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Europe Versus Coronavirus - Spain: a War without Bombs

BLOG - 4 May 2020
Key Points
1

Alongside Italy, Spain is the country worst affected by the epidemic in Europe. The wave of contaminations that swept across the country in early March rapidly overwhelmed the healthcare systems of certain regions, a situation that has accelerated the rate of deaths related to Covid-19. The lack of medical and personal protection equipment, especially for care workers, has challenged the image of a country with one of "the best healthcare systems in the world".

2

The government’s response, considered by some to have come too late, is also marked by particularly restrictive containment measures. Citizens have been confined to their homes since "el Estado de alarma" (the state of emergency) was declared on March 14, and the permits for exceptional outings did not extend to children for well over a month. On March 31, Spain suspended all non-essential economic activities for a period of ten days.

3

The economic consequences of the crisis are expected to be particularly severe in Spain. The International Monetary Fund (IMF) projects that the country’s GDP will shrink by 8% in 2020, while the unemployment rate could reach close to 20% (compared to 13.8% before the crisis). Expectations of a major reconstruction plan driven by the European Union now occupy a central place in the Spanish public debate.

4

The Spanish government’s response to the covid-19 crisis is characterized by its social dimension. The government of Pedro Sánchez, a coalition between the left and the radical left, has put in place a range of measures especially designed to protect the most vulnerable: a ban on layoffs, the possibility to defer rent payments and the accelerated implementation of a universal basic income as part of the response to the crisis.

Timeline

  • January 31: First confirmed Covid-19 case on Spanish territory, in the Canary Islands.
  • February 4: Creation of an inter-ministerial committee for the fight against the coronavirus.
  • February 19: The Champions League game between Valencia and Bergamo takes place in Milan. This event is later considered to have been one of the principal vehicles of contagion.
  • February 25: As official testing starts in the peninsula, the first cases are confirmed in Madrid, Barcelona and Castellón.
  • March 3: 200 cases are recorded in the peninsula. A change in methodology and a resort to post-mortem testing reveal that the first Covid-19-related death occurred in Spain on February 13.
  • March 7-8: Over the course of this weekend, several mass gatherings contribute to the further spread of the virus (International Women’s Day, the Vox party congress and Spanish football league games). The number of confirmed cases increases from 500 on March 7 to 5,200 on March 13.
  • March 10: First statement on the crisis by the President, in which he praises the quality of the Spanish healthcare system. The Madrid region announces the closure of daycares, schools, universities and cultural institutions, and is swiftly followed by the Basque Country and Catalonia. The government invites regions particularly affected by the epidemic to introduce social distancing measures and suspends flights from Italy.
  • March 12: The Presidentcalls on all regional governments to close schools and announces his decision to regulate the price of medications. Regional governments are granted an advance of €2.8 billion for help with their public health expenses. A further €1 billion is released from a contingency fund for priority health needs.
  • March 14: While opposition parties denounce the absence of a government response to the saturation of hospitals, the government invokes article 116 of the Constitution to declare a state of emergency (Estado de alarma), which allows it to centralize decision-making related to public health and the police. Travel is restricted to an absolute minimum, mass gatherings are banned and most stores are ordered to close.
  • March 15: Launch of the government’s #EsteVirusLosParamosUnidos campaign ("United we will stop the virus").
  • March 17: Pedro Sánchez announces a €200 billion relief package (20% of Spain’s GDP) to combat the economic consequences of the crisis and, on the same day, announces the closing of the country’s land borders.
  • March 21: Creation of a scientific and technical committee for the fight against Covid-19.
  • March 22: All air and sea borders of countries in the European Union and the Schengen Area are closed for public health reasons.
  • March 28: The government announces a halt to all non-essential economic activities.
  • March 29: An air-bridge is set up between Spain and China to deliver medical and personal protection equipment. The delivery is quickly followed by scandal when half a million of the test kits purchased by the Spanish government prove to be defective.
  • March 30: An Imperial College study reveals that the number of contaminations in Spain could be six times higher than official figures indicate.
  • April 1: Turkey becomes the first country to respond to the request for help addressed by Spain to NATO through the Euro-Atlantic Disaster Response Coordination Center.
  • April 6: The government announces its intention to introduce a universal basic income.
  • April 14: The IMF forecasts an 8% decline of Spain’s GDP.
  • April 18: The death toll surpasses 20,000. The government extends the state of emergency to May 10 and announces the first easing of measures. As a prerequisite to the plan for an end of the lockdown, a study is launched to evaluate the spread of the virus in the peninsula per age group and region.
  • April 26: For the first time since March 14, children are allowed to leave their homes.

