“Here we go again”: a second wave of virus seizes Spain

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MÁLAGA, Spain – As of noon on Sunday, 31 patients were in the main coronavirus treatment center in Malaga, the city with the fastest rising infection rate in southern Spain. At 12:15 p.m., the 32nd arrived by ambulance. Half an hour later came number 33.The trash can near the door was overflowing with masks and blue surgical gloves. Relatives hovered silently outside – one in tears, another feeling a touch of déjà vu.

“My brother-in-law got the virus in the spring,” said Julia Bautista, a 58-year-old retired office administrator, awaiting news from her 91-year-old father on Sunday.

“Here we are again,” she added.

If Italy was the harbinger of the first wave of the coronavirus pandemic in Europe in February, Spain is the harbinger of its second.

France is also expanding rapidly, as are parts of Eastern Europe, and cases are on the rise in Germany, Greece, Italy and Belgium as well, but last week Spain recorded more far the most new cases on the continent – more than 53,000. With 114 new infections per 100,000 inhabitants during this period, the virus is spreading faster in Spain than in the United States, more than twice as fast as in France, around eight times more in Italy and Great Britain and ten times faster in Germany. .

Spain was already one of the hardest-hit countries in Europe, and today has around 440,000 cases and more than 29,000 deaths. But after one of the world’s toughest lockdowns, which verified the spread of the virus, it went on to enjoy one of the fastest reopens. The return of nightlife and group activities – far faster than most of its European neighbors – has contributed to the resurgence of the epidemic.

Couples dance to salsa music as the sun sets in Málaga, Spain on Saturday. —Samuel Aranda / The New York Times

Today, as other Europeans reflect on how to restart their economies while protecting human life, Spaniards have become an early indicator of how a second wave might be, how harsh it might be. hit and how it might be contained.

“Spain may be the canary in the coal mine,” said Prof Antoni Trilla, an epidemiologist at the Barcelona Institute for Global Health, a research group. “Many countries can follow us – but hopefully not at the same speed or with the same number of cases that we face.”

Admittedly, doctors and politicians are not as terrified of Spain’s second wave as they are of the first. The death rate is about half the rate at the height of the crisis – falling to 6.6% from the peak of 12% in May.

The median age of patients has fallen to around 37 years from 60 years. Asymptomatic cases account for more than 50% of positive results, which is in part due to a fourfold increase in tests. And healthcare facilities feel much better prepared.

“We have experience now,” said Dr María del Mar Vázquez, medical director of the Malaga hospital where Bautista’s father was being treated.

“We have a much larger stock of equipment, we have protocols in place, we are better prepared,” Vázquez said. “The hospitals will be full, but we are ready.”

Yet part of the hospital is still a construction site – contractors have yet to complete renovations to the hospital wing that cares for coronavirus patients. No one expected the second wave for at least another month.

And epidemiologists don’t know why it happened so early.

Explanations include an increase in large family gatherings; the return of tourism to cities like Malaga; the decision to return responsibility for tackling the virus to local authorities after the national lockdown is over, and the lack of adequate housing and health care for migrants.

The newlyweds in Malaga on Friday. —Samuel Aranda / The New York Times

This surge has also been blamed on the revival of nightlife, which was revived earlier and with more flexible restrictions than in many other parts of Europe.

“We have this cultural factor linked to our rich social life,” said Ildefonso Hernández, former director general of public health in the Spanish government. “People are close. They like to get to know each other. ”

For several weeks in places like Málaga, nightclubs and discos were allowed to open until 5 a.m. as regional politicians tried to revive an economy dependent on tourists and partygoers. Party-goers were only allowed to dance around a table with friends, rather than mingling with strangers – but the rules weren’t always followed.

In a notorious incident in early August, an artist was caught on camera spitting at dancers on a crowded dance floor at a beach club outside of Malaga.

The venue was quickly closed, all nightclubs were ordered to close two weeks later, and bars are now due to close at 1 a.m.

As beds continued to fill up in hospitals in Malaga over the weekend, residents still crammed into bars along some beach fronts until well after midnight. In some bars, the tables were squeezed together – much closer than current rules of two meters, or about six feet, allow.

