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The three European countries included in the northwest littoral of the Mediterranean region – Italy, France and Spain – reported their first cases of the SARS-CoV-2 coronavirus early in 2020. The subsequent epidemic strongly impacted these countries, challenging the healthcare systems efficiency, and the capacity and transparency of their public statistics structures. Because public statistics were not fully adapted to such a new health situation, the available official data could not wholly describe the epidemic correctly. This paper developed an indicator derived from the prevalence of SARS-CoV-2 aiming to describe the time and spatial dynamics of the epidemic. Although the analysis was not applied to France due to the lack of data available, the comparative analysis among Spain and Italy highlighted some similarities and certain divergences, partially attributable to the features of each country‘s national demographic patterns and the peculiarities of applied health protocols. Finally, mortality during the first wave of the epidemic has been analysed for the three countries, demonstrating higher mortality index in Spain, although the reported number of SARS-CoV-2 declared deaths does not explain a portion of this mortality excess. [ABSTRACT FROM AUTHOR]

Background: The novel coronavirus disease is an ongoing pandemic that started in China in December 2019. This paper is aimed at estimating the first two infections waves in Italy in relation to adopted health policies. Design and methods: We moved deaths of the Italian COVID-19 registry from recorded to infection date by the weighted moving average. We considered two infection fatality ratios related to the effective or saturated health system, we estimated the likely incidence curve from the resulting deaths and evaluated the curve shape before and after the national health policies. Results: From the 24th of February 2020 to the 7th of February 2021, we estimated 6,664,655 (4,639,221-9,325,138) cases distributed on two waves. Suitable daily infection fatality rates were 2.53% within the first wave and 1.15% within the second one. The first wave (February-July 2020) had its peak on the 14th of March 2020 (26,575). The second wave (August 2020-February 2021) was fatter with the peak on the 12th of November (60,425) and a hump in December before decreasing to 26,288 at the end. Adopted health policies were followed by changes in the curve rate. Conclusions: Tracing infection contacts and quarantining asymptomatic people reduced virus lethality in the second wave. Restriction on population mobility is effective within a suppression strategy, distance learning reduces contacts among families. Removal of restrictions should be implemented by sequential steps for avoiding a quick rising of incident cases. A reasonable public health daily goal to control both virus spread and lethality could be to find at least 87 cases for each death. [ABSTRACT FROM AUTHOR]