Wall St.Journal Weekend 29Feb2020

THE WALL STREET JOURNAL. ** Saturday/Sunday, February 29 - March 1, 2020 |A

two new cases announced Fri-

day had traveled to Iran.

Europe, home to richer na-

tions with mostly well-devel-

oped health systems, should be

in a stronger position than

most to handle epidemics. But

there hasn’t been a systematic

evaluation of the widely differ-

ing pandemic response plans in

place across the continent. Un-

known is whether there are

weak links that may increase

the continent’s vulnerability as

a whole.

Each country has its own ap-

proach to assessing the compli-

cated trade-offs involved.

Among these, they need to

keep people safe—without

causing unnecessary damage to

the economy. They will seek to

assess the true spread of the

disease—but avoid overwhelm-

ing laboratories with negative

tests. And they will seek to be

transparent with the public

without creating irrational pan-

ics.

The U.K. has begun rolling

out mass testing of its citizens

to include anyone displaying

flulike symptoms. France and

Germany are testing people

with symptoms if they have

also recently traveled to af-

fected regions or have been in

contact with known sufferers.

The Netherlands and Belgium

have been restricting tests to

those who have been in contact

with known cases.

It is likely only a matter of

time before more clusters

emerge across the continent.

“What you’re seeing in Italy,

we have to assume is happen-

ing in other parts of Europe,”

said Jeremy Farrar, director of

the Wellcome Trust, a large

medical-research charity.

The key, according to Dr.

Farrar, is keeping containment

efforts going as long as possi-

ble. This helps prevent a surge

of cases overwhelming already-

strained health systems during

the winter flu season. “Every-

thing you’re doing is trying to

dampen the peak and delay the

onset of the epidemic,” he said.

WORLD NEWS

As the coronavirus spills
across borders in Europe, the
continent—with its patchwork
of nation states through which
people travel freely—faces a
test of how well it can cooper-
ate. Adding to the challenge,
the spread of the virus comes
during the winter, when the re-
gion’s health systems are under
most strain.
Geographic borders are no
barrier to viruses, but they can
mark big differences in how
governments respond to them.
Europe’s national governments
are responsible for responding
to epidemics, with the Euro-
pean Union playing a limited
role, and the countries’ geogra-
phies, wealth and health sys-
tems differ widely.
On Friday, as expected, the
number of cases in Europe
grew.
Italy, the country most af-
fected, said 821 people tested
positive for the coronavirus as
of Friday evening, 21 of whom
have died, compared with
around 650 confirmed cases
the day before.
In Germany, authorities reg-
istered over 30 new coronavi-
rus patients, pushing the total
number of confirmed infections
to over 50. More than 1,
people have been quarantined
in the western state of North
Rhine Westphalia, with the
highest number of infections.
The disease spread further,
with infections confirmed in
the southern states of Baden
Württemberg and Bavaria, the
central state of Hessen, and in
the state of Hamburg in the
north.
The number of confirmed
coronavirus cases in Spain rose
to 32, national authorities said
Friday, up from 23 the day be-
fore.
The U.K. said the number of
people known to have the virus
had risen to 20, with the latest
victim being the first not to
have traveled abroad. Previous

BYDENISEROLAND
ANDSTEPHENFIDLER

Medical staff in Albania check

passengers arriving from Italy;

below, a soldier blocks a road

in Italy’s Veneto region.

FROM TOP: GENT SHKULLAKU/AGENCE FRANCE-PRESSE/GETTY IMAGES; CLAUDIO FURLAN/ASSOCIATED PRESS

In an attempt to contain the

spread of the virus, Iran can-

celed Friday prayers for 23 of

the country’s 31 provincial capi-

tals. Iran’s Health Ministry

warned that more cases would

be confirmed in the coming

days. Schools were set to close

from Saturday through Mon-

day, and low-risk and ill prison-

ers were to be released on fur-

lough for the Persian New Year

in March to avoid infection.

Some clerics and worshipers

have defied orders to stay away

from Iran’s holy sites and

shrines. “We have a relatively

difficult week ahead,” Health

The outbreak in Iran has

lasted at least a month, Mr. Bo-

goch estimated.

Deputy Health Minister Qas-

sem Janbabaei, in a discussion

on state television Thursday,

said Iran hadn’t been hiding

coronavirus numbers.

The World Health Organiza-

tion hasn’t estimated the infec-

tion rate in Iran.

