Wednesday, June 16

Spain comes out of the state of alarm with euphoria, doubts and concern | Society

Spain is no longer in a state of alarm. The worst health, social and economic crisis in decades – with a balance that is close to 80,000 deaths – this Sunday enters a new de-escalation that this time should mark the definitive decline of the pandemic. The country needs about 100 days to start recovering the vital and social spaces that the coronavirus has forced it to give up. For full normality, experts predict, there is still much more to do: at least a year.

At some point in mid-August, Spain will be able to do the math and see if the goal is closer. The incidences, still very high, should be below 25 cases per 100,000 inhabitants and mortality has plummeted thanks to a vaccination campaign that by then will have protected about 70% of the population. But first, the political and judicial system must demonstrate that it is capable of avoiding the chaos of last summer – which now threatens to repeat itself – when restrictions are necessary that affect fundamental rights, such as the curfew and confinements.

The map of restrictions in each community as of May 9

“People want to go back to their old routines. I myself am very nervous to go back to serving at night ”, describes Carlos Domingo Morla, owner of the Negronix hamburger restaurant, in the Navas neighborhood of Barcelona. The place, far from the tourist centers of the Catalan capital, had managed to gather a clientele that mixed neighbors and foreigners before the abrupt confinement of March 2020. “I still remember the day that everything stopped. Nothing has ever been the same. We have continued to open some noon, but we do not make even 5% of the cash as before. Now is the time to get everything back on track ”, proclaims Morla.

Carlos Domingo, owner of the Bar Negronix in Barcelona, ​​prepares his terrace.
Carlos Domingo, owner of the Bar Negronix in Barcelona, ​​prepares his terrace. Joan Sanchez

For now, the epidemiological situation continues to worry experts. “We still have too many cases,” laments Elena Vanessa Martínez, president of the Spanish Society of Epidemiology (SEE). Although it has been a week since the curves of new positives and hospitalizations consolidated their downward trend, eight communities – including Madrid, Catalonia, the Basque Country and Aragón – this Friday remained above 200 cases per 100,000 inhabitants.

“There are many infected people capable of transmitting the virus. The percentage of the vaccinated population is still small. In this situation, I am concerned about the false security message that is being transmitted with the end of the state of alarm and the lifting of the curfew. This will increase mobility and promote the circulation of the virus. The most vulnerable population is already protected, but the potential public health problem that a regrowth would entail is still enormous ”, adds Martínez.

Hospitals offer the most favorable side of the evolution of the pandemic. “Yesterday we managed to close a covid plant, which is excellent news,” celebrated on Friday José Miguel Cisneros, head of infectious diseases at the Virgen del Rocío Hospital (Seville). “We hardly see income of people 80 and over anymore thanks to vaccines. And what is foreseeable is that those of the new groups that are now being immunized will disappear ”, he adds.

05/04/2021 - Barcelona - In the image the ICU of the Vall d'Hebron Hospital in Barcelona.  Photo: Massimiliano Minocri

One year without breath in ICUs

The Spanish health has administered in the last week almost three million doses of vaccines. Faced with the uncertainties that the new scenario opens up, the solid progress of the immunization campaign is for all the specialists the best news. “The initial shortage of vaccines raised some doubts, but when the vials have started to arrive, the system has responded very well and the rejection among the population is being minimal”, defends Amos García Rojas, president of the Spanish Association of Vaccination (AEV ).

More than 13 million Spaniards (almost 30% of the population) have already received at least one dose, and about half of them have already completed the regimen. Figures that, if the expected rate of arrival of new vaccines is taken into account – more than 20 million before June 30, five of them single-dose from Janssen, and more than 60 million before the end of summer – clear the doubts that the Government can meet its objective of having immunized 70% of the population in August.

“The fear of thrombi and logistical problems are the only significant obstacles we are running into,” explains José Luis Alfonso, head of preventive medicine at the General Hospital of Valencia. “Between 5% and 10% of the population declines to be vaccinated with AstraZeneca and Janssen. It is not a large percentage, but it is relevant enough to take it into account ”, he adds.

“The logistical problems are minor and we are solving them, but they take a lot of work,” laments Alfonso. As illustrative data, it uses the following: “Almost half of the mobile phones of the patients that the public network has are outdated or incorrect. As the most used means of communication is SMS, this forces us to redouble our efforts to locate and communicate with the people to be vaccinated ”, he says.

