Spain’s hospitals are beginning to see another surge in patients, with the health ministry reporting this week that 805 people had been hospitalised over the past seven days as experts search for reasons why Spain is struggling more than its European neighbors.
Not two months after battling back the coronavirus, Spain’s hospitals are beginning to see patients struggling to breathe returning to their wards.
The coronavirus devastated the country in March and April, with the daily death toll reaching more than 900 fatalities a few months ago.
While an enhanced testing effort is revealing that a majority of the infected are asymptomatic and younger – making them less likely to need medical treatment – concern is increasing as hospitals begin to see more patients.
And experts are searching for reasons why Spain is struggling more than its neighbors after western Europe had won a degree of control over the pandemic.
But one thing is clear: The size of the second wave has depended on the response to the first one.
“The data don't lie,” Rafael Bengoa, the former health chief of Spain’s Basque country region and international consultant on public health, told The Associated Press.
“The numbers are saying that where we had good local epidemiological tracking, like [in the rural northwest], things have gone well,” Bengoa said. “But in other parts of the country, where obviously we did not have the sufficient local capacity to deal with outbreaks, we have community transmission again, and once you [have] community transmission, things get out of hand.”
Bengoa is one of 20 Spanish epidemiologists and public health experts who recently called for an independent investigation in a letter published in the medical journal The Lancet to identify the weaknesses that have made Spain among the worst-affected countries by the pandemic in Europe despite its robust universal healthcare system.
'Family gatherings are dangerous'
Except for teenagers and young adults, Spaniards largely comply with mandatory face mask rules. The health ministry also embarked on one of the world’s largest epidemiological surveys, randomly testing more than 60,000 people to find the prevalence of the virus to be 5 percent, far from reaching “herd immunity”.
Spain’s ministry reported on Tuesday that 805 people nationwide were hospitalised over the past seven days. Half of the 64 people who died over the previous week were from Aragón, the region surrounding Zaragoza.
With a population of 47 million, Spain leads Europe with 44,400 new cases confirmed over the past 14 days compared with just 4,700 new cases registered by Italy, with 60 million inhabitants.
Hospitalisations have quintupled in Spain since early July, when Covid-19 cases went down to a trickle after a severe lockdown stopped a first wave of the virus that had pushed the healthcare system to the breaking point.
“There is no one single factor in such a pandemic,” said Manuel Franco, a professor of epidemiology at John Hopkins and Spain’s University of Alcalá, who also signed The Lancet letter.
Franco cited Spain’s economic inequalities that have exposed poorer communities – especially fruit pickers – to greater harm, understaffed epidemiological surveillance services and its large tourism industry. Combined with other factors, they could have formed a lethal cocktail.
Bengoa believes that social customs and traits prevalent in Mediterranean cultures, which emphasise physical contact and smaller personal space, have also worked against Spain.
“Family gatherings are dangerous in Spain. We are being anti-Spanish in social gatherings if Spaniards don’t kiss, hug and touch one another," Bengoa said, adding that Spanish and Italian families live in larger, more multi-generational groups than in most northern European countries, making contagion inside households more likely.
Some authorities seem to agree. A Canary Islands public awareness campaign shows a family gathering to celebrate a grandfather’s birthday, with people taking off masks and embracing, only to end with the grandfather in a hospital bed.
Regional smoking ban
A ban on smoking on streets and restaurant terraces when social-distancing cannot be guaranteed came into effect on Thursday in Spain's northwestern region of Galicia in a bid to halt the spread of the virus. Under a law approved by the regional government of Galicia late on Wednesday, smoking in public is not allowed if it is not possible to maintain a distance of 2 metres (6.7 feet) between people.
The head of the regional government of Galicia, Alberto Nunez Feijoo, said several experts had warned his administration that "smoking without any restrictions, including on a terrace without any limitations, with people nearby, or in crowded places, without any social distancing, represents a high risk of infection". Other areas are considering similar restrictions.
Some of Spain’s regions have complained that the central government has not given them the special authority to confine people to their homes that it used under a three-month state of emergency. That has led to the regions being limited to recommending that people stay at home – instead of ordering them to do so – and thus lower compliance rates.
(FRANCE 24 with AP and AFP)