30. 9. 2020
Experts attribute the development of the COVID-19 cases, which made Spain the worst affected country in Europe, to overconfidence, lack of resources and mistakes in planning during the de-escalation process, points out Pablo Linde.
In early July, Prime Minister Pedro Sanchez said: “We have defeated the virus, controlled the pandemic and cut the curve.” But in just under two and a half months, Health Minister Salvador Illa warned: “Madrid is facing difficult weeks.”
The so-called new normality, which Spain entered after 21 June, lasted less than three months. Coronavirus restrictions that were lifted by that date have slowly returned in various regions across the country. As of August 18, all nightclubs in Spain had been closed and restrictions were imposed on smokers in public places. Since then, new measures have been gradually introduced in a number of areas, with a total curfew being reconsidered if it has not already been introduced.
This is a story of failure. Spain managed to stop the worst coronavirus incidence in Europe only between the last spring weeks and early summer. Today, it again has the worst spread rates on the continent, with figures far higher than any of its neighbors. So what happened in the meantime?
To answer this question, we must return to the plan to de-escalate anti-pandemic measures. Several experts agree that Spain had a model strategy. According to the national plan, the restrictions were to be relaxed asymmetrically, as the regions would reduce the incidence and show the capacity to effectively control the pandemic should another wave strike.
However, this plan had two major problems: the Ministry of Health did not specify what the incidence needed for the release should be, nor what specific health care safeguards should be put in place. In other words, there were no clear parameters to follow. In addition, many regions entered a new phase of the de-escalation plan at a time when it should not have done so. For example, Madrid has entered phase 2 with a promise to strengthen its epidemiological monitoring capacity – a promise it has never made. Madrid then jumped straight to the new normality, when the state of emergency ended before all regions had gone through all phases of the de-escalation plan.
Miguel Porta, a professor of epidemiology, preventive medicine and public health, is convinced that the failure of the new normality dates back to before the pandemic began. “It was not the lack of criteria for de-escalation that failed, but rather the application of these criteria,” he argues, blaming the “incompetence of the state.” “It’s not even a problem for politicians, but rather for state machinery,” he explains. Porta points out that Spain does not yet have a Public Health Agency, which it has been setting up with colleagues for years. According to him, the Spanish healthcare system works, “as if we were still in the 19th century.”
The closest thing Spain has to the Public Health Agency is the Health Emergency and Emergency Coordination Center (CCAES), a department of the Ministry of Health with less than a dozen staff that has been quickly overwhelmed by the crisis. Even more worrying is the fact that Spain does not yet have a system that can collect data in a timely and proper manner.
Spain also does not have enough tracers or primary medical capacity. These vital measures to contain the second wave of the pandemic are well below the European average. This, together with the relaxed access of some citizens to security measures, the fact that some companies have not done enough to protect employees; stubborn refusal to close nightclubs; and, according to experts, a certain element of randomness has led to an increase in cases of coronavirus disease and the introduction of new restrictions and widespread quarantine.
Probably the label “new normality” itself was unfortunate, because it suggested to people that it was just a return before a pandemic, which did not correspond to the situation at all.
It is possible that between the present and the acquisition of the vaccine, we will have to abandon the short-lived idea of a new normality. The fight against the virus will take months and there will be a third wave. One of the most respected Spanish public health experts Rafael Bengoa and 19 colleagues wrote a letter to a medical journal The Lancet, calling for an independent assessment of the government ‘s response to the crisis, which should identify what went wrong and propose measures to ensure that problems do not recur in the event of another pandemic.
“I wouldn’t strive for a new normality,” says Bengoa. “A return to political and social normality, to inequality, is not what should be done.” Together with another group of experts, he is working with the World Health Organization on a document that sets out long-term conditions for creating a more organized and equitable health system that is more respectful of the environment. In other words, the goal is to learn from mistakes, which has not always been the case during this pandemic.
Details in Spanish: HERE