Interview on the Portuguese response to COVID-19 pandemic with Carla Nunes, statistician and epidemiologist. Carla Nunes is the Director of the National School of Public Health, at Nova University of Lisbon (Portugal), and the Coordinator of the COVID-19 Barometer project, which analyses the evolution of the pandemic in Portugal.
What did Portugal do so differently, compared to other countries, to achieve such good results during the lockdown — lower number of deaths and of positive cases?
Carla Nunes: I think that what made a difference in relation to Italy or Spain, which are countries culturally similar — we kiss and hug —, was that the pandemic hit us later, after we had seen the situation in Italy and what could happen to us. It was scary. Portugal took the first steps earlier than other countries. And not only did the state act very quickly, also people joined easily. Some schools and universities even closed before the health authorities asked for it.
And was there anything that could have gone better?
Carla Nunes: There were things, related to organization of health services and information systems, for which we were not prepared and we are now trying to reorganize the whole process.
Regarding the cases, having outbreaks in nursing homes was a problematic situation. We could have reacted better. We have noticed that health professionals in Portugal work in several places at the same time and we didn’t immediately understood what would be the consequence of having health professionals circulating a lot.
After three weeks of lockdown, what led to the first phase of easing lockdown rules on May 4?
Carla Nunes: The goal, both for closing and opening lockdown, is not to have zero new cases. This is impossible. The objective is to be able to have some businesses working, while we continue to get some new infections cases progressively, but still protecting vulnerable people from the disease and keeping health services functional. At the moment it is working fine. As long as we can keep treating properly the sick ones and we can protect vulnerable people (like the elderly), let’s ease the lockdown.
Portugal has three phases of easing lockdown rules. How was it like the first phase, from May 4 to May 17?
Carla Nunes: In the first phase, government rules were cautious and people were mostly staying at home still. It was a very cautious unlocking. This will make the returning [to regular life] slower, but more careful.
A big step now as of May 18 is to put children (younger than 3 years old) in schools, because that is what would allow parents to return to work and revitalize the economy.
June 1, the third phase of easing lockdown rules, will open most businesses. What do you expect for this summer?
Carla Nunes: Going to the beach during summer vacations is a very important habit in our culture. Forcing us to work from home it’s one thing, but forcing us to stay at home during summer vacations is a lot different. The government was very clear about opening the beaches: we are not going to police you, each one has to be their own police. If things get worse, we lock it down again.
What could lead the situation to get out of control?
Carla Nunes: What could happen at the worst-case scenario is to return to square one, abandoning all the preventive measures that we were using for the last two months. I don’t think it’s possible.
In September, there will be another big test, because all of the children and teenagers will go back to school. Could this possibly lead to a lockdown again?
Carla Nunes: In the worst case scenario, yes. But it is not expected at all, also because we are expected to gain some immunity. With the little steps we are taking I don’t think we’ll need to turn back and apply some lockdown rules.
• COVID-19 barometer