Europe Versus Coronavirus - Spain: a War without Bombs

The spread of the virus in Spain

In Spain, the virus has spread with striking speed. According to official data, Spain - with a population of almost 47 million - was first affected eight days after Italy and two days after Germany. Between March 5 and 13, the curve of contaminations shows a particularly steep upward slope, culminating in an explosion in the number of cases. By Friday, April 25, 219,000 people had tested positive for coronavirus - the highest figure in the European Union.

On a per-capita basis, Spain is second only to Belgium in European deaths related to Covid-19. Between March 12 and 17, the number of deaths increased tenfold - a trend that did not peak until April 2. On Friday, April 24, the Spanish Health Minister announced that the daily number of deaths linked to coronavirus fell to its lowest level in a month, with 367 deaths in the preceding 24 hours. By then, the epidemic had cost the lives of 22,500 people in Spain, compared to 26,000 in Italy and 22,200 in France. This particularly high death toll masks marked regional disparities: the regions most affected are Madrid, with 7,765 deaths, Catalonia, with 4,393 deaths, and Castilla-La Mancha, with 2,259 deaths.

As in France, the official figures for the epidemic should be taken with caution. According to a study published by Imperial College London, the low number of tests carried out in Spain means that the total cases are likely underestimated, and may in reality have reached up to 7 million by the end of March. While this discrepancy could be explained by the country’s low screening capacity, the ambiguity surrounding the number of contaminations likely extends to the number of deaths: as revealed by newspaper El Pais, many more deaths seem to be tied to the epidemic than are announced by the government each week.

This uncertainty surrounding figures is one of the key reasons for the Spanish population’s mistrust of the government’s crisis management, but it does not detract from the surprisingly swift spread of the epidemic.

A far-reaching response

Among the main criticisms of Spain’s handling of the crisis, those concerning the belated nature of the government’s response are the most virulent. Indeed, on Sunday, March 8, when the World Health Organization (WHO) declared that the threat of a pandemic had become "real" but "controllable", the Spanish government chose not to cancel the demonstrations organized for International Women’s Day. Hundreds of thousands of demonstrators gathered in the country’s main cities who, under the slogan "stop the patriarcavirus", contributed to accelerating the pace of contamination.

Whether or not this means that the response came too late is a matter of debate. The opposition points out that hundreds of cases had already been confirmed in the capital, and accuses the government of having minimized the health risk to encourage the population to support the fight for emancipation - a fight the Spanish left has waged for several decades. As with France’s decision to maintain the first round of municipal elections in March, the Spanish government’s refusal to cancel International Women’s Day events will remain highly controversial in public opinion.

In the days that followed, the autonomous communities most affected by the virus - the Madrid region, the Basque Country and Catalonia - chose to gradually close schools and cultural institutions, while the Health Minister called for social distancing measures and invited people in the main centers of the epidemic to work from home. Finally, on March 12, the government called for these measures to be applied to all the autonomous communities.

In Germany, federalism has emerged as a force in the face of the crisis, but the power devolved to Spanish regions may have hampered that country’s ability to respond effectively. As noted by Andres Ortega, a researcher at the Elcano Royal Institute, "the government was unable to take control of the regions’ medical resources or to impose public-order measures until the state of emergency was declared".

Following the declaration of the state of emergency, Spain ordered one of Europe’s strictest lockdowns. Travel is restricted to the absolute minimum, gatherings are banned and the majority of stores have been forced to close. Spaniards are allowed to leave their homes for a limited number of reasons, but as these relate only to essential purchases, to work for those unable to work from home and to pets that need to be taken out, children ended up housebound altogether. Children are, in fact, seen as risky drivers of contagion, and were forced to stay at home for a period that eventually exceeded one and a half months. The radical nature of this measure and the psychological effect it may have in the long run are the subject of considerable debate in Spain. It is no coincidence that the first easing of measures announced in mid-April relate in particular to children, who can now leave their homes for up to one hour a day.

The "best healthcare system in the world"?

Under the state of emergency, all civil and military, public and private health resources are to be made available to the Ministry of Health. Private companies in possession of medical and personal protection equipment were given 48 hours to notify national authorities of their stock. The army and its "Military Emergency Units" were immediately dispatched to disinfect places at risk, to contribute to the erection of field hospitals, or to evacuate corpses.

The mobilization of Spanish society in support of the national effort is symbolized by several emblematic actions. As of March 25, Real Madrid’s stadium has been transformed into a storage space for corporate donations to the healthcare system. The head of the Inditex Group (Zara) made nearly €62 million available for the purchase of medical equipment. As in other European countries, the textile and automobile industries are adapting their production lines to produce much-needed personal protection equipment and ventilators. To compensate for the lack of space in Madrid’s hospitals, the city’s Exhibition Center has been converted into a field hospital. In spite of this widespread mobilization, however, hospitals are utterly overwhelmed. Inresponse to the shortage of intensive care beds and ventilators, the Spanish Society of Intensive and Critical Care Medicine (SEMICYUC) published an ethical guide to help intensive care units choose which patients to treat. Medical staff in Spain are among the most affected in Europe: on April 10, a study revealed that healthcare personnel represent at least 15% of confirmed cases and that 19,000 doctors and nurses had tested positive since the beginning of the epidemic.

