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Paramedics wearing suits along with face masks and goggles as a protective measure against the COVID-19 coronavirus stand outside the Alvaro Cunqueiro hospital in Vigo, northwestern Spain, on March 25, 2020. As the global death toll soared past 20,000, Spain joined Italy in seeing its number of fatalities overtake China, where the virus first emerged just three three months ago. Image Credit: AFP

Madrid: Spain prides itself on being a tight-knit society that respects parents and grandparents, where powerful bonds across generations mean that the elderly play an integral part in family life, beyond just helping to look after grandchildren.

So even in a country besieged by the coronavirus epidemic, where the death toll overtook China’s on Wednesday, the news this week about Spain’s nursing homes has come as a particular shock.

Soldiers who were sent to disinfect nursing homes had found people “completely abandoned, or even dead, in their beds,” the defence minister, Margarita Robles, revealed Monday. More gruesome discoveries followed, including the revelation of two dozen deaths in a single nursing home in Madrid.

Amid the thousands of tragedies created by the virus, the stories emerging from those homes have shaken the nation not only for their horror but for undermining the view the Spanish had of themselves.

“We have really kept a welfare state and a strong family support structure, but this terrible news coming from nursing homes must also force us to acknowledge some very serious deficiencies,” Marina Subirats, a well-known Barcelona-based sociologist, said in a telephone interview.

El Pais, the country’s leading newspaper, wrote in an editorial that the deplorable situation in some nursing homes had exposed “a bitter black hole in our welfare state.”

Public health care system

Another source of pride for the Spanish has been the country’s robust public health care system; last year, a study ranked Spain as the world’s healthiest country. But that part of the national self-image has also taken a beating from a pandemic that has overwhelmed many hospitals and sickened thousands of health care workers.

Spain’s official death count from COVID-19, the disease caused by the new coronavirus, climbed Wednesday to over 3,400, almost 300 more than in China. Only Italy, at more than 7,500, has had more fatalities, but Spain’s toll is growing faster. On Wednesday, 738 died in Spain, versus 683 in Italy.

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Paramedics wheel a patient into the Burgos general hospital in Burgos on March 25, 2020. Image Credit: AFP

The growth of new infections and deaths appears to be levelling off in Italy, the hardest-hit country, but in much of Europe and around the world, they continue to accelerate. Spain reported about 8,000 new cases on Wednesday, a new high, raising the national total above 47,000, compared to about 5,000 new infections in Italy, which has had more than 74,000.

Spain’s government has not said how many bodies or neglected residents have been found in nursing homes, but Spanish public prosecutors are investigating possible criminal neglect.

Nursing home affected

At least 24 people were reported dead Wednesday at a nursing home that had been disinfected by the army over the weekend, in the Madrid district of Chamartin. Two other Madrid homes have recently been similarly decimated.

In the Madrid region, over a fifth of the nursing homes have had cases of coronavirus, authorities said Monday. Compounding the problem, dozens of their infected employees are now isolated at home.

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A member of the Military Emergencies Unit (UME) carries out a general disinfection at a local market in Badalona near Barcelona on March 25, 2020. Image Credit: AFP

Countries across Western Europe, which have some of the oldest populations in the world, are struggling to protect the most vulnerable among their aging people - while also acknowledging that the crisis among the elderly, particularly in nursing homes, might be far worse than anyone knows.

In Italy, authorities have conceded that their coronavirus death toll did not include those who had died at home or in nursing homes. Similarly in France, officials have said that only those who died in hospitals had been recorded as pandemic-related - a practice they said would change in the coming days.

Older victims in Spain

Fernando Simon, the director of Spain’s national health emergency centre, on Wednesday acknowledged the cost to Spain of not having managed to protect those in nursing homes. “When the virus enters nursing homes, of course the number of dead rises a lot,” he said.

Spain’s coronavirus victims have been older, on average, than those in other countries. Over 65 per cent of the Spanish dead were 80 or older, according to a data sample provided from the health ministry, compared to 50 per cent in Italy as of last week, and 15 per cent in China in February.

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As nursing homes have come under fire, directors of some of them have accused the government of passing on the blame for its own shortcomings in a crisis that has left doctors, nurses and mortuary employees without the protective gear they need.

In Spain, thousands of health care professionals have been infected, accounting for 15 per cent of the country’s total cases, the highest percentage reported by a country. And nursing home workers, like those in hospitals, are not only particularly exposed to the virus, they can also be vectors for its spread.

Probe into retirement homes where residents have died

In Catalonia, the northeastern region of Spain, regional authorities are launching their own investigation into two retirement homes near Barcelona where more than 20 residents have died. Over 200 residents have been infected in 70 retirement homes in Catalonia.

Across other parts of the country, regional authorities are now scrambling to evacuate homes or take full control of them.

On Tuesday, a convoy of ambulances transferred 28 infected residents from their home in Alcala del Valle, a town in the South, while the mayor and the regional administration blamed each other for allowing three people to die inside. The sick residents were taken to a home in La Linea de la Concepcion, about 80 miles away.

While some regions have been far less affected by the coronavirus than Madrid, clusters are showing up in homes for the elderly almost everywhere. In Alicante province in southeastern Spain, deaths in retirement homes have accounted for 95% of the coronavirus deaths.