In general, Spain is proud of its health system. In that country, taxes and social security contributions pay for its public health care, which is free and universal. The coronavirus crisis has shown the value of this system and of the staff who are on the front line of care.
Spain is now the second country in Europe with the most cases of infected people: 4,209 cases, 120 dead, 189 cured. The figures move with the minutes; while this is being written, positive diagnoses may be rising.
The Community of Madrid has more than half of them and it is the most affected: more than 2 ,000 cases and 56 deaths.
Health, like education, is the responsibility of each autonomous community (which in the Americas would be understood as states). The crisis of the coronavirus has also made evident the impact of the cuts to public health by the conservative governments in Madrid in recent years and their measures to privatize it.
A nurse, Guillén del Barrio, also a union delegate who works at the hospital in La Paz, one of the reference hospitals in the Spanish capital, tells El País’ Isabel Valdés that he has been without sleep for 30 hours, and that in 2008 they had 2,100 beds and 2,200 more professionals than now. The same newspaper published on February 9, 2020, when the coronavirus had not yet arrived, that the Community of Madrid leads in many aspects the privatization of health care compared to other Spanish regions.
At this time of the emergency, says del Barrio, they are working with a shortage of protective equipment, in emergency rooms where virtually all patients have coronavirus, some in the corridors, without replacement of personnel.
Eduardo Fernández, another nurse in the Intensive Care Unit of another of Madrid’s large public hospitals, the Reina Sofía, draws a similar picture. “If that staff is not increased, we cannot speed up admissions and discharges.” At the time of the El País report, there were six nurses in that hospital who tested positive for coronavirus, 38 in research, seven other health workers at home, 40 were working under medical surveillance and 55 had made casual contact with people who had been diagnosed.
Journalist Raúl Rejón writes for Eldiario.es that in several health centers in the Community of Madrid there is already a lack of space to separate those infected from the rest of the patients, and also a lack of masks for health staff. In one week, according to the article, the isolation of health personnel has more than doubled.
“The rapid influx of infected people meant that doctors and nurses had to attend people with coronavirus in wards with all kinds of patients. The shortage of masks caused them to contact them without all the protection. At the Valdemoro center, for example – one of the main sources of contagion [in Madrid] – when cases increased rapidly, the emergency room doctors came in contact with positive cases and continued to work by taking their temperature twice a day,” Rejón writes.
Papá también es médico en Madrid, 64 años. Vive con mi hermano pequeño (mamá murió). El otro día me dijo que me llevara a mi hermano y le dejáramos solo. No sé cuándo podremos verle. Ni a mi hermana, que trabaja en un hospital vasco. Qué locura todo. https://t.co/rHNFX9Gb7y
— Aurora Nacarino-Brabo Jiménez 🦕 (@auroranacarino) March 12, 2020
The government of the autonomous community of Madrid announced on Thursday that they will put private health care centers and hospitals under their command. Bars and terraces will be closed (schools have already suspended classes throughout Spain for two weeks). All those with mild symptoms will be considered suspected of having the coronavirus and will only be tested when there is improvement, to confirm that it is negative.
In the last week, the understanding of the restriction and containment measures taken by the authorities has been directed at preventing people from becoming a source of contagion, thus protecting the most vulnerable and not collapsing the Spanish health system: #frenarlacurva (break the curvature) and #quédateencasa (stay home) is the campaign.
Fernando Simón, de @sanidadgob, explica por qué es importante seguir a rajatabla las recomendaciones de los expertos. Debemos implicarnos todos y todas para #FrenarLaCurva.#INFOCoronavirus pic.twitter.com/gQ20mObJUV
— Salud Pública (@SaludPublicaEs) March 11, 2020
The mortality rate of this virus is very low, it is curable, but its contagion is fast: healthy and younger people, although with mild or asymptomatic symptoms can infect the most vulnerable, which are the elderly, elderly with other pathologies, immunosuppressed people or with other conditions that are a risk factor.
“We cannot afford the free circulation of the coronavirus because 17% of the population (current Chinese data) would become ill (severe or critical), a number of patients that is not absorbable by the health system,” Margarita del Val, researcher in immunology and virology at the “Severo Ochoa” Molecular Biology Centre, explained in a letter.
“So we need quarantines, contact tracing, and any measure that manages to reduce the speed at which, slowly, we will all be infected. We must gain as much time as possible so that the infection of all will hopefully take 100 years. We have to gain time so that there is a vaccine or a treatment (…) But, above all, we need to keep our health system from collapsing,” she wrote.
In an interview, Magda Campins, head of Preventive Medicine and Epidemiology at Vall d’Hebron Hospital in Barcelona, said that, unlike other coronaviruses, we do not know the animal that served as the initial contagion and “reservoir”. “And this has helped it spread in a spectacular way. At the moment, stopping it completely is practically impossible. (…) It’s quite unlikely that we will be able to control it completely. What we have to do is contain it so that the epidemic curve does not continue to rise sharply, but rather is progressive so that we can deal with it from the health system without it collapsing and reducing the rate of transmissibility.”