The sudden overwhelming of Spain’s health system as the progress of Covid-19 starts to spiral out of control has its origins in the slow and confused response of the Spanish government over a month ago, experts have warned.
On Wednesday the country’s death toll rose by a record 738 and the figure climbed 655 again yesterday, leaving the country facing the second most lethal outbreak worldwide behind Italy, with more than 4,300 fatalities.
With the benefit of hindsight – and with alarming echoes of the approach taken in Britain – the Spanish government appears to have been too slow to instigate suppression measures and prevent the exodus of people from the capital Madrid.
Throughout February and early March, the focus was on containment of what were seen as isolated cases imported from abroad. But given the lengthy gestation period of this coronavirus, a deadly and unseen epidemic was developing.
The decision to allow mass gatherings to continue through the first weekend in March now looks like a terrible blunder. Two female cabinet ministers and the wife of Prime Minister Pedro Sánchez tested positive days after attending a massive International Women’s Day march in Madrid.
In the days that led up to a national lockdown, there was also vacillation. A special cabinet meeting was held on March 12 to announce measures to mitigate the economic costs of an epidemic, only for Mr Sánchez to announce the following day that another government meeting would be held on March 14 to draw up a state of emergency action plan.
The delay in instituting a full lockdown during a sunny spell of spring weather allowed many Madrid dwellers and their children, who were no longer obligated to attend school, to head for second homes and other rural options around the country.
Exasperated mayors closed beaches and told Madrileños to stay inside their holiday homes. Leaders of several Spanish regions, including Catalonia, called for Madrid to be sealed off as the epicentre of contagion, but it now looks like their words were insufficient.
“I think it was a mistake to allow the large geographical dispersion of people that occurred in the days before the lockdown came into effect, and this may have facilitated the spread of the virus,” said Pere Godoy, President of the Spanish Epidemiology Society.
Testing was also insufficient, with Spain’s health authorities drawing fire for failing to ramp tracking and testing measures. The country only reached 15,000 to 20,000 tests per day this week, finally catching up with other major EU countries, like Germany.
A lack of protective equipment for health workers in Madrid, a situation familiar to British health workers, has also played a role. The result is that more than 10 per cent of confirmed cases in Spain are among medical staff, further reducing the capacity of a healthcare system already at breaking point.
Spain’s health service has enjoyed a good reputation in recent decades, but it has been no match for the exponential acceleration of the Covid-19 epidemic that has seen the number of deaths multiply by a factor of 12 in the past 10 days.
Since March 15, the day Spain was placed on lockdown, the caseload of confirmed cases of infection has multiplied sixfold to 47,610, and the number of patients requiring intensive care has risen from 382 to 3,166.
As the second-most visited country in the world after France, Spain was always going to be vulnerable to this global pandemic, and indeed the first two coronavirus cases registered were among foreigners in island resort areas.
Now the contagion is moving faster in other regions outside Madrid, that are even less well equipped to cope. Old people’s residences, especially private centres where staff are overstretched and underequipped, have borne a painful brunt of contagion and death.
Bad decisions taken a month ago – or more accurately a lack of decisions – are now bearing a terrible fruit.