CDV Coronavirus Updates

Last Update: August 03, 2021

Understanding the Covid Situation in Europe - Summer 2021

We recognize that news reports can create a tremendous amount of confusion and uncertainty, and it is very difficult to understand what is true and what is sensationalism these days. For this reason, we have created this page that presents simple facts regarding how Covid has progressed in Europe. We mainly focus on Italy, but this data is remarkably similar throughout Europe, including Portugal. What you will see here is pure data directly from the Italian Ministry of Health, presented in a simple chart format to make it easier to understand the information. You can verify all of this data through the daily update repository provided by the Italian Ministry of Health at this link.. Italy has maintained meticulous data every day since the beginning of the pandemic.

Our goal is to show how we decipher the data, but also present it in such a way that you can draw your own conclusions. We strongly believe that if you spend a little time reading this page, if you have any concern over coming to Europe, those concerns will be allayed

About the Waves

Italy has experienced four waves of Covid. The first wave was the major outbreak in March 2020. The second was in October 2020, the third began in February of 2021, and the fourth began in July of 2021. When you look at each of these waves, you can see incredible differences that, when compared, put quite a bit into context. We will not focus on the first wave, because the data was all very new, and they did not have good testing yet. Still, looking at the following waves tells a very powerful story that you simply will not see in news reports overseas.

The Second Wave

This chart shows the first 30 days of the second wave, which began in early October of 2020. On Oct 1, 2548 cases were reported, and at the time there were a total of 291 people occupying CCU and ICU beds nationwide. Within a week, each day there were between 50 and 100 more CCU/ICU beds being occupied each day, and by Oct 31, 1,843 CCU/ICU beds were occupied. This wave finally peaked on Nov 13, with 40,902 cases reported and 3,320 CCU/ICU beds occupied. Fatalities, which typically max out about 10-12 days after the peak hit 853 on Nov 24. This data is important to remember when looking at the waves that follow, because in this second wave, they still had no vaccine, and had significantly better testing capabilities than they had in the first wave.

The Third Wave

Italy had a slower start to its vaccination rollout than some countries, so in January and February, they were only doing between 50,000 and 100,000 doses per day. However, they were focusing on people on the 80+ age group, and those with very severe co-morbidities. By the end of March, they were administering roughly 300,000 doses per day. As such, the third wave, which started slowly in February 2021, and peaked at the end of March, 2021 looked very different in terms of cases versus hospitalizations and deaths. More people were getting Covid, but the hospitalization and fatality rate was roughly half what it had been in the prior wave. This wave peaked with 31,758 cases on March 31, but the CCU/ICU peak was 1,843 patients. Fatalities per day were averaging around 350 10-12 days later. Again, roughly half the average of the second wave despite significantly higher cases counts.

The Fourth Wave

By early summer 2021, Covid cases had fallen dramatically, and the vaccination rollout increased to roughly 500,000 to 600,000 per day. They had gradually lowered the age limit for those able to get the vaccine, and at the beginning of July, roughly 50% of the country had been fully vaccinated. Then Italy went into the finals of the European Cup of Soccer, and eventually won it. Millions of Italians were attending massive celebrations, mostly younger people, of course. The younger Italians made up the vast majority of the remaining unvaccinated population, and at the same time the Delta variant hit Italy. All of the sudden cases began to go up again, but this time was VERY different. While cases were going up, hospitalizations and fatalities have remained extremely low. This makes perfect sense based on all of the science we have come to learn about Covid. Younger people without co-morbidities are generally asymptomatic or have what amounts to a common flu. In fact, a month into the fourth wave, the daily case peaks have been roughy 400% lower than they were in March. The hospitalization rate went down 1,500% compared to March. For context, on July 1, 2021, there were 229 CCU & ICU beds occupied, while on August 1, 2021 there were 230 occupied. An increase of one. Average hospital admissions during the second half of July were in the 10 - 20 per day range, while in March they were 200 - 300. Furthermore, hospital stays are significantly shorter, so discharges are happening as fast as admissions. Fatalities a full month into the 4th wave are between 5 and 20 on average per day. Contrast that with the fact that in May, while cases were dropping, fatalities were in the hundreds per day still. In June, cases were dropping even more, but the average fatalities per day in June was double that of July.

What we are seeing is an increase that is a fraction of previous waves in terms of cases, while hospitalizations and fatalities are still trending down, even though we are far enough into the fourth wave that we would otherwise have been seeing them go way up by now. More importantly, more than 95% of these cases are among the still unvaccinated population..

So What Does All of this Mean?

If you stop and think about it, these numbers make perfect sense. A healthy 20 year old that has not had the chance to get their vaccine yet is not protected. Introduce the more easily spread Delta variant, and that 20 year old is more likely to get it. Mix all of that in with a massive national championship win, and you are simply going to get a bump in your numbers over the next several weeks. But as we know, young and healthy people rarely get serious cases of Covid. Some rarely do, but not many. This explains the extremely low number of hospitalizations and deaths. Add to that there are a few people in older age groups that could not get vaccinated because of other medical conditions, or simply chose not to, and you get a small number of bad outcomes.

For these very reasons, Italy has done away with making decisions based on "case count," and are focusing specifically on what is happening in hospitals, much as they would with an influenza outbreak. The country is now divided into colored "zones" based on severity of outbreaks. "White" means Very Low Risk. "Yellow" means Low Risk, "Orange" means High Risk, and "Red" means "Very High Risk." Despite the recent increase in "cases," all of Italy remains "WHITE." or "Very Low Risk" because actual hospitalizations have been so incredibly low.

Perhaps to put this into greater context, remember that the fatalities in this fourth wave are currently ranging between 10 and 20 per day. In the 2018 flu season, there was an an average of 68 influenza-related fatalities per day in Italy. In an average day, roughly 500 Italians die from heart disease, 100 from cancer, and 73 from Alzheimers.

