Sociodemographics and COVID-19

Is Australia really different from Italy and Spain?

Australia has thus far managed to keep its rate of new infections related to COVID-19 low and its total number of issued tests high relative to other Western developed nations. Watching the numbers climb amidst the rest of the world, many have growing concerns, wondering if the current rate of infections will continue to climb for the next several months in Australia or if the curve will level sooner. Government Deputy Chief Medical Officer Professor Paul Kelly issued a public statement expressing his profound faith in the Australian government moving forward, stating, “We are not Italy, Iran, or Spain…we have reason to be confident we will keep ahead of the curve.” He goes on to list government efforts alongside common sense health guidance, leaving many to wonder if this is an unfounded sense of exceptionalism or if there really is something unique about Australia compared to other countries. 

As it turns out, there are significant differences between European nations such as Spain and Italy, who have been hit particularly hard by COVID-19, and Australia. But there are also similarities. Thorough analysis of these various social, spatial, and demographic factors which predate COVID-19 could offer valuable insight into its possible spread. It is only through first understanding this framework that we are able to accurately predict what is to come and safeguard against it.

Proxemics: The Study of Personal Space

Southern Europeans consistently have lower personal space requirements than average, rivaled only by Eastern Europeans and Latin Americans. Though this varies based on the individual, on average Italians and Spaniards in social situations are comfortable standing 90cm apart from strangers and around 70cm from acquaintances. When speaking with close family and friends, Spaniards were comfortable with slightly under 60cm where Italians were comfortable with as little as 40cm. The result of these social conventions is a greatly reduced proximity well below the 1.8 meters of social distance recommended  to prevent the spread of coronavirus. 

In Italy, it is considered rude to position oneself towards the door rather than towards other individuals when in public, even in close proximity situations such as elevators. In both cultures, there was an overall tendency towards physical touch as an expression of friendliness or politeness. Reaching out to touch a friend’s arm in conversation is seen as a sign of friendliness. A kiss on both cheeks is considered to be a simple polite greeting. 

Both Spain and Italy are considered contact cultures, which embrace a high level of social engagement and reduced personal space restrictions. By contrast, Australia is a non contact culture, in which a much larger amount of personal space is considered the norm, even between close friends or family. 

When considering whether Australia will experience greater numbers of outbreaks in the coming months similar to what Italy or Spain has experienced, it is important to note that the behavioural adaptations Australians would have to make to comply with COVID-19 safety guidelines are much less drastic than people in contact cultures such as Italy or Spain. Behaviour that is considered basic manners in these places unfortunately pose a risk, as COVID-19 is primarily spread through respiratory droplets as a result of sneezing, coughing, speaking and even breathing. 

Population Density

While both Italy and Spain have larger overall populations, Australia has more major cities with over one million people residing there. The national population distribution in Australia is very stratified, with the majority of its population residing in urban areas but a large portion residing in rural areas. As COVID-19 seems to have spread more rapidly in densely populated areas, this may present a problem for the slight majority of Australia’s population.

While Australia is more heavily stratified in its population distribution than either Italy or Spain, this difference pales in comparison to the radically different land distributions of Australia compared to either Spain or Italy. The national area distribution is a measure of how the landmass of the country is used. Australia is dominated by rural land, leaving its population congregated into a smaller overall area than either Spain or Italy.  

Both Italy and Spain feature a relatively even distribution of its population in either intermediate or urban areas located throughout the countries. In contrast, Australia features an extremely dense concentration of its population in various cities in the Southeast. Almost 50% of Australia’s total population is located in Sydney, Melbourne, or Brisbane. The most populous area of Australia extends between Melbourne and Sydney along the ocean. 

While the overall population density of Australia is extremely low at only three residents per km² due to the vast amount of rural areas, its urban population density is around 400 residents per km². 

In contrast, the overall population density of Italy is reported at 206 residents per km², with an urban population density that varied widely from 376 (Bologna) to 2,279 (Naples) residents per km². 

The overall population density of Spain was somewhere in the middle at 94 residents per km², but with an extremely high population densities in major metropolitan areas such as Barcelona and Cádiz at 15,991 residents per km² and 9,700 per km², respectively.

All of this seems to suggest that there is indeed a dramatic difference between the most densely populated areas of Spain and Italy as compared to Australia. If one was to journey by car from Sydney to Melbourne, the trip would take roughly 875km, requiring the driver to pass through several small to medium sized cities, with only Albury boasting over 50,000 residents. In contrast, a trip from Madrid to Barcelona would take roughly 621km, bypassing Lleida (over 430,000 residents) and Guadalajara (over 258,000 residents) along the way. The journey from the major hubs of Italy, Rome and Milan, is shortest of all at 573km. Yet along the way the driver would pass Parma, Bologna, and FLorence, all with populations of over 190,000. So while Australia’s population is concentrated in the same region, there is a reduced overall chance of spreading infection between major population hubs. 

While it is true that COVID-19 has the capacity to infiltrate rural areas, its reach is limited should individuals follow safety guidelines. Within rural areas, engagement with others is much less frequent and outside of a few household tasks such as grocery shopping, refueling gasoline, and picking up prescriptions, it is not inevitable. Those in rural areas are accustomed to a certain degree of social isolation and already have a culture of self-sufficiency that lends well to the unique safety precautions surrounding the virus.

Furthermore, unlike both Italy and Spain, Australia is an isolated continent. This makes it more difficult to circumvent regulations which attempt to safeguard against international spread of the disease. 

