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HOSPITAL

How Spain’s hospitals are now paying the price for Christmas festivities

Less than a month after Christmas, staff in the intensive care unit at Barcelona's Hospital del Mar are working non-stop.

How Spain's hospitals are now paying the price for Christmas festivities
Photos: AFP

Electronic bleeps alert them to the multiple needs of patients in their care, most of whom are intubated and unconscious.

At one bed, several staff are turning a patient face down to facilitate breathing, while others check an X-ray showing lungs whitened by pneumonia. In another corner of the unit, a physiotherapist moves the limbs of a sleeping woman.

“Incoming patient,” warns a voice over the intercom.     

Soon eight staff surround a patient on a gurney who has just arrived from the general ward. “Got an oxygen tank?” says one. “Where's the intubation equipment?”

“We're tired, we've spent a year in the same situation,” admits doctor Mapi Gracia.   

“We knew this was going to happen after Christmas because the restrictions weren't very tight. Right now we don't know how bad it's going to get and we're just hoping the hospitals aren't overwhelmed.”


The latest data showing hospital admittance and ICU occupancy across all of Spain's regions. Source: Spain's Health Ministry Jan 21st

 

Crammed with patients

For weeks, it's been difficult to find empty beds, admits Gracia.   

“We started the day with two free beds but a patient came in and now we're expecting a second. And once again that will mean the intensive care unit is totally full.”

As feared, the easing of travel restrictions over Christmas to allow families to get together caused a huge spike in infections, with Spain counting record numbers of new cases as the pandemic's third wave has taken hold.

And it is the hospitals that are counting the cost, government figures show.     

Over the past fortnight, the number of people going to hospital rose by 82 percent while intensive care admissions increased by 60 percent, prompting some regions, such as Valencia to set up field hospitals.   

Overlooking the sea, Hospital del Mar was founded in 1905 to treat sailors with infectious diseases who docked in Barcelona's port, but today four of its 12 floors are devoted to treating patients with Covid-19, who have also taken up all of its intensive care space.   

Other patients in need of critical care are being treated in the surgical resuscitation units, reducing the hospital's capacity to carry out any non-urgent surgery.

And the rising caseload has medics worried, with Spain registering record new infection levels since Christmas, pushing the number of cases over 2.4 million and deaths to more than 55,000.

“It's not the tsunami we experienced in March or April but it's worse than in the second wave” which in Spain began in July and continued until the late autumn, says Julio Pascual, the hospital's medical director.

“In November, the intensive care unit wasn't completely full of Covid patients but now it is. At the time, we had two floors devoted to Covid, while now we are filling a fourth,” he told AFP at his top-floor office which has a view over Barcelona beach.

'They just keep coming'

Wearing her own clothes again, 71-year-old Dora Lopez is waiting to go home after being discharged following 40 days in hospital.   

She arrived in mid-December “with a very high temperature” and was placed in intensive care.

“The first days in intensive care, I just threw in the towel, I couldn't cope any more, I felt like I was suffocating,” said Lopez.   

Although she was one of six people discharged that day, another 13 were waiting in A&E to be admitted onto the ward.

“We are trying to speed up the process of discharging people so that the hospital doesn't become overwhelmed, but more and more people keep coming in,” says doctor Silvia Gomez a specialist in infectious diseases.   

“We are all emotionally affected. And when you go out into the street and see people not observing the restrictions, you just don't understand,” she told AFP.

“It's as if they don't appreciate the effort we're making.”

Depression, suicidal thoughts 

According to a study of 10,000 Spanish medics carried out by Hospital del Mar researchers, nearly half — 45 percent — suffered mental health issues following the first wave of the pandemic.

Around 28 percent presented signs of depression, a figure six times higher than in the general population, and 3.5 percent had considered suicide, the study showed.

“Here everyone has been in tears. There have been many of us who have been very affected. And until this ends and we start getting back to normal, it will continue,” shrugs 29-year-old nurse Carla Molina.

For now, the vaccine campaign which began at the end of December is starting to shine a bit of light at the end of the tunnel.