The number of Spaniards who have passed the coronavirus infection is close to 3.6 million people, according to the daily balance offered by the Ministry of Health. This figure could actually rise to almost six million people, according to successive seroprevalence studies. In any case, and adding to them all vaccinated people, “more than half of the population is still susceptible to contracting the virus.”

“It is something that we must not forget, and the fall of the state of alarm may extend the idea that there is no risk,” criticizes Daniel López Acuña, former director of Health Action in Crisis at the WHO. “Let’s not fool ourselves. We will continue to need measures to reduce movement and social interaction, but from now on this will first be at the discretion of each autonomous community and then it will be prosecuted. And this is not good news because it hinders the decision-making processes, as we are already seeing ”, he laments.

The epidemiologist Pedro Alonso, who directs the WHO’s World Malaria Program, is missing tools “like those that Germany has equipped itself with”, which has recently approved a federal law that provides for a night curfew and the limitation of meetings social from 200 cases per 100,000 inhabitants to 14 days, and commercial closings from 300.

The government of the socialist Pedro Sánchez, on the other hand, has resisted adopting a similar solution and has opted, through a royal decree-law approved last Wednesday, for the Supreme Court to decide, in case of conflict, through a quick procedure which fundamental rights can be restricted according to epidemiological evolution. A solution that has been criticized by the court’s own judges. In recent days, the clash of criteria in the decisions of the higher courts of the Basque Country, the Balearic Islands and the Valencian Community anticipates conflicts.

Atmosphere in the streets of Santiago de Compostela on the last day of the state of alarm.
Atmosphere in the streets of Santiago de Compostela on the last day of the state of alarm. OSCAR CORRAL

Discos with open dance floors, restaurants with interiors full of diners, outdoor parties … After months of restrictions and with much accumulated fatigue among the population, what experts fear most is that dangerous social dynamics will be promoted that the communities, due to lack of political will or lack of adequate tools, are unable to stop.

“It is important not to repeat the mistakes we made in the previous de-escalations,” says Rafael Cantón, head of the microbiology service at the Ramón y Cajal Hospital (Madrid) in relation to the end of the state of alarm. “If you open the measures a lot, the interaction and transmission of the virus increases. That is unavoidable. But you have to put a stop to it in some way. It is true that there is fatigue, but it is necessary to find the formulas that allow maintaining the distancing and prevention measures until we manage to have practically the entire population vaccinated ”, he adds.

The international context is also uncertain. “Vaccination has reduced mortality in the United States and the European Union,” says Pedro Alonso. “But it is being very uneven. Nine out of 10 doses have been administered in rich countries, which for now are moving towards a scenario of greater tranquility that contrasts with the rest of the world. What happened in India is just a warning that the unpredictable can always happen and that the appearance of new variants that return us to the starting box cannot be ruled out. Let’s be careful because it was said that this virus mutated little and we are seeing that this is not entirely true “, he concludes.

The coronavirus pandemic has revealed important deficiencies in the governance of the Spanish health system, as well as in its information systems. Even today, it is still impossible to capture the situation of the pandemic with any precision – cases, hospitalizations, deaths … – despite the avalanche of data that the Ministry of Health and the communities publish every day, very often suffering from important notification delays or other problems such as duplications.

“We have made very little progress in the last year despite everything that has been said,” laments a health officer on the front line in the fight against the pandemic, who requests anonymity and is very critical of the “immobility that seems to be He has imposed”. “A year ago there was a lot of talk about the commission of inquiry necessary to see what had failed to prevent the pandemic. Now it seems that there is no desire to analyze it. And it is something serious, because the basic problems that prevented us from preventing and reacting quickly in the early phases of the pandemic remain the same ”, censorship.

At the Negronix, the colored metal chairs were still stacked this Friday while Morla finalized the preparations for the premiere of the new terrace. It will not be the only novelty of the place, which also offers cocktails and tapas with a Caribbean flavor. “We have changed many things about the letter. After everything that has happened, customers cannot find the same when they come. Changing, looking for and offering new things is the best way to leave behind all this horrible time we’ve been through ”, he says.

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