Virology experts say the key is protecting Spain’s hospitals from being overwhelmed by COVID-19 this time

MADRID – Just a few days after the start of the new school year, Spain’s capital faced fresh sanctions on Monday, becoming a relentless second wave of cases.

But those measures – strict control over the distance between seats rather than tables in food-service settings, funeral attendance for 25 people and 50 on the road, and reducing the 10-person limit in social ceremonies – total the nation’s Infections seem minor. 500,000, according to the latest figures from Johns Hopkins. Official numbers indicate that the threshold has already been reached. Spain has the most infections in Europe, although it is against more than 6 million cases in the US, with Spain having seven times the population.

Madrid’s new measures are cold comfort for parents, including this journalist, who will send at least one child to all-in-person classes of 21 children. More than 2,000 teachers from 66,000 Madrid recently tested positive for COVID-19 and will have to retire. Elsewhere in the country, two schools have already been closed due to infection.
At the heart of the resurgence of Spain’s affairs has been the rush to return to normalcy. Spain’s experience has also been affected by government desperation to bring back bars to the tourism industry and operations; Highly relaxed family gatherings; Insufficient safety protocols for field workers; And dealing with inactive youth with partying effectively, and spreading the virus.

As much as New York did, Spain got out of the depths of the COVID-19 transition with the most drastic measures possible, but Spain fell back only two months later. This time, how the country pulls itself out can be a blueprint for other countries and municipalities. MarketWatch spoke to these experts via email in hopes of lighting up where Spain now stands and what should be done.

Juan Jesús Gestal Otero, professor emeritus of preventive medicine and public health at the University of Santiago de Compostela in Galicia, was one of 20 experts to sign a letter in the British Medical Journal Lancet, which Spain’s COVID-19 response Was asking for an independent review. .
Market Inspection: What significant mistakes did Spain make after the lockdown in the spring, and what should be done now to correct the situation?
Otero: The contact took a long time to be traced and running. This should begin when the case curve began to decline. This would have helped to control the disease more at the end of de-escalation. Each autonomous community set up its own tracking system, many of them insufficiently staffed.
Market Inspection: Will Madrid’s new measures, such as the ability to bite in bars and restaurants, really help bring the disease under control?

Johns Hopkins

Otero: I don’t think those measures help a lot to stop the outbreak. … To keep the disease under control, the most important thing at this time is to strengthen the tracking capacity of the National Health System. If this is not done soon, the continued increase in outbreaks may ultimately affect the tracking capability of the system and cause loss of control and aggravate the situation. National coordination is also very important.
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Market Inspection: What are the differences between now and March that are encouraging and discouraging?
Otero: It now has epidemiological surveillance capability, although it requires much improvement for early diagnosis and contact tracing of cases, and the ability to perform several tests, which allow the detection of large numbers of asymptomatic patients. Most of the current cases are young people in which the disease is less severe, the reverse is in March – April, and the health system is not under pressure. It is discouraged to see that some social groups, mostly youth, are encouraging outbreaks with their behavior.
Market Inspection: What other countries should learn from Spain?
Otero: Strengthening epidemiological surveillance systems. Start tracking contacts of cases as soon as possible and perform several, many tests to find the largest possible number of asymptomatic patients. Return to “new normal” very carefully to avoid new outbreaks. Do not authorize activities that are inconsistent with a respiratory epidemic, such as spending time in closed, poorly ventilated places with many people, parties, nightlife activities. … Raising awareness of the need to take protective measures in homes upon receiving visitors, getting them in well-covered rooms, avoiding family parties… as it is in homes where most infections occur Occur.
Dr. Vicente Soriano is the director of UNIR Medical Center in Madrid and a physician and professor of infectious diseases at UNIR Health Sciences School and Medical Center.
Market Inspection: What do you understand by Madrid’s new measures to stop the virus?
Soriano: The confluence of crowds, the return of working activities for many, and easy access to tests – compared to negligible in March – to a new boom in large-scale cases. This will last for the next few weeks. To date, many new PCR + diagnoses have been found in young and asymptomatic people, this second wave will soon spread to the entire population, again including the most vulnerable population. Indeed, although the condition of most of the large hospitals in Madrid has not deteriorated yet, it reminds us a little of the events in February, when heavy rains began to occur.
Market Inspection: What about contact tracing and other efforts?
Soriano: The advent of rapid antigen tests will help, although there is room for further improvement, testing saliva (instead of nasopharynx fluid), selling in pharmacies and allowing self-testing at home, like pregnancy tests, as often as convenient. Ho.
Market Inspection: What else needs to be done?
Soriano: Regional governments are required to work further on three areas: (1.) To assess non-urgent patients and manage them with the help of telemedicine to avoid the collapse of hospital emergency departments. Increase the role of primary care physicians in the form; (2.) Medicalization and ensuring adequate health care workers and protective equipment for nursing homes for the elderly and other institutional patients – more than 60% of the deaths during the first COVID-19 tsunami wave in Spain at these locations calculation; (3.) Ensuring adequate share of doctors and nurses in clinical trials and clinics and hospitals to withstand the new COVID-19 surge. Acting upfront is always better at the time of demand, when the damage is already done.
Market Inspection: As a parent, how do you feel about sending your children back to school?
Soriano: The reopening of schools is an important decision supported by the fact that young people are rarely ill and allow parents to continue their jobs. Therefore, I am in favor of reopening schools and therefore allow my four children to attend school, with the maximum guarantee that they are established. I am aware that temporary termination of groups, classes and periodic matters will be reported. Unavoidable. But working under this threat is better to cripple or close the school.
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