Just over two months ago, the President of the Spanish Government, Pedro Sánchez, announced: “We defeated the virus, controlled the epidemic and bent the curve”. However, the current discourse is totally contrary, with Spain leads the list of western European countries with the most confirmed cases of Covid-19 infection.
On June 21, the day after the end of the state of emergency, Spain lifted restrictions and began to run out of things. However, some of these limitations returned to certain territories as early as July. Just after, on August 18, all of Spain was observing stricter restriction measures that have been increasingly hardening in certain regions to the present point, where certain regions of Madrid are again observing limitations on mobility.
The neighboring country only managed to move away from the worst European statistics on the incidence of Covid-19 between the last weeks of spring and the first of summer, returning to lead in the middle of summer, with numbers much higher than those recorded in any other country in Europe. western. What, after all, caused the “new normal” principle to fail in Spain?
To answer this question, experts go back to the period when the lack of definition began. The plan itself was “exemplary”: an asymmetric survey of the restrictions, with distinction between levels, which progressed as the communities presented a sufficiently low incidence of the disease and sufficient capacities to face the epidemic.
However, experts point out two essential problems: the Ministry of Health did not quantify what this incidence should be and what guarantees each community should provide regarding the control of the epidemic’s progress.
Therefore, there were no clear parameters and many communities advanced in level when they were not yet prepared. The most evident case is that of Madrid, which has advanced to phase 2 under the promise of an epidemiological surveillance capacity that has never been fulfilled.
“The new normality was something else. What we experienced was simply a hasty downturn without doing homework”, Explains to the newspaper The country Miguel Hernán, professor of epidemiology at Harvard University.
Hernán considers that in order to reach the moment of lifting restrictions, four requirements were necessary, which, in his opinion, were not met by Spain.
The first was the ability of the autonomous communities to create and reinforce assistance and diagnostic skills, as well as monitoring, isolation or quarantine. The second for the definition of transparent and harmonized epidemiological indicators by the Spanish Government that would facilitate coordinated actions. Third, the specialist considers it necessary to outline specific measures to initiate the lack of definition by multidisciplinary specialists. Finally, a continuous decision-making process based on the assessment of epidemiological data from the previous three weeks.
For Miquel Porta, a professor specializing in epidemiology, preventive medicine and public health, the Spanish failure to enter the “new normal” dates back to the period before the pandemic. “It was not in the design of criteria for the lack of definition that we failed, but in the application of those same criteria”, defends the specialist, justifying this failure with the “incapacity of the State”.
“It is not even a problem for politicians, but for state apparatus,” he continued. “The Treasury is a shined mechanism, with 21st century tools. Obviously there is fraud and it could work better, but any city tax in any corner of Spain is registered. Ours [serviços de vigilância epidemiológica e de saúde pública] work as they did in the 19th century, ”concluded Miquel Porta.
Failures in screening and overconfidence
The consistent failures in tracking contacts close to those infected by Covid-19 are another reason given for the growth of the epidemic curve in Spain. Madrid, for example, should have screening teams to monitor positive cases, identify and monitor close contacts. However, there is no evidence that these teams actually existed and many patients in quarantine say they have never been contacted by these teams.
In addition, experts also report an excess of confidence. “Calling it normal again was perhaps a failure, because it made us trust ourselves”, admits Saúl Ares, a scientist at the National Biotechnology Center.
“As long as the virus is with us, we must have three things in mind: enhanced full-time primary care; screening teams and, thirdly, even if the incidence is low, the population must live with the rules of a certain distance until this passes. We must avoid meetings in closed environments and always wear a mask, in addition to the other hygiene rules ”, explains Saúl Ares.
All of these reasons are coupled with the behavior of some companies that did not make enough efforts to protect their workers and citizens in general, who did not follow the directions of the Ministry of Health in the period of lack of definition.
“After almost four months locked up, it is normal to want to return to normal. But all governments know that this prejudice is dangerous in any situation. We should have a more solid deconfination plan. All the communities seemed ready, but some were not. And if we add that to a very irregular behavior of the citizens, the perfect storm“, says Rafael Bengoa, one of the most renowned specialists in Public Health in Spain. “For many people, the new normal was to return to normality and thus a fundamental mistake was made: not assuming that we were returning to a moment when the curve was falling, but the virus had not yet disappeared”, stresses Daniel López Acuña, former director of emergencies for the World Health Organization (WHO).
In short, experts warn that, until a vaccine arrives, the concept of “new normal” should be forgotten. Rafael Bengoa, along with 19 other experts, signed a manifesto in the magazine The Lancet to demand that the Spanish Government study what has failed and propose measures to prevent Spain from following the same path in the future, because, according to experts, other pandemics will emerge.
“I would not go looking for a new normal,” says Bengoa. “It would go as far as we do not need to maintain social distance, but returning to the political, social normality of the inequalities that exist in the country, is not the way to go”, he adds.