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COVID-19 RULES

How Spain wants to lead global shift in Covid-19 surveillance

With governments and populations worldwide desperate for an end to the pandemic, talks over when the virus might be reclassified have intensified. Spain has stepped up and wants to lead an international push for Covid-19 to be monitored in a similar way to seasonal flu.

spain covid surveillance
A healthcare worker tends to a Covid-19 patient in the ICU in Barcelona. Spain has seen a surge in Covid-19 infections since December and prevalence is currently among the highest in Europe. (Photo by Josep LAGO / AFP)

“Spain wants to lead this debate because it is timely and necessary to do so,” Health Minister Carolina Darias has said, adding that Spain asked the European Centre for Disease Prevention (ECDC) to “study new strategies” to deal with Covid.

Spain is in a good position to open the debate, having one of the world’s highest vaccination rates with 90.5 per cent of its population over the age of 12 fully immunised.

But the question has sparked disagreement between governments seeking some sort of normality and some parts of the medical community which advocate keeping its guard up.

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

Spain’s left-wing government has been a prominent advocate of reclassifying Covid as an endemic disease with milder seasonal outbreaks that humanity can live with, like the flu.

The country is working with the scientific community to eventually shift from “managing a pandemic to managing a disease which we hope science will reclassify as an endemic illness”, Spanish Prime Minister Pedro Sanchez said this week.

Although Omicron has triggered a surge in infections, there have been fewer deaths and lower rates of hospital admissions, with many governments easing restrictions, reducing isolation times and loosening border controls.

“As Covid becomes endemic, we will need to replace legal requirements with advice and guidance,” British Prime Minister Boris Johnson said Wednesday, announcing that restrictions were being lifted in England.

Arguing “we must learn to live with Covid” in a similar way to seasonal flu, British Health Secretary Sajid Javid said the government would set out a long-term plan for living with coronavirus within months.

READ ALSO:

‘False hope’

On Tuesday, however, World Health Organization chief Tedros Adhanom Ghebreyesus insisted that the pandemic was “nowhere near over”, warning that new variants were still “likely to emerge”.

The UN health organisation also warned against the temptation to play down the seriousness of an endemic disease.

“Endemic in itself does not mean good — endemic just means it’s here forever,” the WHO’s emergencies director, Michael Ryan, told the Davos Agenda roundtable on vaccine equity, citing malaria as an example.

Fernando García, an epidemiologist and the spokesman of a public health association, warned that talk of treating Covid-19 as an endemic illness at this stage was “creating false hope”.

“We are indeed moving towards the virus becoming more endemic, but we cannot say we have already reached that status,” said Marco Cavaleri, head of the European Medicines Agency’s (EMA) vaccination strategy.

There is no numerical threshold that distinguishes between an epidemic and a disease which is endemic, Garcia told AFP.

“An epidemic is when there is a very significant outbreak of cases, above the normal, which is what we have experienced since the beginning of 2020,” he said.

“And endemic diseases may have a seasonal trend but do not put pressure on the health system.”

Nor is it a foregone conclusion that the virus will evolve to cause less harm.

‘Mild symptoms’

“Future severity remains a big unknown. There is no law dictating that a virus must become milder over time,” Antoine Flahault, director of Geneva’s Institute of Global Health, wrote on Twitter.

“It is very hard to predict the evolution of virulence.”

When Covid-19 becomes endemic, “most people who become infected will have mild symptoms”, Garcia said.

“There will be a few who suffer complications that mean they end up in hospital and die,” he added.

“But you’ll never see one in four intensive care beds occupied by Covid-19 patients, not even five percent of them. Cases will probably be handled by primary care.”

In Spain, more than 23 percent of intensive care beds are taken up by Covid patients and more than 91,000 people have died since the pandemic first took hold in March 2020.

Of that number, 2,610 died between December 17 and January 18.

Some healthcare professionals have backed the Spanish government’s approach.

“Let’s stop visiting and testing healthy people with mild symptoms, or tracking and testing their contacts, let’s abandon self-isolation and quarantine,” urged a recent article by SemFYC, which represents around 19,000 family medicine specialists.

“All these activities… have been rendered meaningless with acquired immunity (both through infection and through vaccination) and the arrival of Omicron,” it said.

