The COVID-19 policy response in Spain and Portugal: a study of measures to slow down infection rate

Abstract

BackgroundThe COVID-19 global pandemic triggered massive policy responses worldwide. Measures taken during the pandemic differed across countries and time. Governance systems may influence the capacity of countries to respond promptly and mobilize the necessary resources in time. Identifying measures and when they appeared are critical questions to assess emergency response strategies. The objective of this study was to analyze the policy response to slow down the infection rate of COVID-19 cases in Portugal and Spain according to timing (related to death rates) and stringency.MethodsA descriptive comparative study of non-pharmaceutical interventions was conducted through a content analysis of policies and records review of official government sources. Portugal and Spain were selected considering the similarities between national health systems, but different government organization and epidemic impact. The Autonomous Community of Madrid was also included as example of subnational systems. Death rates were retrieved from daily statistics of open secondary sources.ResultsResults show that countries responded with a complex mix of measures across policy sectors, following dynamic patterns established by the epidemic evolution and governance systems. Policies aimed to reduce the spread of the virus, enable individuals and businesses to comply with restrictions, and reinforce National Health System's capacity. The declaration of state of emergency was a critical tool to organize actions under clear leadership, especially in devolved contexts.ConclusionsOur findings suggest that, in early epidemic phases, a centralized command can be more effective at timely enacting nationwide stringent measures. Evidence from this study contributes to the argument that a fast, robust, and early response might have been more effective at containing spread at the initial stages of the pandemic.Key messages The policy response included measured to reduce spread of infection, enhance adherence and strengthen health systems capacity to deal with the pandemic.The declaration of state of emergency was essential to ensure an organized, coherent, timely, and robust response, especially in devolved contexts.