COVID-19: Spain's elderly suffer as coronavirus tears safety nets

Barcelona: The elderly of Barcelona's working-class Poble Sec neighborhood, the generation who survived widespread hunger after the Spanish Civil War, started out vulnerable.

Drawn to Spain's industrial heartland a generation ago, they relied in retirement on free lunches from neighborhood social centers. Many received medical care from the local clinic, where doctors and nurses made house calls. Social workers brought them groceries.

But the coronavirus pandemic has heightened their fragility, stripping away the safety nets that kept them fed and healthy and exposing them to a daily threat of infection that they know could kill them.

For two weeks, a photographer accompanied Barcelona's visiting health care workers and emergency medical personnel as they tended to Spain's home-bound elderly.

The autonomous region of Catalonia, of which Barcelona is the capital, ranks only second to Madrid in Spain's official count of virus infections and deaths, with nearly 30,000 cases and more than 3,000 dead.

As in similarly hard-hit Italy, Spain's elderly aren't usually being tested for COVID-19. They also aren't being admitted to hospital intensive care units, where coveted beds and breathing machines are prioritized for younger, healthier patients with a better chance of survival. Nationwide, only 3.4% of Spain's ICU patients are over 80.

As a result, Barcelona's elderly are suffering at home, alone and more isolated than ever. Few know for sure if they have the virus, but the threat that they might catch it _ even from the visiting medical teams they need _ has only heightened their anxiety.

Alba Rodriguez is a pediatric nurse by profession but shifted gears to care for Barcelona's elderly who are confined to their homes. She has had to get creative to protect herself, fashioning hazmat suits out of giant yellow garbage bags that she and her fellow nurses wear over their scrubs.

The nurses know well there is a chance they might infect their patients during their visits, and they take all the precautions they can. Sometimes the elderly refuse medical care until it's too late, because they fear visiting medics might bring the virus into their homes.

Maria Perez Gomez, 70, reluctantly called emergency medical services when she started having trouble breathing and developed a cough and fever. When the medics arrived, she begged them to tell her she wasn't positive, though she suspected she was. "Please leave me here at home, don't take me to the hospital," she pleaded. "Tell me doctor that I don't have the virus."

Enrique Pastor, 86, lies in bed surrounded by the oil paintings he created as he waits for the doctor to examine him during a home medical visit. Pastor's usual caregiver tested positive for the virus, leaving the bedridden retired port worker home alone with his wife.

A home care doctor performs a physical exam on Felicidad while her son, Joan, holds her arm at her home. Felicidad had been admitted to the hospital after suffering a stroke but was sent home within a day and soon developed respiratory symptoms.

Gonzalo Garcia, 61, does have the virus and was hospitalized for it. He was discharged after he improved, and immediately went back home _ to his waiting 91-year-old mother, Gloria. After a few days, he took a turn for the worse and had to call emergency services again.

"I'm drowning. I'm drowning. I can't breathe," he told the medic who arrived to check his lungs as he heaved on the living room sofa. All Garcia could manage was a raspy whisper. The ambulance took him away. His mother was left alone.