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TRAVEL NEWS

TRAVEL: Spain extends ban on unvaccinated non-EU tourists

Britons, Americans and other non-EU/Schengen travellers who are neither vaccinated nor recently recovered from Covid-19 will not be able to visit Spain for tourism for at least another month, Spanish authorities have confirmed.

TRAVEL: Spain extends ban on unvaccinated non-EU tourists

The Spanish government has again extended temporary restrictions for non-essential travel (including tourism) from most third countries for another month, until June 15th 2022.

That means that non-EU/Schengen adults who reside outside of the EU and who haven’t been fully vaccinated against Covid-19 or recovered from the illness in the past six months cannot go on holiday to Spain during the next month. 

Therefore, Spain continues to not accept negative Covid-19 tests from British, American, Canadian, Indian or other third-country nationals who are neither vaccinated nor recently recovered. 

There had been hopes that the shorter two-week extension to the ban on non-essential travel issued on April 30th, as well as talk of the “orderly and progressive reopening” of the country’s borders, would mean that unvaccinated third country nationals would be allowed into Spain in May.

But in the end, Saturday May 14th’s state bulletin confirmed that Spain will keep the same measures in place for another 31 days, stating that they “will eventually be modified to respond to a change of circumstances or to new recommendations in the context of the European Union”.

Spain’s ban on unvaccinated non-EU travellers is arguably the last major Covid-19 restriction in place in the country, and other EU countries such as Sweden, Poland, Denmark, Czech Republic and Ireland are allowing unvaccinated tourists in.

This latest announcement by the Spanish government marks the umpteenth extension to non-essential travel from outside of the EU/Schengen area over the past two years of the pandemic, the previous one was due to expire on May 15th. 

But perhaps this extension is the most surprising, as the Spanish health ministry has modified its rulebook to treat Covid-19 like the flu and the country wants to recover the tourism numbers it had pre-pandemic.

The ban affects unvaccinated British tourists in particular, as the UK is still the biggest tourism market for Spain, but Britons’ non-EU status means they have to follow the same Covid-19 travel rules as other third-country nationals.

Vaccinated or recovered third-country travellers

Those who were fully vaccinated against Covid-19 more than two weeks prior to travel to Spain will need to show a valid vaccination certificate with an EMA or WHO approved vaccine.

If their initial vaccination treatment was completed more than 9 months ago (270 days), they’ll need to show they’ve had a Covid-19 booster shot. 

As for non-EU/Schengen travellers who have recovered from Covid-19 in the past six months, they will need to show a recovery certificate to prove this

According to Spain’s Health Ministry, recovery certificates accepted as valid are those “issued at least 11 days after the first positive NAAT or RAT, and up to a maximum of 180 days after the date of sampling”, as well as being issued by the relevant authorities.

Exceptions

In early February, Spanish authorities also decided to start allowing unvaccinated non-EU/Schengen teenagers aged 12 to 17 to visit Spain for tourism if they provided a negative PCR.

Spain continues to have a small list of low-risk third countries whose travellers visiting Spain for non-essential reasons can enter without having to present proof of Covid-19 testing, recovery or vaccination. 

This is updated weekly and can be checked here by clicking on the PDF under “risk and high risk countries/areas”. 

READ ALSO: Can I travel to my second home in Spain if I’m not vaccinated?

If you’re not vaccinated or recovered, the exceptions for travel to Spain from third countries that fall under the non-essential travel restrictions are:

  • You are a resident in the EU or Schengen country.
  • You have a visa for a long duration stay in an EU or Schengen country.
  • You work in transport, such as airline staff or are in a maritime profession.
  • You work in diplomatic, consular, international organisations, military or civil protection or are a member of a humanitarian organisation.
  • You have a student visa for a country in the EU or Schengen zone.
  • You are a highly qualified worker or athlete whose work cannot be postponed or carried out remotely.
  • You are travelling for duly accredited imperative family reasons.
  • You are allowed entry due to force majeure or on humanitarian grounds.
  • And as mentioned earlier in the article, if you have a vaccination certificate that Spain’s Ministry of Health recognises, as well as for any accompanying minors (unless they’re under 12 years of age).

READ ALSO: When do I need to fill out Spain’s Covid health control form for travel?

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