Which common diseases have been most undiagnosed in Spain during the pandemic?

Diagnoses of frequent diseases such as melanoma, pulmonary disease or osteoporosis fell by as much as 50 percent in primary care centres in Spain in 2020 due to the Covid-19 pandemic, a new study reveals.

Doctor diagnosing diseases
Diagnosis of diseases has fallen by 50 percent. Photo: LENNART PREISS / AFP

The study analysed the difference in detected cases of thirty diseases in 2020 compared to the average for 2017 to 2019 and found that diagnoses of many of them had decreased by almost 50 percent. 

It was carried out by the August Pi i Sunyer Biomedical Research Institute (IDIBAPS) based at Barcelona’s Hospital Clínic and was published in the journal ‘Annals of Family Medicine’.

The findings showed that in 2020 there was a drastic reduction in the detection of certain illnesses and diseases. These were hypertension (- 40 percent), hypercholesterolemia (- 36 percent), diabetes (- 39 percent), benign prostate hypertrophy (- 38 percent), osteoporosis (- 40 percent) and chronic obstructive pulmonary disease (- 50 percent).

READ ALSO: Pandemic forces Spain’s hospitals to cancel 570,000 surgeries

Other diagnostic declines observed were ischemic heart disease (- 48 percent), hypothyroidism (- 46 percent), melanomas (- 45 percent), chronic kidney disease (- 43 percent), and benign colon tumors (- 42 percent).

“Primary care made an extraordinary effort throughout the pandemic,” said Antoni Sisó-Almirall, principal investigator of the study and director of research at the Consorci d’Atenció Primària de Salut de Barcelona Esquerra (CAPSBE).

“We must bear in mind that primary care centers have detected more than 80 percent of covid-19 cases, apart from monitoring patients and their contacts. Prioritising covid-19 and its care in primary centers has produced a shift in the care and detection of the rest of the diseases,” he explained.  

READ ALSO: How Covid is complicating the race against time for Spain’s transplant patients

The study also found that there were some pathologies in which this significant decrease was not observed, such as strokes, heart attacks, and some cancers. However, there was an increase observed in mental disorders, especially anxiety, where the number of cases grew by 16 percent. 

According to Sisó, the results of this study help “health planners direct resources to where they are most needed at the moment, which is primary care, and thus reinforce this area so that it is sufficiently prepared.  

Data from Spain’s Health Ministry showed that 13 percent of patients who needed an operation in 2019 had been on the waiting list for more than six months.

While the average waiting time for surgery is 92 days, it can vary by up to 90 days depending on the region. In Castilla-La Mancha for example, the average number of days is 135, while in the Basque Country it is only 45.

According to recent statistics from Spain’s Ministry of Health, cardiovascular diseases such as strokes, heart attacks and ischemic heart disease, were the biggest killers in Spain in 2020, followed by infectious and parasitic illnesses, which included Covid-19. 

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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.