Clean the streets of downtown Malaga. —Samuel Aranda / The New York Times

When it closed, the drinkers spread to the beaches and pontoons, most of the time without masks. There they gathered in groups of more than 20 people – a normal sight in any other Spanish summer, but much larger than the gatherings of 10 or less people now allowed by law.

Some were teenagers who said they had recently recovered from a mild form of the virus and therefore now considered themselves immune. Others felt the restrictions on the pandemic were an overreaction.

“I don’t think COVID is real,” Victor Bermúdez, a 23-year-old salesman, said during a morning meeting on a jetty jutting out into the Mediterranean. “Well, yeah, it’s real – but it’s not as bad as they say. Everything is a plan to kill the poor and stimulate the rich.

During the lockdown, the central government established a clear agenda from Madrid. But with the lifting of the state of emergency at the end of June, some powers were returned to each of Spain’s 17 regional governments, leading to a rambling and muddled approach.

When the regions attempted to apply restrictions on local life, some of their decisions were overturned by local judges, who argued that only the central parliament had the power to introduce such measures.

“We do not have the legal tools that guarantee us the capacity to take decisions,” said Juan Manuel Moreno, president of the regional government of Andalusia, the region of Malaga.

Checking temperatures outside a cinema. —Samuel Aranda / The New York Times

The debate has also become the last proxy for a bitter conflict over the Spanish Constitution that has been brewing for more than four decades. For Catalan federalists and separatists, for example, the debacle shows that power was never properly transferred after the 1975 death of dictator Francisco Franco. For Spanish nationalists, it rather shows how the process of decentralization has already gone too far.

“There is some kind of war going on to show what kind of political system is better,” said Nacho Calle, editor of Maldita, a leading fact-checking service. The decentralized approach has led to a fragmented system for tracking and tracing potential victims of the coronavirus. Some regions employ several thousand trackers to trace people who may have come into contact with infected people, while other regions have only hired a few dozen, slowing the rate at which potential patients are being asked to enter. in quarantine.

And even in areas with a large number of trackers, like Andalusia, health workers on the ground report that the process is still too slow and understaffed in some places.

Francisca Morente, a nurse at a clinic west of Málaga, was one of hundreds of local nurses seconded this summer to work as a tracker due to a lack of staff in her district’s official research unit.

But even now, Morente is one of only five trackers working at his clinic – not enough to make the hundreds of daily calls that a proper tracking service requires. And even once it does manage to track down potential coronavirus patients, those patients still have to wait a week until their tests are processed, due to bottlenecks at local labs.

“We need more trackers and more resources,” she says. “We need a designated follow-up unit in each clinic, instead of this temporary system we currently have.”

Local police tell people to put on their masks outside a bar. —Samuel Aranda / The New York Times

A lack of institutional support for undocumented migrants also contributed to the second wave, some experts say. Some recent outbreaks have broken out among foreign farm workers living in cramped collective housing.

Prevented from claiming unemployment benefits and formal employment contracts, undocumented migrants cannot easily miss work if they are ill. They also cannot afford the types of homes that would allow them to easily isolate themselves.

“If I have to quarantine, then I can’t work,” said María Perea, a 50-year-old Colombian housekeeper who is awaiting the results of a coronavirus test on Monday. “And if I can’t work, I don’t have any money.”

But in general, doctors say Spain is in a much stronger position to fight the virus than it was in March.

National coordination is improving – the central government last week agreed to an agreement to deploy 2,000 troops as contact tracers. Testing speeds are accelerating – in Málaga, the largest hospital can process tests in a single morning, thanks to the recent purchase of a series of robots. Across the road, a makeshift hospital hastily built in April is empty, ready for an increase in cases.

“It’s not like the first wave,” said Carmen Cerezo, 38, a train attendant who waited outside Malaga hospital while her father was tested for coronavirus inside.

“We’re calmer now,” she said.

A closed nightclub in Málaga. For several weeks after Spain lifted its lockdown, nightclubs and discos were allowed to stay open until 5 a.m. —Samuel Aranda / The New York Times



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