ANALYSIS: ‘We expect the coronavirus situation in Spain to get a lot worse’

Hospital staff around Spain tell Graham Keeley just how bad the coronavirus health crisis has become and why it will likely get much worse in the weeks to come meaning a second lockdown may be inevitable.

ANALYSIS: 'We expect the coronavirus situation in Spain to get a lot worse'
Photos: AFP

Health experts have said that despite the state of emergency imposed last week, unless the surge in COVID-19 cases slows down dramatically, more drastic measures are necessary.

No doubt, like most people right now, I find myself dazzled by the sea of data about the pandemic.

So, to find out what the real situation is on the ground, I went back to doctors whom I'd first interviewed back in April during the first wave of the pandemic.

Dr Natalia Silva is a surgeon in the accident and emergency section at San Juan de Déu, a large hospital in Barcelona.

During the desperate, dark days back in April, when the pandemic reached its first peak and 900 plus coronavirus deaths were recorded across the country in a single day, she told me how she used to cry every time she drove home from a shift.

“You cry. You cry a lot, heartbroken. I am trying to understand how we have come to this. I know that the rest of the people do not imagine a third of what happens in hospitals,” she wrote in a diary at the time.

Six months later, Dr Silva is back in the thick of it.

When I tried to speak to her she was the duty doctor at her hospital, which entails a 24 hour shift with occasional naps if there is a moment free.

She sent me this message: “The situation in Catalonia is pretty critical and in my hospital the number of cases rises each day.

“We are not in the same situation as we were in April, when there are more patients than we have capacity to treat. However, I think we are an exception given that the situation in other hospitals is more complicated.

“We expect the situation to get much worse in a few weeks.”

In Madrid, Dr Sara Alcantara, a specialist in intensive care, works at the 700-bed Hospital Universitario Puerta de Hierro.

Back at the height of the first wave, she said she believed many more people had died from COVID-19 than were being reflected in official figures.

“There are two problems: They are not testing all the people who die. And it is not the same dying from coronavirus as dying with coronavirus,” she told me then.

“There are people who, for example, are dying from a brain haemorrhage who also had coronavirus. Some are being counted as dying from coronavirus whereas that is not the reason for their deaths.”

Now, Dr Alcantara says though the situation is nowhere near as bad as it was in April but there are tough months ahead.

One hundred of the hospital's 700 beds are being used to treat coronavirus patients. Of these, eighteen out of the 22 intensive care beds are being used by COVID-19.

“Some of my colleagues say they wake up in the middle of the night and worry how we are going to be able to treat all these patients,” she said.

“This situation is not as bad as it was in April in that we can cope – at the moment – but it is going to get worse with the start of winter and more patients coming with flu.”

Dr Alcantara viewed the prospect of a second lockdown with mixed feelings.

“Undoubtedly it would make things easier for us as medical practitioners as the number of patients suffering from COVID-19 would decrease. On the other hand, I am also a citizen. I realise that this would mean great hardship for many people who may die of hunger,” she said.

Some public health experts have said the government is correct to wait and see if case numbers fall as a result of a nationwide curfew and other restrictions imposed last week.

“Home confinement is very restrictive with respect to people's freedoms. I think it is appropriate to give the measures already applied a little more time and assess whether they are working,” Andrea Burrón, the spokesperson of the Spanish Public Health Association, told El Pais newspaper.

The death toll from coronavirus reached 38,118 on Wednesday, after the government revised its methodology for recording infections and fatalities. It was a sharp rise from the unrevised figure on Tuesday of 36,495. The tally of infections now stands at 1,284,408 cases.

But Dr Rafael Bengoa, a former director of the World Health Organisation and adviser to President Barack Obama, believes unless there is a sharp reduction in infections, a full lockdown is only weeks away.

“It's a necessary move to ensure control of the second wave. The numbers are so high it will be necessary for it to last longer than in other countries. It is also really important to use these next few weeks to reinforce isolation processes so these work the next time around after the fall (of infections) in the second wave,” he told me.

“We must not repeat the lack of outbreak control which happened after the first wave.”

Dr Bengoa said Spain should follow the lead of France and impose a lockdown while allowing children to continue to go to school, which should last for about three weeks.



Graham Keeley is a Spain-based freelance journalist who covered the country for The Times from 2008 to 2019. Follow him on Twitter @grahamkeeley





Member comments

  1. Since San Joan de Deu is a specialist pediatric hospital you’re unlikely to see a full picture there. Try Vall d’Hebron for a big general hospital in a poorer area where people HAVE to go to work rather than work from home.

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Spanish government announces end of masks on public transport

The Minister of Health, Carolina Darias, announced this Thursday that masks will no longer be mandatory on public transport from February.

Spanish government announces end of masks on public transport

Darias confirmed that masks on public transport would no longer be compulsory after the Spanish cabinet meeting on February 7th.

She did not specify exactly when the new measure would come into force, although government agreements are usually approved the following day in the Official State Gazette (BOE), so the official end to the mask rule could be on February 8th.

“I will raise the proposal of eliminating the mandatory use of masks on public transport”, she said, adding that next week she will convene with the Interterritorial Council of the National Health System to “put this measure into effect”.  

Darias did clarify, however, that masks would still be mandatory in health settings such as health centres and hospitals “as the experts advise”. 

Last week, Darias reported the possibility of eliminating the mandatory mask rule in pharmacies, but this is currently being “weighed up” by the experts.  

Manuel Franco, an expert in Public Health and a member of the Spanish Society of Public Health and Sanitary Administration (Sespas) explained that “the World Health Organisation (WHO) is already considering the decision to lift the public health emergency warning for Covid-19” and adds that “if this goes ahead, it would make no sense to maintain the mask rule”.  

The use of masks ceased to be mandatory outdoors almost a year ago, on February 10th, 2022. Then, two months later, on April 20th, the government announced they wouldn’t be required indoors either, except in health centres and on public transport. 

The latest bulletin of Sentinel Surveillance of Acute Respiratory Infection in Primary Care (ARIs) and in Hospitals (SARI), announced a drop in infections and hospitalisations and said that the rates for Covid-19 remain stable.

The decision to end the mask rule in February comes after health experts who advise the Spanish Ministry of Health said that masks should no longer be required on public transport

On Wednesday, January 25th the director of the Health Alerts and Emergencies Coordination Center of the Ministry of Health (CCAES), Fernando Simón, assured that the end of the mask rule on transport would be announced “shortly” either “next week or the following”.  

Then, on Thursday morning, government spokesperson, Isabel Rodríguez, stated that the decision to remove the mask on public transport would be taken “immediately, when possible”, but pointed out that the government was looking at the situation in China first.