Spain’s health experts divided over whether Covid-19 should be treated like flu

People, some wearing face-masks, walk in a street as they enjoy a day out in Barcelona on December 31, 2021. (Photo by Pau BARRENA / AFP)
People, some wearing face-masks, walk in a street as they enjoy a day out in Barcelona on December 31, 2021. (Photo by Pau BARRENA / AFP)
The Spanish government's plans to view Covid-19 as an "endemic disease" similar to seasonal influenza would mean infections aren’t counted so rigorously, a strategy that not all health professionals in Spain agree with as cases continue rising. 

On the same day that Spain’s fortnightly infection rate reached new heights – 2,989 cases per 100,000 people – Prime Minister Pedro Sánchez on Monday confirmed that his government wants to change the current daily reporting of Covid cases to a surveillance system that’s used for the winter flu.

Although Sánchez didn’t offer many details about these new parameters to monitor Covid-19, he did say that the exhaustive control of cases would be abandoned, and therefore also the call for testing upon the onset of any Covid-19 symptom. 

His government wants to treat Covid-19 as an “endemic disease” similar to la gripe (the flu in Spanish), given its low mortality rate with Omicron the dominant strain in particular.

To justify this decision, Sánchez stressed that “the situation” of the pandemic “is not that of a year ago”, since “we know the virus better and while waiting for what the reports say, Omicron seems to have milder health consequences”.

According to the Socialists’ leader, his government has been “working for weeks” with the country’s Centre for Health Alerts and Emergencies (CAES) to determine these new parameters and is now agreeing on the final details with the regions. 

No start date has yet been given, but it’s not expected that the new system will be implemented until Spain’s six coronavirus wave is over.

Spain’s Health Ministry did say back in August 2021 that it intended to stop using the infection rate and other case number indicators to determine if the country’s epidemiological situation was improving or worsening, but the idea has been put on ice until now. 

If health authorities adopt the same monitoring approach as with seasonal influenza, instead of reporting every Covid case that’s detected in the country, something unsustainable in the long term, a group of primary health care doctors from health centres and hospitals in Spain will be strategically chosen to act as witnesses and report back.

Most primary care workers have called for this to happen, saying that acquired immunity in the population and the Omicron variant allow for it to work, and that the current testing and quarantine measures are unfeasible at this stage. 

According to the President of Spain’s Society of Family Medicine Salvador Tranche, the decision will “save” the currently overburdened primary health care system, which is having to deal with a barrage of patients with mild symptoms when it could be diagnosing other pathologies.

For Tranche, rather than the infection rate it should be bed occupancy rate of Covid patients in hospital wards and ICUs that’s used as the main parameter.

But it’s not an opinion that all health professionals in the country agree with. 

“If we stop taking action, what we are going to have are more infections,” leading epidemiologist and former WHO directive Daniel López Acuña told Spanish broadcaster RTVE, arguing that focusing only on serious cases and hospitalisations is “like cheating while playing Solitaire”.

“It’s a mistake to think that the problem will no longer exist by not counting infections, or by reducing the number of days of isolation, or by establishing quarantines in schools with five children instead of maintaining what was had. The problem continues to be there, and it has to be addressed,” López Acuña concluded.

For the spokesperson for the Spanish Society of General and Family Physicians (SEMG) Lorenzo Armenteros, it would be “hasty” to implement this new monitoring system in an attempt to “minimise the situation”. 

“Do we have to see as normal that there are 200 deaths a day?” argued Vicente Martín of Spanish Society of Primary Care Physicians (SEMERGEN).

“What is the number of deaths that should be considered acceptable?”

Over the past three weeks, there have been 1,500 Covid deaths recorded in Spain. 

It’s a far cry from the 19,000 people who died in Spain from Covid during two months last winter in the midst of the country’s third wave, but a fatality figure that’s growing again, albeit at a slower pace. 

The World Health Organisation’s Regional Director for Europe Hans Kluge has also said that considering Covid-19 an endemic disease is “not a good idea” as the virus has already surprised the world “more than once” already and that “we must be very cautious with predictions for the future”.


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