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COVID-19 STATS

‘The last wave?’ Spain’s ICU staff left exhausted by recurring Covid battle

Seemingly milder for some but still highly contagious, Omicron has filled intensive care beds again at a hospital near Barcelona where shattered staff are still fighting a virus that refuses to retreat.

A healthcare worker watches a Covid-19 patient through the door, at the semi-critical respiratory unit of the Bellvitge University Hospital in Barcelona on January 19, 2022. - Milder for most but still highly contagious, Omicron has filled intensive care beds again at a hospital near Barcelona where shattered staff are still fighting a virus that refuses to retreat. (Photo by Josep LAGO / AFP)
A healthcare worker watches a Covid-19 patient through the door, at the semi-critical respiratory unit of the Bellvitge University Hospital in Barcelona on January 19, 2022. - Milder for most but still highly contagious, Omicron has filled intensive care beds again at a hospital near Barcelona where shattered staff are still fighting a virus that refuses to retreat. (Photo by Josep LAGO / AFP)

“Every time we think we’ve reached the end of the tunnel, it just gets longer,” sighs Rafael Manez, head of intensive care at Bellvitge University Hospital, one of the largest medical facilities in Spain’s northeastern Catalonia region.

Since the pandemic took hold nearly two years ago, overwhelming hospitals across the world, this veteran specialist has steered clear of making predictions, with Covid-19 exhausting them all.

Although more than 90 percent of Spain’s population over the age of 12 has been vaccinated, it has not spared the nation from an explosion of Omicron infections, giving it one of Europe’s highest incidence rates in recent weeks.

In Catalonia — one of Spain’s most populous regions with 7.7 million residents — Covid patients are taking up more than 42 percent of intensive care beds, far above the national average of around 23 percent.

And it also has the highest number of patients in critical condition, although there are hopes this wave is on the verge of peaking.

“Our medical teams are really tired, especially by the sense of uncertainty. Will this be the last wave or will there be another?” wonders Gloria Romero, head of nursing at the hospital’s intermediate respiratory care unit.

“This takes a toll on healthcare professionals. How long will this situation go on?”

‘It’s very hard’

With 40 of its 44 beds taken up by Covid patients, the pace has not slowed at the intensive care unit of this hospital, which serves a heavily populated metropolitan area just south of Barcelona.

Inside the unit, staff suddenly start running as a patient appears to run out of air, quickly helping him.

But the work never stops in the ICU, where some 40 percent of those brought in are not vaccinated.

“The unvaccinated patients, who are the ones we’re mainly dealing with, are those who are in denial about their illness and even about the treatment,” says Santiago Gallego, the ICU’s head nurse.

The impact on staff of working through a nearly two-year pandemic is increasingly evident, triggering unprecedented levels of stress and Covid infections, with 600 employees forced to take time off since December 1.

And given the latest explosion of cases, the hospital has also been forced to once again cancel visits, with the most seriously ill patients left to fight for their lives alone, far from their loved ones and only the staff to stay by their side.

“It’s very hard physically but most of all emotionally because it just never ends,” admits Elena Cabo, a physiotherapist who works in the ICU, her voice breaking with emotion.

SPAIN-HEALTH-VIRUS-HOSPITAL

Healthcare workers tend to a Covid-19 patient at the Intensive Care Unit (ICU) of the Bellvitge University Hospital in Barcelona on January 19th, 2022. – Milder for most but still highly contagious, Omicron has filled intensive care beds again at a hospital near Barcelona where shattered staff are still fighting a virus that refuses to retreat. (Photo by Josep LAGO / AFP)

The vaccine as key

But all the staff just keep on working in the hope that this disease will start to retreat.

“The only thing which is really effective is preventing it through vaccination, nobody can argue with the fact it’s had an impact,” says Manez.

And if Spain didn’t have such a high rate of vaccination, “we would certainly be in a much worse state than we were two years ago,” he reflects.

