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.

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