They work in governments of different political colors. Many of them are doctors by training and all have shared the anguish of receiving dizzying numbers of deaths without knowing how far they would go. That probably explains the tone in which they express themselves, so different from the permanent anger of the Congress of Deputies. This is the account of the pandemic of seven regional health councilors a year later.
Verónica Casado, head of Health in Castilla y León, recalls: “We saw things from China far away and the news we had is that it was a bit like a flu.” The director of the Center for Health Alerts and Emergencies of the Ministry, Fernando Simón, had declared at the end of January 2020: “Spain is not going to have, at most, beyond a diagnosed case.”
The incidence of the coronavirus has been measured for months in the number of infected per 100,000 inhabitants , but the counselors perfectly remember the first infected – “an Italian student”, “an Iranian professional” … – because it was the moment in which all their plans were blown up.
Was there overconfidence? At the end of January 2020, at the first inter-territorial council, the Health Councilors are informed of the situation in Wuhan. Subsequently, the head of the area in the Valencian Community, Ana Barceló, travels to Brussels to represent the autonomous communities in the meeting of the European Council of Ministers, in which the WHO also participates. “There we began to realize the dimension of the problem that was coming our way.”
Asked why no one sounded the alarm, why restrictive measures were not applied before, all affirm that “information was lacking.” “We did not know the basics. That the virus is transmitted mainly by air, that the mask is essential…, we were ignorant of all that ”, says Miguel Rodríguez, Minister of Health of the Cantabrian Government.
A precedent played against him and in favor of the virus. “It happened, I think, to all of us,” says Verónica Casado. “There was a previous threat with influenza A [in 2005] that looked like it was going to be terrible and finally nothing happened and that gave us a false security.”
The head of Health in Extremadura, José María Vergeles, agrees: “We were scalded by the supply of tamiflu [the medicine against influenza A], which we did not have to use later.”Spain acquired 15 million units. As of December 2009 it had barely used 6,000.
There were no protocols and those that were made changed “almost daily,” Casado recalls. At first, recalls the Galician councilor, Julio García Comesaña, PCR was only carried out on those who came or had been in contact with people from “very specific regions”, such as China.
Then the reagents for the tests began to be scarce. For this reason, Vergeles affirms, “today it is impossible to know the magnitude of the first wave: we did not do enough tests. “At that time”, affirms Jesús Fernández Sanz, councilor of Castilla-La Mancha, “we attended to the people who came to the doors of the hospitals. We treated the disease, we did not prevent it ”.
“The Americans kept our respirators”
What would they have done differently then with the information they have now? In the telematic conversation with EL PAÍS there is an eloquent pause. Everyone thinks of the lives that could have been saved. “If we had known, we would have had enough reserves of protective equipment and respirators,” explains the Minister of Castilla y León.
“It was very hard not being able to protect the health workers,” agrees the Valencian. “We were dependent on the Chinese and German markets, which later also interrupted supply. It was impotence .
The feeling of not being able to control absolutely anything, the anguish of seeing that the material did not arrive, that the toilets were getting infected, that you were removing equipment from toilets .There were professionals who died because they did not have that material, “he laments.
The Minister of La Rioja, Sara Alba, remembers a phone call from the then Minister of Health, Salvador Illa, “at the end of February or the beginning of March.” “He asked me how many respirators we had and how many we were able to get. It was the first ‘click’ of the pandemic ”.
“I regret many decisions,” he adds, “but I also applaud many others.” “It has been very hard. We had 17 beds in the ICU and we had to set up more than 100 ”.
The councilor of Castilla-La Mancha returns to March 2020. “If there had been masks, neither in the 8-M demonstration, nor in the Atleti match, nor in the Vox act there would have been so many contagions.
But as much as we ran, buying what we needed was an ordeal . We had 100 paid respirators that never came to us because the Americans kept them. We had to buy them in Turkey. They weren’t the best, but they got us out of trouble. ”
Everyone admits that at first, the restrictive measures sounded like science fiction, but in the last year the pandemic has on more than one occasion imitated the script of those films that will no longer be seen with the same eyes. “The tools they used in China seemed incredible to us,” says the Galician counselor.
