The first is governance. Coordination is crucial in any country, but especially in one like Spain in which responsibility for health is devolved to 17 very diverse regions. The Health Alert and Emergency Coordination Centre (Centro de Coordinación de Alertas y Emergencias Sanitarias in Spanish), created in 2004, provides a mechanism for coordination between the national and regional governments. This mechanism has not, however, ensured that measures are fully coordinated. Thus, the Basque Country declared a public health emergency before any other region, whereas Catalonia requested a complete shutdown of the region, including closure of air, sea, and land ports. Madrid, La Rioja, and Vitoria banned gatherings of more than 1000 people. These measures were accompanied by a range of social distancing measures, including closure of schools, universities, libraries, centres for older people, and sporting venues, and even restricting all movement in some of the most affected areaS.3