Iran and Italy cited by numerous countries as the source of cross-border infection

Spreader effect from two countries worst hit early on after Chinese outbreak

An external view of a bar that makes home deliveries during phase 2 of the coronavirus emergency, in Turin, Italy. EPA

What emerges from examining the coronavirus spread country-by-country is that a clear trail leads back to Italy and Iran.

The history of Covid-19 will inevitably show that after China both countries will likely be regarded as early ‘super-spreaders’ for Europe and the Middle East.

Northern Italy has for a long time held a high number of flight slots to China, mainly as a result of trading links. Similarly, there is a large Chinese population, particularly around Florence, involved in the clothing industry.

Numerous European countries have reported their first Covid-19 cases coming from Italy, either from Milan or from ski trips in the Alps in February.

Spain, which at one point had the highest death toll in Europe, reported four separate cases in late February that all stemmed from Northern Italy. Within a few days a further eight cases from Italy and one from Iran became known.

In France there are multiple reports of the first infections coming from bordering Italy, although one key event, potentially unrelated to its neighbour, stands out as a super spreader. The Christian Open Door Church hosted its annual assembly in late February attended by 2,500 people. Half of them contracted the virus and spread it to the country and beyond.

In German many cases in Baden-Wurttemberg were traced to Italy, while a number of spreaders arrived by air from Iran and China.

Lithuania’s first case came from a woman who had just returned from a business trip to Verona on February 28. A week later another a couple who had been skiing in Cortina d’Ampezzo, Italy, were also admitted.

Similarly, Belgium, which has one of Europe’s highest death rates, had it first transmission early March linked to holidaymakers returning from Northern Italy after half-term.

In South Africa a person returning from Italy became the country’s first confirmed infection.

While Sweden managed to contain its first confirmed case that came from Wuhan, a subsequent raft of cases appeared a short time later all stemming from Italy.

The US likely became infected directly from China. Despite blocking flights taken by foreign nationals it still allowed US citizens to return from China, without going into quarantine. It also waited three days to March 16 to restrict British flights into the US over those from the European Union. On that date Britain already had 1,543 cases.

Like America, Britain was probably infected directly from China. Three direct flights from Wuhan continued to Britain, with 2,000 people entering the country over a two-week period at the end of January.

Iran and China have long had close links. Iran’s first infected victim was a businessman who returned from China to the religious city of Qom.

Iran has fared particularly poorly during the crisis, thanks in no small part to government decisions.

The regime refused to lockdown cities and then claimed that America had "hyped Covid-19" to suppress turnout during elections. Despite the disease threat, a closed parliamentary session was held in late February. Since then more than a dozen former and serving politicians have died from Covid-19 with 8 per cent of parliament infected. Iran suffered 1,433 deaths before it went into lockdown, the highest of the 20 countries listed in The National's research.

Neighbouring Iraq’s first victim was an Iranian religious studies student studying in Najaf.

At least four Iranians were among the early confirmed infected people who came to Saudi Arabia but all came via third countries without disclosing that they had come from a heavily infected country. While Saudi closed its religious sites early it took two weeks from the first death to go into full lockdown, with 150 members of the royal family infected.

In late March King Salman ordered free hospital treatment for all virus patients regardless of their visa status. Saudi has suffered 283 deaths, Iran 6,902.