“I remember the phrase: ‘That can be done in China, but not here’, shortly before the confinement. Barceló agrees: “Talking about restrictive measures was not in our vocabulary.”
The Extremaduran counselor recalls that one day, at nine in the morning, he gave a press conference saying that the face-to-face training was being maintained and in the afternoon it was suspended. “We got used to making very hasty decisions to mitigate the situation. We have had to learn so many things… ”, he adds.
“It is difficult for us to do pedagogy if others have everything open”
Today all the counselors consulted agree that together with the use of the mask, the most effective measure has been the closure of the interiors. “There is no doubt,” says the Cantabrian official. “And the American center for disease control has just published a study that relates the non-use of the mask, the opening of the hospitality industry indoors and the increase in mortality at 21 days.”
The relationship is good, but Madrid’s decisions have complicated their lives. “We don’t have any madrileñophobia. But we are concerned about what happens in Madrid ”, admits the councilor of Castilla-La Mancha, a neighboring community. “During the worst stage of the third wave, they threw us in our faces that Madrid, with all the bars open and without perimeter, was better than us.
It was true and the message came in like a cannon. We spent more than a month with everything closed enduring that criticism, but in the end we have seen how some communities have lowered the curve and Madrid remains in worse numbers than anyone else. Does it have to do with measurements? I think so”.
“Respecting the decisions made by Madrid,” says the Valencian minister, “they have affected us.” “It is difficult to do pedagogy with some economic sectors when with worse epidemiological data, other communities do not proceed to close certain activities .”
The councilor of Castilla y León, governed in coalition by the PP and Cs, recalls that she has asked “many times” for a unity of criteria because when there are none “much more pandemic fatigue is generatedand much more disaffection ”. In any case, they celebrate the frequency of inter-territorial councils.
“Never in the history of this country has there been so much debate, deliberation and meeting,” summarizes Casado, who claims, yes, a reform of the public health law. “With more legal tools, some of these conflicts would also have been avoided,” he says.
“We must raise it for some cases”
García Comesaña clarifies that Galicia has not proposed that the vaccine is mandatory. “Yes it is true”, he admits, “that there are health personnel who decide not to be vaccinated and we could demand that it be a requirement to be vaccinated, for example, to work in a residence”. For the Cantabrian councilor, “there is no need to be afraid to propose compulsory vaccination”.
“In Spain it has never been done because vaccination rates in general are very high, but in other neighboring countries it is and nothing happens,” he adds. Barceló points out: “It is controversial, but I think that at some point we will have to study whether it may be a requirement with personnel working in residences or with large dependents.”
A health worker administers an AstraZeneca vaccine in Seville in February. On video, seven Health Councilors comment on the debate on compulsory vaccination. PACO PUENTES / EPV
Galicia has 200 people vaccinating in primary care and another 50 in the hospital setting.
Extremadura began to administer the doses with 180 nursing professionals. In the Valencian Community they also have retired personnel under the age of 70 and from the field of private health.
In Castilla-La Mancha there are 600 people just to vaccinate and they hope that the 1,000 hired to track contacts can dedicate themselves to providing injections when infections fall. All the counselors point out that there will be no shortage of hands when the promised doses arrive.
Asked if they have been angered by the cases of colleagues, politicians, bishops or public representatives who have skipped the vaccination schedule , they emphasize that they have been a “minority”, but several councilors are “outraged”. “Especially for those representatives or important figures,” says the Valencian, alluding to the infantas.
“Those cases”, regrets the Extremaduran councilor, “have caused the vaccinations of center managers to be looked at badly, which were more than justified. And all this coincided with the time when a primary care director of ours was infected by reinforcing a vaccination team and died. The pain and the pain for that fact have covered the rage ”.