The spread of the new coro-

navirus through Iran’s higher

echelons began with a Tehran

district mayor.

The current deputy health

minister’s predecessor, Iraj

Harirchi, who was the head of

the coronavirus task force, also

confirmed he was infected, af-

ter appearing at a press confer-

ence feverish, mopping sweat

off his forehead.

On Thursday, the highest-

ranking woman in Iran’s gov-

ernment, Vice President for

Women’s Affairs Masoumeh

Ebtekar, said she had con-

tracted the coronavirus. Ms.

Ebtekar gained fame in the U.S.

four decades ago, under the

moniker “Mary,” as spokesper-

son for the students who seized

the American Embassy in Teh-

ran.

After top reformist parlia-

mentarian Mahmoud Sadeghi in

a video said he had been in-

fected, the head of the parlia-

ment’s national security and

foreign policy committee, Moj-

taba Zonnouri, who regularly

meets with top decision mak-

ers, was diagnosed.

At least two other parlia-

mentarians tested positive,

lawmaker Mohammadali Vakili

said.

TEHRAN—Coronavirus in-

fections among Iran’s senior

leaders are raising questions

over the extent of an outbreak

that has become a flashpoint in

the world-wide spread of the

virus.

A week after Iranian author-

ities confirmed the first case of

the novel coronavirus in the

country, at least 34 people have

died among 388 confirmed

cases, the health ministry said

Friday.

But the number of Iranian

officials who have tested posi-

tive for the virus has drawn at-

tention to the official statistics,

with some researchers suggest-

ing the number of infections is

far higher—possibly in the tens

of thousands.

“It’s now apparent to the

world that there is a significant

burden of illness in Iran,” said

Isaac Bogoch, infectious-dis-

eases physician at the Univer-

sity of Toronto and co-author

of a report on the outbreak in

Iran published Monday.

Mr. Bogoch and other re-

searchers at the University of

Toronto and Dalla Lana School

of Public Health estimated the

number of cases in Iran at

roughly 23,000. With a model

used during the 2009 outbreak

of swine flu, the researchers es-

timated with a confidence in-

terval of 95% that between

11,520 and 41,280 were likely

infected in Iran.

BySune Engel

RasmussenandAresu

Eqbali

Expertssaythehighmortality

rateinIranmaybedueto

underreportingofmildercases.

Coronavirus deaths as a

percentage of total cases, as

of 3:13 p.m. CET, Feb. 28

Sources: Johns Hopkins Center for

Systems Science and Engineering;

Iran Health Ministry (Iran)

*Iran data is the latest reported.

Iran

China

Italy

HongKong

Japan

SouthKorea

88%

3

2

2

1

0

Trevi Fountain banned Chinese

customers, a measure that

sparked widespread outrage.

Tensions are even rising be-

tween Italy’s regions. The

overwhelming majority of

sickened people are from It-

aly’s wealthier north. Now,

southern Italians are telling

northerners to keep away.

There are currently no

travel restrictions within Italy,

except for the quarantined

towns, 10 of which are in Lom-

bardy and one in Veneto. And

there are no medical checks on

people traveling from the af-

fected regions to other parts

of Italy, but that may change.

“How is it possible that

people are arriving from Lom-

bardy and Veneto and no one

at the airport checks on

them,” Nello Musumeci, Sic-

ily’s governor, said after sev-

eral cases of coronavirus

traceable to the Lombardy

outbreak were confirmed on

the island earlier this week.

“It would be better if no tour-

ists came from the north.”

In the weeks after the Chi-

nese outbreak began, similar

acts of discrimination were di-

rected against Asians and peo-

ple of Asian descent. In one

widely viewed video, an Italian

man told Chinese tourists in

Florence “to go cough in your

homes.” A cafe near Rome’s

Cristiano Giuriato, an Italian

waiter in Madrid, said in a

Facebook post after a regular

customer of the bar where he

works brought him a face

mask and made him wear it. “I

have been stripped of my dig-

nity and bullied for no reason,

just because I am Italian.”

Meanwhile, many other Eu-

ropeans are avoiding Italy, with

the numbers of travelers drop-

ping so deeply that airlines

have canceled flights, while

trains in Italy are nearly empty.

Some Italians abroad are

feeling no longer welcome.