Aging Population

For many years now, Italy has had difficulty dealing with an aging population. Compared to Australia or Spain, Italy has a significantly higher percentage of its population over sixty-five and up to 60% of its population is over forty years of age. 

In Italy, around 96% of all elderly people continue to live in their own homes, relying largely on relatives to care for them when needed. Significant portions of the elderly population lived in homes with their adult children, which some critics argued may be putting these elders at risk. The impact of this when it comes to COVID-19 are debatable, as the country has experienced a wave of deaths in its nursing homes despite relatively low uptake for these services. It is possible that family members, who are often not medical professionals, may not take the necessary precautions to prevent the spread of illness.

In Spain, a significant proportion of the population considered caring for elderly relatives to be a moral duty, especially amongst the older and conservative members of the population. Though there was a distinct difference in that Spanish elders preferred to remain in their own homes out of a sense of pride rather than move in with the family members caring for them. Last year, over two million Spanish elders lived alone and heavily valued their autonomy. 

By contrast, Australia has a highly developed home care programme available to elders alongside traditional nursing home programs. Australian elders are more likely to request informal assistance from their spouses or formal assistance from private commercial organisations or government entities than other family members. This indicated a less strong cultural trend to require familial involvement in the care of elders than either Spain or Italy.

Cultural Components

Both Spain and Italy place a high value on family embeddedness, demonstrated in a reluctance for young people to obtain their own places of residence well after they are financially able to do so. These cultures highly value a high level of engagement with family members, with an increased value placed on the extended family than in Australia. This is indicated by the high levels of young people up to twenty-nine who continue to live with their parents, in both Italy and Spain. Though slightly over half of young people continue to live at home in Australia, there is a much less pronounced cultural trend that encourages young adults to continue to live with family.

Both Spain and Italy had distinct emphasis on their food cultures, often gathering with large groups of family, friends, or coworkers to share meals. Both countries offered generous lunch breaks in the middle of the day to encourage workers to gather for an extended meal break or take a siesta at home. 

Australians have marginally higher levels of internet usage as compared to either Spaniards or Italians, which has continued to be the case in the midst of the pandemic. This could help fortify individuals in their attempts to social distance, as habitual social media usage will lend to a decreased disruption in their social lives. 

Ultimately, no country is immune to the impacts of COVID-19, which has been demonstrated by news reporting and the lived experiences of healthcare workers the world over. There are some shared risks between Italy, Spain, and Australia regarding urban areas which feature higher levels of population density. Studies based in Africa have shown that coastal areas with large populations carry a greater importation risk than their landlocked counterparts. 

Overall, the sociodemographic data available before the COVID-19 outbreak would seem to indicate that there are significant differences in social behavioural patterns, cultural components, and urban sprawl when comparing the three countries. While only time will tell when the curve will flatten, it would seem that there are several components unique to Australia which provide significant fortifications against the spread of the virus.

(datawrapper.de)

The World Bank: Population, total – Italy, Spain, Australia
Italy	Spain	Australia
Total	60,431,283	46,723,749	24,992,369

Worldometers
Italy	Spain	Australia
Net population Density (perkm2)	206	94	3

World Population Review
cities > 1M	100,000-1M	10,000-100,000
Italy	2	31	892
Spain	2	88	770
Australia	5	14	375

OECD (% of total pop) in 2018
Italy	Spain	Australia
Total population (million)	60.442	46.773	24.993
Young population (<15)	13.3	14.8	18.8
Working age population (15-64)	64	65.8	65.5
Elderly population (>65)	22.68	19.29	15.66

Worldometers	Total cases	New Cases	total deaths	new deaths	total recovered	active cases	serious, crit	tot cases/1M pop	deaths/1M pop	total tests	tests/1M pop
Italy	139422	17669	26491	95262	3693	2306	292	807125	13349
Spain	148,220	14,792	48,021	85,407	7,069	3,170	316	355,550	7,593
Australia	6052	50	2813	3189	87	237	2	319,784	12541

**Importation risk

(https://www.sciencedirect.com/science/article/pii/S0140673620304116?casa_token=efNXKIKXYrUAAAAA:Vp2yssOjnLFhcF7WLHfjiLDkluCLCvm9UQ6PH4jgivX_Xpyv6VQhU-zG2RIWrhFqRMPPxLky9Q)

Gilbert et. al

Preparedness and vulnerability of African countries against importation of COVID-19

(https://science.sciencemag.org/content/early/2020/03/05/science.aba9757.abstract?casa_token=9UaHvgd9noMAAAAA:XAJg29gCAD7whhK_ugymKFGsOSz_0u_D3RUP69YlfEmg4hMMLUbl5ZmUOZ6OH7qvUfkmImOGfIOz_A)

Chinazzi et. al

The effect of travel restrictions on the spread of the novel coronavirus outbreak

Australia total land: 7,692,024 km2

.7% urban

53,844 km2 urban area

Spain total land: 505,990 km2

14.4% urban

72,862 km2 urban area

Italy total land: 301,338 km2

24.6% urban

74,129 km2 urban area

Italy

(https://worldpopulationreview.com/countries/italy-population/cities/)

(https://www.thelocal.it/20200309/map-which-parts-of-italy-are-affected-by-coronavirus-outbreak)

(https://github.com/pcm-dpc/COVID-19/blob/master/schede-riepilogative/regioni/dpc-covid19-ita-scheda-regioni-20200408.pdf)

Spain

(https://worldpopulationreview.com/countries/spain-population/cities/)

Australia

(https://worldpopulationreview.com/countries/australia-population/cities/)

10% of population in rural towns