The nature of this sixth wave of infections has also raised long-awaited hopes that Covid-19 is starting to shift from a pandemic to a more manageable endemic illness like seasonal flu.

“The people that are coming in are not as young and they have more underlying health problems, so it’s starting to look more like a more common virus,” explains Mikel Sarasate, a pulmonologist at the intermediate respiratory care unit.

But nobody wants to get ahead of themselves or play down the severity of a virus that has killed more than 91,000 people in Spain and sickened so many.

“The flu, which is the closest thing we know, doesn’t attack patients this badly or with such intensity,” Sarasate says, warning about a comparison which for most specialists remains premature.

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COVID-19 STATS

Outbreak or seventh wave? Health experts divided as Covid cases rise in Spain

Spain’s decision to stop counting all infections has some epidemiologists arguing health authorities are turning a blind eye to rising cases. But is the country truly heading towards a seventh wave?

Outbreak or seventh wave? Health experts divided as Covid cases rise in Spain

Three weeks since the Easter holidays came to a close and the indoor face mask rule was lifted in Spain, the Covid infection rate among over-59s has increased considerably, for most health experts predictably. 

It’s double what it was on April 1st – going from 459 cases per 100,000 up to 813 per 100,000 – and although Covid hospitalisations have risen by 78 percent in a month, pressure on hospitals remains stable. 

Not that this can be considered a complete picture of the epidemiological situation in Spain as the health ministry decided last March it would stop requesting data from the regions for infections among under-60s. 

This is part of the Spanish government’s plan of managing Covid-19 in a similar way to other endemic diseases such as seasonal influenza. 

The focus in recent weeks has been lifting Covid restrictions, not counting and reporting all Covid infections as frequently and rigorously and keeping a close eye only on the elderly and vulnerable. In a nutshell, returning to life pre-coronavirus.

But for some epidemiologists, the 55,578 new infections and 234 Covid deaths in the past week are indicative of the fact that the virus is still raging strong and that the end of Covid rules may have come too soon.

“We’re not facing a silent wave of the pandemic.  We’re walking blindfolded into a new wave, we don’t want to see it and we don’t want to name it,” Daniel López-Acuña, former director of emergencies at the World Health Organisation, told public broadcaster RTVE.

“There is a considerable rise in the infection rate, and  a rise in the infection rate sustained over time is a new wave, whether you want to call it that or not , López-Acuña added, arguing that if the incidence in under-60s were also analysed, “we would see the same infection rate or greater”.

Epidemiologist Quique Bassat argues that although there is talk among health experts of a seventh wave, “what we don’t know is how long it will last and if this is the beginning of what will end up being a seventh wave, or if it’s really just a new outbreak.” 

For Bassat, who is regularly interviewed on La Sexta and Antena 3 news, a rise in cases after the Easter holidays and the removal of face masks indoors is “what was expected”, but that “doesn’t mean that the population should be scared” and it “isn’t necessary to change the current strategy” of the health ministry.

“Pressure on healthcare is what has to determine if we should take a step back in the de-escalation of Covid-19 measures,” Bassat concludes.

It’s clear that the Spanish government’s approach to this stage of the pandemic is subject to a variety of opinions among the scientific community.

Some health experts, such as immunologist Matilde Cañelles of Spain’s Higher Council for Scientific Research (CSIC), consider it “irresponsible” to stop quarantine for positive cases and not count infections when there are still 30 people dying of Covid every day in Spain. 

Others take a more pragmatic approach and call for the fourth dose (second booster) of the Covid-19 booster vaccine to be offered to over-80s in the country as previously suggested, as the infection rate in this group is now over the 1,000 per 100,000 mark.

For epidemiologist Oriol Mitjà, Covid-19 adviser for the Catalan government, the coming weeks will shed more light on how big this coronavirus wave will be.

“Omicron is a variant with vaccine escape and with the potential to infect up to 60-70 percent of the population. 30 percent were infected at Christmas, 30 percent will avoid it and 30 percent can be infected now,” Mitjà tweeted.

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