Analysis

On March 22, Spanish President Pedro Sánchez declared that "we are entering the most difficult days, which will test our moral and material capacity for resistance". Spain has 2,000 Covid-19-related deaths at this time - a figure that is multiplied by ten a month later. Though the first cases appeared later than in Italy, Spain has the highest number of contaminations of any European nation and is among the countries that has suffered the highest losses during the Covid-19 crisis. And while the saturation of hospitals in the most-affected regions is enough to speak of a bona fide public health tragedy, the economic impact of the crisis promises to be particularly severe. As indicated by Pedro Sánchez in a press conference on April 18, "when we will once again be able to go out into the streets after the lockdown is lifted, we will have to face a world ravaged by a war without bombs".

Spain’s management of the crisis is built on political division. The crisis response of socialist Pedro Sánchez, who managed to reach a minority government coalition deal with the radical-left Podemos party in January of this year, has been profoundly called into question. The presidents of Spain’s autonomous communities blame the federal government for not consulting the regions enough, while the right-wing opposition, led by Pablo Casado, president of the People’s Party, denounces the government’s "arrogance" and "incompetence" and has so far opposed the establishment of a national unity pact. As Pedro Sánchez’ popularity continues to dwindle in public opinion polls, the press alludes to a "Spanish exception": while public support for the ruling powers usually grows in times of crisis, Pedro Sánchez is the only European leader whose popularity has weakened as a direct result of the epidemic.

Spain believed that its geographical position, paired with its healthcare system which is considered to be one of the best in the world, would allow it to contain the epidemic.

Not a single European country was prepared for this crisis, but Spain perhaps even less so. Until early March, Spain believed that its geographical position, paired with its healthcare system which is considered to be one of the best in the world, would allow it to contain the epidemic. Yet in a matter of mere days, Spain became the country with the highest number of contaminations in Europe. In the face of this rapid spread, the Spanish strategy to combat Covid-19 has been more akin to a far-reaching and generalized response than to a targeted containment strategy.

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.

Several factors may account for its progression. Experts consider that the return of FC-Valencia supporters who attended a match against the team in Bergamo, the epicenter of the epidemic in Italy, on February 17, contributed to the spread of the virus in Spain. His Excellency José Manuel Albares Bueno, Spain’s new ambassador to France, points out that the Spanish way of life, characterized by a mixing of generations and special care for the elderly, hastened the spread of the virus among the country’s older citizens. Furthermore, as the virus reached Spain earlier than many other countries, it did not benefit from the same learning process that enabled countries such as Germany and Austria to take action at the first signs of contagion.

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".

Private companies in possession of medical and personal protection equipment were given 48 hours to notify national authorities of their stock.

On March 14, as the saturation of Madrid’s hospitals became a reality and the lack of a federal response was denounced by the opposition, the government invoked article 116 of the Constitution to declare the state of emergency, which allowed it to centralize all decisions related to public health and the police. "The government of Spain now has decision-making power over the whole territory", said President Pedro Sánchez.

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. In response 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.

This especially bleak scenario is, in part, a consequence of the decision made on March 30 to wholly suspend all economic activities considered non-essential for a period of ten days, thus plunging the country into a form of "hibernation". This measure was demanded by the leader of the radical-left party, Deputy Prime Minister Pablo Iglesias, but imposed against the advice of business representatives - notably that of the Spanish Confederation of Business Organizations (CEOE) - who emphasized the measure’s economic cost. The uncertainty facing the tourism sector is another factor in the country’s grim economic outlook: tourism accounts for almost 11% of Spain’s GDP and 12% of total employment, and its recovery is likely jeopardized for the foreseeable future.

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.


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 health crisis acts as a catalyst: the political tensions upon which the government is trying to impose itself are exposing Spain’s old divisions.

Heavily criticized for its management of the crisis, President Pedro Sánchez faces the rise of the young leader of the Spanish People’s Party, Pablo Casado, who emerges as the incarnation of a conservative opposition that appears to be the main beneficiary of the epidemic. However, as demonstrated by the latest polls, the criticisms leveled at the President do not cast doubt on the political dominance of the Socialist Party. The crisis thus appears to reinforce Spain’s two-party system, bolstering both the Spanish Socialist Workers’ Party (PSOE, +3.7 points compared to the last elections) and the People’s Party (+4.6 points), while the extreme left- and right-wing parties are seeing their popularity decline, with Podemos and Vox losing 1.2 and 3.4 points respectively.

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

 

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