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Italy, Spain, UK health services struggle to cope

VERDUNO, CUNEO, ITALY – 2020/03/31: Medical workers wearing Personal Protective Equipment (PPE) are pictured outside Verduno hospital (Alba-Bra hospital).

Nicolò Campo

A lack of beds, protective equipment and doctors are just some of the issues being faced in Europe, as the coronavirus crisis exposes the weaknesses of the region’s national health systems. 

After deep austerity measures over the last decade, the health systems of countries like Italy, Spain, the U.K. and Portugal are struggling to keep on top of the ongoing outbreak of COVID-19. There are some common issues, such as a lack of testing kits to monitor the virus, and not enough protective clothing and equipment.

“Overloaded,” a junior doctor in the north of Portugal, and who didn’t want to be named due to the sensitivity of the issue, told CNBC. “There are no personal resources nor (enough) equipment for everything.”

Portuguese Prime Minister Antonio Costa has said all EU nations are finding it hard to meet demand for equipment, but claims his country’s health system is delivering on other non-virus cases.

Not enough doctors

There is one crucial thing that governments are finding it difficult to provide enough of: heath-care workers.

“A lot of staff are in quarantine, and those who aren’t end up doing shift on top of another shift,” the Portuguese doctor added.

The president of the Portuguese medical association has appealed to retired doctors to return to the national health service and help during the emergency. The country saw a large exodus of health professionals in the wake of the 2011 sovereign debt crisis, with some opting to move elsewhere, where the wages were higher. This has also been the case in Spain and Italy, where the lack of medical staff has been a key issue during the pandemic.

MADRID, SPAIN – MARCH 31: Interior of an IFEMA pavilion fitted out as a temporary hospital for patients with coronavirus, on March 31, 2020 in Madrid, Spain.

Europa Press News

When asked about the biggest challenges facing Italy’s health-care system, Vincenzo Defilippis, director of the local health authority of Bari, in southern Italy, told CNBC: “The scarcity of doctors and nurses.”

These health-care workers are the front line in the fight against what European heads of state have dubbed a “coronavirus war.” There are a growing number of medical staff who have died as a result of the coronavirus — in Italy, for instance, over 60 health-care professionals have died so far, according to the Italian national doctors association.

In Spain, meanwhile, there have been more than 12,000 infections among health care workers to date, according to the El Pais newspaper. The General Medical Council of Spain said it did not have enough data to confirm how many medical professionals had died from the virus so far when contacted by CNBC Monday, however, it has previously confirmed that one doctor, aged 59, and a nurse, aged 52, had died from COVID-19.

Meanwhile in the U.K., one in four doctors are off work because they are either sick or in self-isolation, according to the Royal College of Physicians earlier this week.

Lack of protective equipment

Infections among medical professionals have reportedly been accentuated by a lack of protective equipment, such as masks.

“Our main concern is to get as soon as possible the right equipment to protect ourselves,” Tomás Cobo, an anaesthetist at a hospital in Madrid, Spain, told CNBC via email.

The total number of infections and deaths in Spain have surpassed those of China, where the outbreak emerged in late 2019. The virus has taken so many lives that in Madrid some bodies have been moved into an ice-skating rink, as the funeral homes have run out of space.

Italy was not ready for COVID-19 pandemic.

Giuseppe Navarra

Professor of surgery at the University of Messina

One of the main criticisms of the Spanish government is that it didn’t stock up on medical equipment early enough. The government has vowed to buy and distribute 550 million masks, 5.5 million tests and 950 pieces of assisted breathing equipment over the next eight weeks, the health ministry announced last week. 

In Britain, the government has also been criticized for a lack of protective equipment being available. Richard Horton, the editor-in-chief of the U.K. medical journal, The Lancet, said in an article that the country’s national health system “has been wholly unprepared for this pandemic.”

A spokesman for the U.K. government said Thursday that there have been some “distribution problems” of protective equipment, but noted that this is a temporary issue.

Not enough beds

Another issue plaguing the health services in Europe is the inability to accommodate the large numbers of patients falling gravely ill at the same time.

“We have a great problem with the total number of ITU (intensive therapy unit) beds,” Cobo, from Madrid, added. Italy, the worst-hit country in Europe, faces the same problem.

“In the last decade, the (Italian national health service) has seen cuts of more than 37 billion euros ($40 billion) with a significant reduction of ICU (intensive care unit) beds together with a progressive privatization of health care, especially in the rich north,” Giuseppe Navarra, professor of surgery at the University of Messina in Sicily, told CNBC via email.

“Italy was not ready for COVID-19 pandemic,” he added.

Doctors are on the street in front of the emergency entrance of the hospital of St. Pau to thank the support of the neighbors during the crisis of coronavirus – Covidien-19 in Barcelona, Catalonia, Spain, on March 31, 2020.


The Italian government has received masks, ventilators and expert advice from China, and the Italian health ministry has said the additional distribution of protective equipment will be prioritized to medical staff.

Both Defilippis and Navarra told CNBC that some health-care workers had been told to continue working even if they have tested positive for the virus, “unless symptomatic.” The Italian government was not immediately available for comment when contacted by CNBC Thursday.

Testing issues

The U.K. has been criticized for a lack of testing. Horton slammed the U.K. government’s strategy, saying that ministers did not follow advice from the WHO “to test, test, test every suspected case.” Prime Minister Boris Johnson’s government has promised to accelerate testing of suspected cases.

Johnson, who is himself self-isolating after testing positive for the virus, said on Wednesday that testing was “the way through. This is how we will unlock the coronavirus puzzle. This is how we will defeat it in the end.”

Health experts believe a lack of testing can party explain why Italy and Spain have been hit with more coronavirus cases than China. Essentially, the more people that get tested, the better that authorities can respond.

Given the unprecedented challenges and the pressure on health-care systems, governments across Europe have announced different steps to support their own sectors, including developing contracts with private care facilities and by announcing new funding. 

As well as ramping up the procurement of equipment and tests, European governments have also built temporary infrastructure to house infected patients, and institutions such as the Red Cross and Doctors without Borders have helped to monitor the spread of the virus.

“We are confronted with an exogenous, global shock that has no precedents in modern history,” Italy’s Conte said in an interview last month.

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