“I feel utterly humiliated,”

Europe’s Fragmented

Health Systems

Come Under Strain

erupted on Feb. 20, Italian au-

thorities have restricted public

gatherings and shut down

schools in the country’s north.

The towns in the region of

Lombardy where the clusters

of infections began have been

sealed off, with armed forces

blocking the roads in and out.

That hasn’t stopped new

cases with links to northern It-

aly from appearing as far

south as Sicily, in Switzerland

and in Spain’s Canary Islands,

where Italian tourists were va-

cationing.

Despite the widening epi-

demic, Italy has pushed back

against suggestions that other

European Union nations could

shut their borders to Italians

over fears of contagion.

“The idea that Italian citi-

zens could be banned from en-

tering another country is un-

thinkable in Heaven or on

Earth, and among the 27 mem-

ber countries this is clear,” Vin-

cenzo Amendola, Italy’s minis-

ter for European affairs, said

earlier this week after meeting

with EU ambassadors in Rome.

So far, Romania has intro-

duced restrictions, imposing a

two-week quarantine on any-

one traveling from Lombardy

and neighboring Veneto. Hun-

gary has also announced vehi-

cle checks on its land borders,

saying it would quarantine

people who may have been ex-

posed to the virus, without

specifying Italy.

Outside the EU, a growing

number of countries have

closed their borders to Italians.

Among them are Mauritius

and the Seychelles, beach-holi-

day destinations popular with

Italians, as well as Saudi Ara-

bia and Israel, which on

Thursday forced an Alitalia

plane to return to Rome

shortly after landing. Only Is-

raeli passengers were allowed

to disembark.

ROME—When the coronavi-
rus outbreak began in China, a
wave of fear and mistrust to-
ward Chinese people swept
through Italy. Chinese restau-
rants couldn’t fill tables, while
some Chinese tourists faced
abuse on the streets. Italy,
alone in Europe so far, banned
all direct flights from China.
Now, as Italy combats its
own outbreak, it is Italians
who are taken aback as others
try to avoid or exclude them.
Italians abroad are being
treated as a risk, and several
countries have already banned
travelers from Italy. Others—
including China—have im-
posed a two-week quarantine
on people who have recently
been to the peninsula.
Among those affected by
the new restrictions is 53-
year-old Gabriele Battaglia,
who was on his way from Mi-
lan to Beijing when the Chi-
nese rules changed earlier this
week. He now finds himself
quarantined in China.
“Now everybody is
shocked,” said Mr. Battaglia,
who works for Swiss television
and has been living in Beijing
for nine years. “But I see the
logic in what the Chinese are
doing: They are isolating peo-
ple who come from hot spots,
like they have done for Hubei,”
the Chinese province at the
center of the outbreak, which
has been cordoned off from
the rest of China.
“For them, Italy is a bit like
Hubei,” added Mr. Battaglia,
who must report his tempera-
ture twice daily to local au-
thorities.
In Italy so far 821 people
have tested positive for the
coronavirus, of whom 21 have
died—more than any other
country after China and South
Korea. Since Italy’s outbreak

BYMARGHERITASTANCATI

Italians Abroad

Now Receive a

Wary Welcome

Minister Saeed Namaki told

state television. “I beg people

to cooperate more with us and

help us in reducing infection.”

Iranian officials have identi-

fied Qom, a Shiite pilgrimage

site, as the source of the out-

break. Qom doesn’t have an in-

ternational airport, making it

likely that the virus, which offi-

cials have said came from

China, passed through Tehran

first.

The global mortality rate for

the coronavirus is about 2.9%,

according to the WHO. Based

on Iran’s latest figures, the

country’s mortality rate for the

virus would be more than three

times the global average.

“Given the number of fatali-

ties that have been reported al-

ready, it’s almost certain that

the true of number cases is

much, much higher than what’s

been detected and reported,”

said Malik Peiris, chief of virol-

ogy at the University of Hong

Kong, who has studied how the

virus spreads.

It isn’t known whether the

discrepancy between Iran’s

numbers and those in other

countries is due to deliberate

underreporting or a lack of ca-

pacity to diagnose the new cor-

onavirus. China on Friday

shipped 20,000 test kits to Iran.

Doubts Emerge Over Iran’s Virus Tally

Iraj Harirchi, left, seen Monday with government spokesman Ali

Rabiei, in Tehran. Mr. Harirchi confirmed he is infected with the virus.

APTN/ASSOCIATED PRESS

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