England's coronavirus death rate is nearly 3 times higher than Ireland's. Proactive social-distancing measures made the difference.

• Ireland and England's responses to the coronavirus crisis have been very different. England wound up with a far higher death rate and death toll.
• England's death rate out of total cases is 13.4%. Ireland's is 3.8%.
• Ireland's early, proactive social-distancing measures helped the country avoid overwhelming its healthcare system to the extent that England has.
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England and Ireland are facing very different coronavirus crises. Whereas England has nearly 109,000 confirmed coronavirus cases, Ireland has about 14,000. In England, 14,576 people have died, while Ireland's death toll is 530.

That means that in England, the death rate out of total cases is 13.4%. Ireland's is 3.8%. England's death rate is about 3.5 times more than Ireland's.

The difference is likely due to Ireland's early, proactive steps to build up its healthcare system and implement social-distancing measures.

Ireland shut down schools banned mass gatherings, and encouraged work from home on March 12. England issued a full country-wide lockdown on March 23, and Ireland followed suit on March 24.

Because the average person with the coronavirus passes it to at least two others, it spreads exponentially, which means every day matters in taking action to prevent more cases — and Ireland's decisive action prevented sharp surges in COVID-19 patients.

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England's early cases and delayed response

England saw its first coronavirus cases on January 29: two Chinese nationals from the same family became sick in York.

More cases were reported through early February, most of which were travel-related. An English man who went to Singapore for a conference in early February infected five others at an Alpine ski resort, and five British nationals aboard the Diamond Princess cruise ship tested positive.

England's Chief Medical Officer, Chris Whitty, told the BBC on February 13 that the government's strategy involved four tactical aims: "The first one is to contain; the second of these is to delay; the third of these is to do the science and the research; and the fourth is to mitigate so we can brace the NHS [National Health Service]."

Containment requires isolating anyone who tests positive, tracing who they had contact with, then testing those contacts, asking them to self-isolate, and repeating the process.

But once the first case of community spread in England was reported on February 28, it was an indication that containment might be impossible. Still, Prime Minister Boris Johnson's government did not implement social-distancing guidance until March 16. Even then, it simply urged citizens to avoid social gatherings and non-essential travel.

Before that, anyone with symptoms was just encouraged to stay home, and people over 70 were told to avoid cruises. Mass gatherings still took place, including the four-day Cheltenham Festival from March 10-13, which drew almost 70,000 people.

Both the Times of London newspaper and Buzzfeed News reported that the slow response was due to a belief within the UK government that the coronavirus could be mitigated in the country, rather than suppressed, through a so-called "herd immunity" strategy.

But officials changed course on March 16 after simulations from Imperial College London showed that scenario would lead to high rates of hospitalizations, straining the health service.

A full lockdown came on March 23, once the country had already confirmed 13,063 and 422 deaths. Johnson himself tested positive for COVID-19 on March 27.

England was at risk of a dangerous coronavirus outbreak, given that the country is roughly 83% urban, which means it has a higher level of density. It also has a relatively high proportion of elderly people, who are at a much higher risk of severe cases. About 18% of England's population is above 65.

Even now, experts think England's death toll could be far higher than the official count. England's Office for National Statistics said 5,979 people in England had died of COVID-19 as of April 3, including at-home and nursing-home deaths. That's 15% more than the numbers published by the health service at that time.

Meanwhile, England's lockdown has been extended until at least May 7.

Ireland's quick action

Ireland reported its first coronavirus case on February 29: a traveler who returned from Italy. The country identified its first patient who'd gotten sick via community spread on March 5.

A few days later, on March 9, Ireland announced that its St. Patrick's Day festival — a gathering of about 250,000 people — would not happen.

The government also began to restrict visiting hospitals and long term care settings and began to build up its contact tracing and surveillance programs.

On March 12, Ireland closed schools, colleges, and childcare facilities — an important step, because some children can be asymptomatic carriers of the virus.

In addition, indoor gatherings of more than 100 people and outdoor gatherings of more than 500 people were canceled. Businesses were encouraged to have workers work from home if possible. Pubs closed on March 15.

An official stay-at-home order was issued March 24, when the country had 1,329 cases and seven deaths.

It also helps, however, that Ireland is overall a younger and more rural country than England — about 69% of the Irish population lives in urban areas, and about 13% of the population is over 65.

Every day and every test counts for countries fighting the virus

Over and over again, researchers have found that the best practices for preventing the spread of the coronavirus (and other infectious diseases) are strict social-distancing measures and mass testing.

A combination of these strategies could prove effective for both England and Ireland — which are both facing more time in lockdown if the growth of new cases doesn't slow down.

In terms of testing, both countries are looking to ramp up their testing capacities. But England still lags behind.

According to Our World in Data, as of April 17 (the latest reported numbers), England has tested 341,551 people — which comes out to about 5.07 per thousand people.

As of 14 April 2020, Ireland confirmed that it tested 90,646 people in total — about 18.55 per thousand.

Still, England's Whitty said on April 16 that the country believes it is reaching the peak of its crisis.

"On the issue of the peak, our view is that it is probably reaching the peak overall and that is what the flattening shows," Whitty said at England's daily government news briefing.

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