“During this year, we'll get there, but there's quite a way to go in 2021,” says hospital director Pascual.   

“There's still a long battle ahead of us.” 

By AFP's Daniel Bosque 

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COVID-19

Spain rules out EU’s advice on compulsory Covid-19 vaccination 

Spain’s Health Ministry said Thursday there will be no mandatory vaccination in the country following the European Commission’s advice to Member States to “think about it” and Germany’s announcement that it will make vaccines compulsory in February.

Spain rules out EU's advice on compulsory Covid-19 vaccination 
A Spanish man being vaccinated poses with a custom-made T-shirt showing Spain's chief epidimiologist Fernando Simón striking a 'Dirty Harry/Clint Eastwood' pose over the words "What part of keep a two-metre distance don't you understand?' Photo: José Jordan

Spain’s Health Minister Carolina Darias on Thursday told journalists Covid-19 vaccines will continue to be voluntary in Spain given the “very high awareness of the population” with regard to the benefits of vaccination.

This follows the words of European Commission chief Ursula von der Leyen on Thursday, urging Member States to “think about mandatory vaccination” as more cases of the Omicron variant are detected across Europe. 

READ ALSO: Is Spain proving facts rather than force can convince the unvaccinated?

“I can understand that countries with low vaccine coverage are contemplating this and that Von der Leyen is considering opening up a debate, but in our country the situation is absolutely different,” Darias said at the press conference following her meeting with Spain’s Interterritorial Health Council.

According to the national health minister,  this was also “the general belief” of regional health leaders of each of Spain’s 17 autonomous communities she had just been in discussion with over Christmas Covid measures. 

READ MORE: Spain rules out new restrictions against Omicron variant

Almost 80 percent of Spain’s total population is fully vaccinated against Covid-19, a figure which is around 10 percent higher if looking at those who are eligible for the vaccine (over 12s). 

It has the highest vaccination rate among Europe’s most populous countries.

Germany announced tough new restrictions on Thursday in a bid to contain its fourth wave of Covid-19 aimed largely at the country’s unvaccinated people, with outgoing Chancellor Angela Merkel speaking in favour of compulsory vaccinations, which the German parliament is due to vote on soon.

Austria has also already said it will make Covid-19 vaccines compulsory next February, Belgium is also considering it and Greece on Tuesday said it will make vaccination obligatory for those over 60.

But for Spain, strict Covid-19 vaccination rules have never been on the table, having said from the start that getting the Covid-19 jabs was voluntary. 

There’s also a huge legal implication to imposing such a rule which Spanish courts are unlikely to look on favourably. 

Stricter Covid restrictions and the country’s two states of alarm, the first resulting in a full national lockdown from March to May 2020, have both been deemed unconstitutional by Spain’s Constitutional Court. 

READ ALSO: Could Spain lock down its unvaccinated or make Covid vaccines compulsory?

The Covid-19 health pass to access indoor public spaces was also until recently consistently rejected by regional high courts for breaching fundamental rights, although judges have changed their stance favouring this Covid certificate over old Covid-19 restrictions that affect the whole population.

MAP: Which regions in Spain now require a Covid health pass for daily affairs?

“In Spain what we have to do is to continue vaccinating as we have done until now” Darias added. 

“Spaniards understand that vaccines are not only a right, they are an obligation because we protect others with them”.

What Spanish health authorities are still considering is whether to vaccinate their 5 to 11 year olds after the go-ahead from the European Medicines Agency, with regions such as Madrid claiming they will start vaccinating their young children in December despite there being no official confirmation from Spain’s Vaccine Committee yet.

READ MORE: Will Spain soon vaccinate its children under 12?

Spain’s infection rate continues to rise day by day, jumping 17 points up to 234 cases per 100,000 people on Thursday. There are now also five confirmed cases of the Omicron variant in the country, one through community transmission.

Hospital bed occupancy with Covid patients has also risen slightly nationwide to 3.3 percent, as has ICU Covid occupancy which now stands at 8.4 percent, but the Spanish government insists these figures are “almost three times lower” than during previous waves of the coronavirus pandemic.

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