To make up for the dearth of equipment, the Spanish government set up an air-bridge with China at the end of March. The Spanish Ministry of Health concluded a €430 million contract with Chinese suppliers for the provision of 550 surgical, FFP1 and FFP2 masks, 5.5 million test kits and 950 artificial ventilators. Notwithstanding the central government’s good intentions, the autonomous communities that have been hit hardest accuse it of poorly distributing the equipment and criticize its inability to transfer patients to the least-affected regions. A scandal also erupted after some of the test kits and masks purchased in China proved to be defective.

In an opinion article published in the New York Times, journalist and writer David Jimenez argues that overconfidence in Spain’s healthcare system - considered to be among the best in the world - partly explains the country’s difficulty coping with the crisis. Spain does have the highest life expectancy at birth in Europe, one of the most egalitarian systems and a much higher number of doctors per inhabitant than the OECD average. But the level of its public health expenditure as a proportion of GDP (8.9%) is well below the European average (9.8%). Hospitals appear to be the biggest victims of this underinvestment: the number of hospital beds per 1,000 inhabitants is also below the EU average, and there were 9.7 intensive care beds per 100,000 inhabitants before the crisis, compared to 16.3 and 33.9 units in France and Germany respectively. In the view of David Jimenez and that of other commentators, the overload of Spain’s healthcare system is a direct result of the years of austerity that followed the last financial crisis.

An economic and social crisis response

Though a Spanish recession is inevitable, the kingdom intends to do its utmost to prevent the economy from falling into a situation comparable to that of 2008. The IMF projects that Spain, previously expected to see growth of 1.2% in 2020, is likely to experience an 8% decline in GDP this year before recovering to a 4.3% growth rate in 2021.

In light of the epidemic’s economic and social impacts, the government has adopted a series of emergency measures. It is mobilizing up to €200 billion in credits, with public guarantees of up to €100 billion and an increase in public spending of around €5 billion. Thanks to a "contingency fund", the Ministry of Health will receive an extra €1 billion in funding. For workers, conditions for access to social benefits have been broadened and provisional procedures help expedite the treatment of Temporary Employment Regulation (ERTE) applications, the Spanish form of partial unemployment. In addition, the government is authorized to control the acquisition of significant shares in companies in strategic sectors, and layoffs have been made impossible during the crisis.

As emphasized by José Manuel Albares Bueno, Spain’s ambassador to France, this economic rescue package is notable for its social dimension. As early as March 10, €25 million was allocated to the autonomous communities in order to guarantee access to food for children in vulnerable situations. A one-month moratorium has been placed on mortgage payments; a state program financed to the tune of €300 million supports the provision of home care services to dependent persons. Electricity, gas and water supplies cannot be cut off and the availability of telecom services is guaranteed. Spain is also speeding up the introduction of a universal basic income, which was first envisaged by the coalition when it was formed in January and is now presented as part of the response to the crisis.

When the Spanish President announced a further extension of the state of emergency on April 18, he insisted on the need for a European response to the crisis, in particular by calling for the creation of a €1.5 trillion EU recovery fund. In the meantime, however, the measures presented for a return to normalcy in Spanish daily life remain limited. While children under 14 can go out for up to an hour a day in the vicinity of their homes since Sunday, April 26, Spaniards will have to wait for early May to regain the right to go for walks or practice physical activity outside their homes.

The Minister for the Ecological Transition must now coordinate an exit strategy that is "gradual" - differentiated by sector - "asymmetrical" - differentiated by region - and "coordinated" - by the central government. In order to guide the lifting of the lockdown, Spain launched a vast study in early April. The Carlos III Health Institute, which conducts the study, is tasked with assessing the true scope of the epidemic in the peninsula based on a sample of 60,000 people. Nevertheless, the lack of medical equipment, especially masks and tests, remains a major challenge for Spain.

Conclusion

The government’s ability to demonstrate that the social model supported by the left in recent years has, through the creation of a universal public health service and a strengthening of public services, helped cushion the shock suffered by Spain is a factor in the PSOE’s place in the polls. The response to the crisis, particularly its social component and its rejection of austerity measures, also appears to be in line with the initial orientations laid out by the main ruling party.

On March 15, the government launched its #EsteVirusLosParamosUnidos campaign - a call for unity that, admittedly, found little echo in society. The oppositions between left and right, between the central state and the autonomous communities, and even between royalists and republicans have not become any less pronounced. Instead, the health crisis acts as a catalyst: the political tensions upon which the government is trying to impose itself are exposing Spain’s old divisions.

With contributions from Ségolène le Stradic and Margaux Tellier

Copyright : Josep LAGO / AFP