Spain

As Spain battles virus, medics' unions hit out

KONFRONTASI-When Spain’s first case of coronavirus was recorded on Jan. 31 - a German tourist in La Gomera, one of the remote Canary Islands - there seemed little cause for concern.

“We believe that Spain will have, at most, not more than a few diagnosed cases,” Fernando Simon, the country’s health emergency chief, told reporters.

Now, COVID-19, the respiratory disease caused by the virus, has killed more people in Spain than China, where it originated.

Across the globe, the pandemic has swamped health systems and triggered calls for more and better protective equipment for those fighting it.

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.

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 Fernandez, 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.

On March 18, the central government issued a document outlining “alternative strategies” for staff dealing with the shortage. Adapted from a similar one prepared by America’s Centers for Disease Control, it said staff lacking masks had five options, including re-using masks or only providing them to staff at the highest risk of infection. It also suggested different kinds of aprons and gloves that could be used.

Some nurses have been forced to improvise, fashioning protective clothing from garbage bags, shower caps, or raincoats from a Madrid amusement park.

In the town of Igualada, an hour’s drive north of Barcelona, a local government spokesman said that about one-third of the hospital’s 1,000 staff - all of whom have been tested - have had to self-isolate either because they had symptoms or were in touch with people who may have been.

A total of 98 people in Igualada have died of the disease and, of the more than 600 infected, 154 are healthcare workers, according to the regional health authority.

On March 12, Igualada became the first municipality in Spain to be completely sealed off, following Italy’s example with the northern region of Lombardy. Only those providing vital services can enter or leave.

Coronavirus: Why are deaths rising so quickly in Spain?

KONFRONTASI-Every night in Spain since the coronavirus state of alert was decreed on March 14, citizens take a moment to applaud the country's beleaguered medical workers.

But this hopeful image does little to dim the pain of the pandemic; Spain's daily death toll reached a harrowing new high of 769 on Friday, bringing the total number of fatalities to almost 5,000.

Fresh cases of coronavirus-related infections did drop, from a record total on Thursday of 8,578 to 7,871 on Friday.

But both numbers are far worse than a week ago, when new cases stood at 2,833.

Another unnerving fact is that compared with Italy, where eight percent of health workers are affected, in Spain by Friday that tally stood at 16.5 percent.

What has caused such a rapid spread of coronavirus in Spain?

Multiple factors

The most high-profile reason touted by the media in Spain is the public health service's uneven and reportedly depleted resources for tackling this, or indeed any, kind of virus-related pandemic.

Academics in Spain partly confirm this as one possible reason, but underline multiple other factors.

"As recently as Wednesday, the Centre for Disease Prevention and Control in Europe pointed out that the impact of COVID-19 depended on a country's level of preparation and its ability to implement rapid countermeasures," Silvia Carlos Chilleron, a professor in the department of Public Health and Preventive Medicine at the University of Navarra, told Al Jazeera.

"If the increase in cases has been fast, as it has been in Spain, and the human and material resources to fight it are not guaranteed, then the impact is more serious. That probably causes a greater number of deaths among the most vulnerable sectors of society, particularly when medical professionals are among those affected."

Also on Wednesday, Spain's State Confederation of Medical Unions (CESM) lodged a case with the country's Supreme Court, asking the health ministry to provide sufficient protective equipment as soon as possible.

CESM alleged in their case, which was rejected, that the ministry had so far failed to provide professional health workers with sufficient protection to carry out their work in a manner that reduces the risk of catching coronavirus.

"People are generally respecting the lockdown and trying not to come into hospitals for minor illnesses and that's helping reduce the risk of contagion," one hospital doctor in southern Spain, who did not wish to be named for fear of reprisals, told Al Jazeera.

"But there is a lack of sanitary material in the hospitals for this kind of crisis, which multiplies the possibilities of health staff getting contagious infections, and that's going to be a huge factor."

Underlying reasons for the coronavirus spread before the state of alert could have been "the low level of perception among the population at large that coronavirus represented a risk", Jose Hernandez, a researcher and assistant professor of sociology at Cordoba University, whose specialties include social health policies, told Al Jazeera.

At that point and "until relatively recently, there wasn't enough information on what coronavirus was", he said.

Spanish population distribution may also have an effect, observed Alberto Mataran, a professor of Environmental Sciences at the University of Granada

"There's a huge density of people in cities like Madrid or on the Mediterranean coast in particular, and a lot of blocks of flats in cities' outlying suburbs.

"Add in a lot of communal spaces, a very affectionate kind of social behaviour compared to some countries - we always shake hands, or hug, or kiss each other, when we meet, for example - and the opportunities for propagation surely could increase, too."

As for the much-cited dearth of resources, Hernandez argued it explains the "relatively rapid saturation" of the health services.

"Also, Spain has a large elderly population, who are very vulnerable, and retirement homes do not, generally, have massive medical resources.

"On top of that, the fact that Spain's hospitals and medical services are run by different autonomous regions creates some very important underlying inequalities."

Hernandez added that while regional governments can demand assistance from Madrid, this does raise the risk of poorly judged medical strategy decisions in the central government.

In 2014, medical staff in Madrid protested against the lack of effective protective equipment and safety precautions amid the Ebola epidemic.

"We could see that the public health system had some big gaps in the early detection of infections. And these are structural weaknesses," he said.