What to Expect in the Coming Months?

Of course, none of us have a crystal ball. But we can apply some logic based on what is going on in Italy right now. As you read above, "cases" have been trending up, but seem to have leveled off, and they are almost exclusively among younger unvaccinated people. As of this writing, 61% of all Italians over 12 have been fully vaccinated. Just a week ago, the number was 55%. Roughly another 25% of the entire nation has received a first dose this past month, and is awaiting the second. Finally, Italy continues to deliver an average of around 600,000 doses per day, the majority of which are going to the younger citizens that make up the current wave.

One common question is that of vaccine hesitancy. In Europe, the vaccine has not been nearly as political as in some other places. This is not to say that there has not been some vaccine hesitancy. Just like anywhere, there are people that are anti-vax, and those that wanted to wait and see a bit. However, these numbers seem to be significantly lower than what we have seen in North America. Recently, Italy announced a "Green Pass" system that will go into effect this week. It requires that people show proof of vaccine, proof of covid recovery, or proof of a negative test less than 48 hours old in order to enter crowded indoor places, like restaurants and museums. It was implemented as a stopgap measure while the rest of the population gets vaccinated without having to force a vaccine mandate. Overall, Italians have taken very well to this, and the vast majority of those that were hesitant have already made appointments for their vaccine.

Based on all of this data, it is expected that in the next month, another 18 million doses will have been administered. This would put the vaccinated population at somewhere between 80% and 90%, closing the gap for the young that make up the current wave. In other words, we see no signs whatsoever that give us worry that we may not be in a fantastic place to start our Late Summer and autumn 2021 season in Italy.

What about Portugal?

Some have noted that the United States Department of State and the CDC had recently raised the threat level in Portugal due to a new wave of cases. While it is absolutely true that there was a new wave of cases in Portugal this summer, the CDC and State Department appear to be somewhat slow to react, as they implemented these warnings at a time when Portugal had already began a downward trend. One which continues to this day. As with Italy, this has been almost exclusively among the younger, unvaccinated population as the Delta variant became dominant. Similarly, hospitalizations and deaths have remained extremely low, and did not track as with previous waves. Portugal was a little slower than Italy with its rollout, hence a somewhat larger wave occurred. However, they have dramatically increased the vaccine effort as they entered into summer, and the lower numbers of cases and hospitalizations are showing and within a few weeks of the beginning of this wave, it peaked and started going down. It never got anywhere close to previous waves.

Are Masks and Social Distancing Required?

As of this writing, Italy has a mask requirement for inside businesses while standing up. There is no outdoor mask requirement. Social distancing measures have also been removed. Portugal still has a mask requirement for outdoors when social distancing is not possible, but has announced that it will end it this month.

Are there any closures anymore?

No. The U.S. State Department website still shows some restrictions in Portugal that have since been removed.

What is required to enter the country?

Any one of the following for both Italy and Portugal:

  1. An official vaccination certificate from your country, showing you are fully vaccinated (2 weeks after final dose. Italy accepts Pfizer, Moderna, J&J, and AstraZeneca. Portugal accepts Pfizer, Moderna, and J&J
  2. If not vaccinated, you may provide proof of recovery from Covid within 6 months prior to your departure.
  3. If neither of the above apply, you must show proof of a negative antigen test within 48 hours prior to entering Italy or Portugal

What is the "Green Pass" & What do I need during my stay?

Both Italy and Portugal participate in Europe's "Green Pass" system. Many outside of Europe have been quite confused by this, but it is actually quite simple. In order to enter some indoor restaurants, events, hotels, etc. you need to have the "Green Pass." In Europe, there is an app for this, but for people coming from outside of Europe, any one of the following is considered a "Green Pass" for visitors:

  1. An official vaccination certificate from your country, showing you are fully vaccinated (2 weeks after final dose. Italy accepts Pfizer, Moderna, J&J, and AstraZeneca. Portugal accepts Pfizer, Moderna, and J&J
  2. If not vaccinated, you may provide proof of recovery from Covid within 6 months of the date presented.
  3. If neither of the above apply, you must show proof of a negative antigen test within 48 hours of the time the Green Pass is requested.

If you will not have been fully vaccinated, or less than 6 months after Covid Recovery during your trip

We would strongly urge all of our guests to be vaccinated, but understand there are reasons some guests will not or can not. If this is the case for you, we believe that both countries will accept negative covid tests taken specifically with this antigen kit: https://www.emed.com/. We cannot guarantee with 100% certainty that this will be accepted, but know it has been accepted in England, France and Germany so far. It would be wise for you to get one to cover every 48 hours of your trip, and a few to spare just in case. Many insurance plans cover the cost of this kit.. Note that the store-bought self-test kits will not be accepted, because they offer no form of verification. If for some reason these kits are not accepted, tests are generally available in all pharmacies for about 10 Euros. Needing to get tested at pharmacies may not always be convenient on our trips, but we will do the best we can to help if the need arises.

What do I need to go back home?

As of this writing, if you are returning to the United States, whether or not you are vaccinated, you must get an antigen test within 72 hours of your flight home. The self-test noted above is accepted: https://www.emed.com/. If you are returning to Canada, a PCR test will be required, and we will help you arrange one while you are with us. If you are returning to a home destination within Europe, follow all the rules for the Green Pass. For South Africa, New Zealand, and Australia, sadly you are still unable to travel, but we truly miss you!

So now what?

It is beautiful over here, and life feels like pre-covid. There is no political toxicity in relation to Covid, there is no 24 hour news cycle selling fear and division, and the food is amazing! Everyone here is just ready to move on. So if you are coming, come and celebrate life with us!