COVID-19: Spain passes Italy in total number of cases

Madrid: Spain became the epicenter of the coronavirus pandemic in Europe as the total number of cases surpassed Italy. Spain said the number of confirmed cases increased to 124,736, from 117,710 a day earlier, according to Health Ministry data. In Italy, total cases stood at 119,827. In what could be a sign of hope, the number of new deaths in Spain declined for a second day, with an additional 809 fatalities in the past 24 hours for a total of 11,744.

Spain’s doctors and nurses, who have released clips of each other cutting up plastic garbage bags to use as protective clothing, say their situation is worse than many.

More than 15,000 of them are sick or self-isolating and unable to help patients. That’s around 14.7% of the country’s confirmed cases, said a health ministry spokeswoman. One union has said the concentration is higher in the capital Madrid - 21% - the epicentre of the outbreak that has killed more than 9,000 and infected more than 100,000.

Medical workers in Italy, for example, make up just under 10% of reported COVID-19 cases, a smaller share than in Spain - although scientists say the data are not directly comparable because medical staff may not be tested at the same rate.

In a town in Catalonia, as many as one in three medical staff have been out of action because they were infected or self-isolating.

Cellphone footage has aired on Spanish TV and on social media showing patients with oxygen tanks packed into the corridors - some laid out on the corridor floors - of hospitals.

Lawsuits

In Spain, unions representing Spain’s medical staff are taking action. Unions have filed lawsuits in at least 10 of Spain’s 17 regions asking judges to compel the authorities to provide equipment within 24 hours in line with health and safety law, said a spokeswoman for the national federation of doctors’ unions, CESM. In Catalonia, the top regional court on Tuesday rejected the 24-hour deadline but said authorities must provide protection measures whenever equipment arrives.

The health ministry said it had always acted on scientific evidence, following experts’ recommendations, and taking steps based on a thorough assessment of the situation at any given time. Health Minister Salvador Illa has said the equipment market was simply overwhelmed, but said on Tuesday the ministry had managed “steady and continuous deliveries” of equipment.

“We feel very proud of what the Spanish healthcare workers are doing,” he told a news conference.

Spain’s health service, like Italy’s, is run at regional level. The central government took control by declaring a state of emergency on March 14, and the authorities are trying to hire thousands of extra staff. But the health ministry - like everyone globally - has struggled to get hold of supplies.

“The explosion of cases in Spain is not normal ... it has been very poorly managed since the beginning,” said Tomas Toranzo, president of CESM, whose members are filing the suits.

“The coronavirus infection was underestimated, treated like a mild flu, and it seemed that this would only affect a few elderly.”

Advice ignored

Unions say their members were ignored. Already in February, there were signs the virus was spreading, said Angela Hernandez, a Madrid surgeon and deputy secretary of the doctors’ union AMYTS.

She said doctors in major hospitals in Madrid noticed a cluster of unusually severe pneumonia cases that didn’t correspond with the end of the flu season - similar to those that Chinese doctors had recorded on the new coronavirus. But strict protocols limiting testing from Spain’s health ministry prevented doctors nationwide from testing for it.

It took until March 11 for the health ministry to allow doctors to test people who displayed even mild symptoms. Such confusion was widespread globally.

Spain’s health workers, a dozen of whom spoke to Reuters, say they were vulnerable in other ways too.

In mid-February, Jesus Garcia Ramos, the representative for health and safety for Madrid’s nurses’ union, Satse Madrid, asked the regional health authority for extra training to prepare for coronavirus patients, he said. One thing they wanted to know: How to take off protective equipment without infecting the wearer.

He said it took 10 days for the first training sessions to begin on Feb. 25, the date Madrid reported its first case. In some other Madrid hospitals, training didn’t start until the first week of March, he added. By then, the number of cases nationwide had leapt from dozens to hundreds.

The Madrid authority did not respond to requests for comment.

Raincoats and shower caps

A doctor in Barcelona said he was also ignored.

Josep Maria Puig, who works at Barcelona’s Hospital del Mar, said he suggested to regional health officials from late February that they consider calling up retired health workers and building makeshift hospitals. It took a couple of weeks for them to act - too long, he said.

Puig, who is also secretary general of Metges de Catalunya, Catalonia’s biggest doctors’ union, said Spain wasted crucial time and “failed spectacularly” to get personal protection equipment (PPE) to its own healthcare workers, despite real-time lessons from Italy: “Italy was 10 days ahead of us, which should have allowed us to see where things could be heading.” A spokesman for Catalonia’s health department did not respond to requests for comment.