Millions rally in Spain on International Women’s Day

KONFRONTASI - Millions of women workers in Spain have taken part in an unprecedented protest march and strike across the country to mark International Women’s Day and oppose wage gaps, domestic violence, and sexual discrimination.

Labor unions in Spain estimated that over five million women participated in the first 24-hour nationwide “feminist strike” on Thursday, which was sponsored by 10 unions and some of Spain’s top female politicians.

Work resumes normally in Catalonia as Spain enforces direct rule

KONFRONTASI-Work resumed normally in Catalonia and calm reigned on the streets on Monday despite calls for civil disobedience from secessionist politicians, in early signs the direct rule imposed to stop an independence bid from Spain was taking hold.

Although some public sector workers have yet to tell their new bosses whether they will accept orders, the lack of unrest came as a relief for financial markets, which rose.

Catalonia, a prosperous region with its own language and culture, triggered Spain’s biggest crisis for decades by holding an independence referendum on Oct. 1, which Spanish courts called illegal.

Spain’s Prime Minister Mariano Rajoy assumed direct control of the region on Friday, sacked its secessionist government and called a snap election for Dec. 21.

However, some of the most prominent members of the Catalan administration, including its president, Carles Puigdemont, and vice-president, Oriol Junqueras, had said they would not accept the move and only the people of Catalonia could dismiss them.

Spain’s state prosecutor on Monday called for rebellion and sedition charges to be brought against Catalonia’s leaders over their push to separate from Spain. Attorney-General Jose Manuel Maza also called for charges of misuse of funds to be laid.

Under Spain’s legal system, the request goes to a judge for consideration. Maza asked the judge to call the secessionist leaders to testify.

The main civic groups behind the pro-independence campaign had called for widespread civil disobedience, and said that public sector workers such as teachers, firefighters and the police should refuse orders from the central authorities.

But most workers started their working day at 9 a.m. (0800 GMT) as normal and there was no sign of widespread absenteeism.

Most sacked Catalan leaders remained ambiguous on Monday and stopped short of directly defying Spain’s authority. There were no signs of any spontaneous demonstration taking place.

Puigdemont posted a picture on Instagram taken in the regional government headquarters, but was not seen entering, suggesting the photo may have been taken by someone else.

Regional transport chief Josep Rull posted on Twitter a picture of him working in his office but he was later seen leaving the building. Spain’s transport minister had said in a radio interview Rull would be allowed to collect his personal belongings but not work there.

When he left, Rull said he would now attend a meeting of his PdeCat party (Catalan Democratic Party).

“Let’s go on with the scheduled agenda,” he said.

Spain's King condemns Catalan leaders as thousands take to streets

KONFRONTASI- Spain’s King Felipe VI on Tuesday accused Catalan secessionist leaders of shattering democratic principles and dividing Catalan society, as thousands took to the streets to protest against a violent police crackdown against the banned independence referendum held on Sunday.

The televised speech, a rare intervention by the 49-year-old monarch who is normally silent on politics, was a sign of how deeply Spain has been shaken by the Catalan vote and a police crackdown that injured 900 people.

Spain, Catalonia tussle over control of Mossos police

KONFRONTASI - Spain's central government and regional Catalan authorities tussled Saturday over who controls the regional police force that is considered key to the success of a planned Oct. 1 independence vote for the northeastern region.

The Catalan government has already vowed to push ahead with the referendum, which the Spanish government considers illegal — and on Saturday said it was refusing to hand over control of the Mossos d'Esquadra police force to Spain's Interior Ministry.

Spain votes in general election after Brexit

KONFRONTASI-People across Spain have cast their ballots for the second time in six months, in a closely watched election just days after Britain's decision to exit the European Union.

Polls closed at 8pm (18:00 GMT) for Spain's roughly 36.5 million voters on Sunday, with results expected shoftly.

Sunday's repeat vote came after the four main political parties failed to agree on a coalition after December's general election resulted in a hung parliament.

5-magnitude earthquake hits central Spain, shaking Madrid

KONFRONTASI - An earthquake measuring five on the Richter scale has jolted central Spain, sending shockwaves through the country’s capital, Madrid.

The Monday temblor, whose epicenter was located seven kilometers (4.3 miles) from the town of Ossa de Montiel, near Albacete, about 220 kilometers (135 miles) southeast of Madrid, sent some panicked office workers into the streets.

According to Spain's National Geographic Institute, the quake struck at 5:16 pm (1616 GMT), while its depth has been given as 14 kilometers (8 miles).

Ten die as Greek fighter jet crashes in Spain

KONFRONTASI-Spain's defence ministry has said that a Greek F-16 fighter jet crashed into a hangar at a military base in Spain where it was participating in NATO training.

The defence ministry said on Monday that ten people died in the crash and 13 were injured.

The F-16 plane crashed shortly after taking off at the training centre in Albacete, 262 kilometres southeast of the Spanish capital of Madrid, according to the ministry statement.

Spain proposed security law angers activists, opposition

KONFRONTASI-Spain’s opposition parties and rights groups have criticized the government for introducing a new security law aimed at limiting public protests.

On Thursday, Spain’s lower house of parliament, known as the Congress of Deputies, approved a highly contentious bill that puts major restrictions on holding protests.

The law introduces hefty fines for unauthorized protests outside strategic installations. The legislation also allows for the summary expulsion of migrants that try to enter the country illegally.

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