Major restrictions become more likely as deaths and infections spike across EU

Governments across Europe have warned their citizens that the coronavirus outbreak could lead to months of serious disruption, as figures for deaths and infections rose sharply again on Monday and new measures were announced restricting large gatherings.

Italy’s government has extended emergency measures across the entire country in a bid to stop the spread of the virus. The nation has the highest number of cases and deaths in Europe. On Monday night – after the death toll rose from 366 to 463 and experts warned that the hospital system in some areas was in danger of collapse – Giuseppe Conte, the prime minister, told people to “stay at home,” as he banned all public gatherings – including Serie A football matches.

In Germany, which reported its first two deaths from the virus on Monday, the health minister, Jens Spahn, appealed for people to work from home and walk or cycle rather than use public transport. Spahn asked people to make hard choices to help avoid the risk of overburdening the country’s health service.

Advice and approaches have diverged widely across Europe and the Middle East as governments struggle to contain the rapidly escalating epidemic.

In the Middle East, Israel took the extreme decision to place anyone arriving from overseas into quarantine for 14 days, Saudi Arabia closed off air and sea travel to 14 affected countries and Iraq banned all public gatherings and called on citizens to avoid visiting sacred cities.

Authorities in Madrid announced that all kindergartens, schools and universities would be closed for two weeks, as the number of cases and around the Spanish capital jumped from 202 to 469 in 24 hours. Authorities in the Basque country also announced the closure of educational centres around the regional capital, Vitoria, where the second-worst cluster has been identified.

Dr Tedros Adhanom Ghebreyesus, the head of the World Health Organization, said that with the virus spreading in so many countries, the threat of a pandemic had become “very real” as he called for aggressive measures” to counter it.

Quick guide What are coronavirus symptoms and should I go to a doctor? Show Hide What is Covid-19? Covid-19 is caused by a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals. The World Health Organization (WHO) has declared it a pandemic. What are the symptoms this coronavirus causes? According to the WHO, the most common symptoms of Covid-19 are fever, tiredness and a dry cough. Some patients may also have a runny nose, sore throat, nasal congestion and aches and pains or diarrhoea. Some people report losing their sense of taste and/or smell. About 80% of people who get Covid-19 experience a mild case – about as serious as a regular cold – and recover without needing any special treatment. About one in six people, the WHO says, become seriously ill. The elderly and people with underlying medical problems like high blood pressure, heart problems or diabetes, or chronic respiratory conditions, are at a greater risk of serious illness from Covid-19. In the UK, the National health Service (NHS) has identified the specific symptoms to look for as experiencing either: a high temperature - you feel hot to touch on your chest or back

a new continuous cough - this means you’ve started coughing repeatedly As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work, and there is currently no vaccine. Recovery depends on the strength of the immune system. Should I go to the doctor if I have a cough? Medical advice varies around the world - with many countries imposing travel bans and lockdowns to try and prevent the spread of the virus. In many place people are being told to stay at home rather than visit a doctor of hospital in person. Check with your local authorities. In the UK, NHS advice is that anyone with symptoms should stay at home for at least 7 days. If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.

Amid mounting anxiety, EU leaders also announced they would hold a teleconference on Tuesday to discuss their next steps to try to slow the epidemic.

“The longer we can slow down the development of the virus, the better,” Spahn said at a press conference at a hospital in Berlin, warning that the restrictions people would face in their daily lives “would last for months rather than weeks”.

“Every individual should weigh up and decide what is easier to avoid and what is harder,” he said, adding that going to work was more important than going to a football match.

Spahn added that he was opposed to shutting schools and kindergartens because that would leave tens of thousands of medical staff unable to go to work, which would have a hugely detrimental effect on the health system.

In the UK, meanwhile, Boris Johnson and senior advisers defended the government’s response to the crisis.

The prime minister rejected calls for harsher quarantine measures and a ban on mass gatherings, arguing that the best advice so far was still simply for people to wash their hands. “Containment is very unlikely to work on its own and that is why we are making preparations for a move to the delay phase,” he said.

Sir Patrick Vallance, the government’s chief scientific adviser, said lots of measures that “seem intuitive turn out to have very little effect” and one of those was screening travellers from high-risk areas at airports.

In other developments on Monday:

In the Republic of Ireland, all St Patrick’s Day parades, including Dublin’s main celebration that draws about 500,000 revellers each year from all over the world, were cancelled due to the risk of a further coronavirus spread.

Cyprus, which was the last EU country to be virus-free, reported its first case.

French culture minister Franck Riester contracted the novel coronavirus and is staying in his Paris home but is “doing fine”, his office said.

Vietnam decided to temporarily suspend visa-free travel for citizens from eight European countries – Denmark, Finland, France, Germany, Norway, Spain, Sweden and the UK.

Iran announced another 43 people had died, pushing the death toll to 237 amid 7,161 confirmed cases. The government said it had released 70,000 prisoners because of the coronavirus outbreak.

Scores of foreign tourists and Egyptian crew remained quarantined aboard a Nile cruise ship, from which 45 suspected coronavirus cases have been evacuated.

The Israeli move was interpreted domestically as a measure to avoid irking Donald Trump. The country already requires travellers arriving from more than a dozen countries to spend two weeks in home isolation, effectively killing off incoming tourism.

Following outbreaks in the US, pressure had been building to add it to the list. But rather than extending the rules specifically on US travellers, and risk an angry backlash from the White House, Israel has instead broadened the policy to the entire planet.

Italy’s government has imposed a virtual lockdown across much of its wealthy northern regions at the centre of the contagion in an effort to contain the virus. Its top sports body on Monday called for all sports events to be cancelled until 3 April.

Tensions in its overcrowded jails erupted on Monday over new containment measures, with riots in at least two dozen prisons and the deaths of six inmates who broke into an infirmary and overdosed on methadone.

Facebook Twitter Pinterest Police stand in front of the entrance of Rebibbia prison in Rome after inmates staged a protest against coronavirus containment measures. Photograph: Andrew Medichini/AP

Prime minister Giuseppe Conte cited Winston Churchill as evidence that great nations persevere when the going gets tough. “These days, I have been thinking about the old speeches of Churchill – it is our darkest hour but we will make it,” Conte told La Repubblica newspaper.

In France, the worst affected European country outside Italy, the person in charge of one of the world’s busiest air transport hubs, Paris’s Orly and Charles de Gaulle airports, was among those to be infected.

The two Paris airports are among the busiest air hubs in the world, with more than 100 million people passing through every year.

The disclosure that Augustin de Romanet had tested positive followed days of rumours in the French media speculating whether Charles de Gaulle airport, Europe’s second busiest, may have been linked to the spread of the virus in France.

Officials in France have been warning it is inevitable that the country would have to go to stage three in its epidemic response shortly. Reports suggested that would involve closing schools, putting its health system on an emergency footing, and perhaps even closure of mass transit systems.

Meanwhile, in the US, where there have been a rapidly accelerating number of infections, federal and state officials in California were preparing on Monday to receive thousands of people from a cruise ship that has been idling off the coast of San Francisco, with at least 21 people onboard infected with the coronavirus.

Additional reporting by Oliver Holmes and Patrick Wintour