emergency measures were not agreed to quickly.

By Tuesday, Spain had more than 172,000 confirmed coronavirus cases, the second-highest, after the United States, as well as the most reported deaths per million inhabitants in Europe (Italy was second and Belgium third). On that measure, Greece was not even among the dozen worst-hit countries, according to data compiled by Bloomberg.

Greece appears to have learned well from Spain’s and Italy’s mistakes and made a few innovations of its own. One was accelerating the digital roll-out of government services, a process that had started in earnest last summer, when Mr. Mitsotakis’s government was formed. The idea was to reduce the need to make government office visits by putting forms online. The government allowed doctors to send prescriptions to patients on their phones, ending the need to take the risk of visiting clinics for routine matters.

The government was also able to persuade Greece’s powerful Orthodox Church to suspend daily services and sacraments, although trying to convince the faithful to stay at home on Orthodox Easter, on April 19, is expected to be met with some resistance, given the relatively low infection and fatality numbers.

The low fatalities rates do not mean the Greek economy will escape severe economic damage. The lockdown is expected to last until mid-May before being lifted gradually – details have been scant. Given the caution that Mr. Mitsotakis has displayed so far, it seems unlikely that he will rush to open the economy fully before the summer.

Andreas Mentis, the head of the Hellenic Pasteur Institute’s department of microbiology, said Greece’s early containment measures have been “very successful,” but warned that the good fortune may not last.

“As we all know, an epidemic can only be stopped by a vaccine and there are some hopeful messages on this front that the first vaccinations will become available in the fall or shortly after,” he told a state-run news agency last week. “Let’s hope this happens, otherwise we will face a real pandemic.”

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