A HOLLYWOOD legend joining folk-dancers from Asturias and showing off her fancy footwork in the street is not a scene your average Oviedo resident witnesses during his or her weekly shop. Even though their northern...
Spain and Covid: 'The Lancet' analyses nation's approach
05/11/2021
EUROPE and, particularly Spain, have spent most of 2021 speaking about 'herd immunity' as the final breakthrough in the Covid-19 battle, which they set at 70% of the population's being vaccinated – yet outbreaks continue across the continent, and contagion and mortality rates in the UK appear to be on the rise.
Prestigious science journal The Lancet analysed whether European countries have achieved the much-desired 'herd immunity', and Spain was highlighted as an example of its success in keeping Covid rates low.
Incidence of the virus in Spain is currently 49 per 100,000 people, or 0.049% of the population, and The Lancet partly attributes this to high levels of vaccination – at present, 88.7% of residents have had both doses.
Spain's short, sharp total lockdown was key
Author of the piece, Tony Kirby, says the next few weeks and months will be 'crucial' in ascertaining whether strategies followed by the different European countries have turned out to be the right ones for controlling SARS-CoV-2.
He firstly highlighted the 'harsh lockdown' enforced in Spain between mid-March and mid-May 2020, thought to be the most restrictive in Europe and on a par with the confinement decreed in the Chinese city of Wuhan where the first Coronavirus cases of this type were detected.
Leaving the house could only be for 'essential errands', such as care duties, animal care, shopping for necessary goods, attending important appointments linked to legal and financial affairs, medical appointments or collecting prescriptions, but only one person was allowed out at a time, meaning couples could not go to the supermarket, and as children had no legitimate reason for being out of the house, were literally living between four walls for nearly three months unless they had to accompany a parent because there was no other adult at home to look after them.
Babysitters were, obviously, not allowed, or even cleaners, except for where a person was elderly or disabled and physically unable to do essential housework, and building work was limited to what was absolutely vital, such as emergency plumbing, fixing leaky roofs, and ensuring hot water, heating and electricity was working properly.
Dog-walking was limited to a 200-metre radius, after completing an 'essential errand' everyone was required to go straight back home - police would even check the date and time on supermarket receipts - going out for walks or even standing in one's front door was illegal, and for those living in apartment blocks or on urbanisations, communal areas were entirely off-limits unless they had to be crossed to reach the outside world.
Nobody was allowed to leave their town for supermarket shopping if they had a store in their own municipality and, in theory, could even be given a strong warning for using one that was not the nearest to their house.
Tony Kirby said these apparently draconian emergency measures immediately meant Spain coped better and reduced infection rates more than much of the rest of Europe, and from then on, the situation had 'largely gone better' for Spain than for its neighbouring countries.
His article points out that the majority of Spanish regions were even able to keep parts of their hospitality industry open, at least in the daytime and even during the massive outbreak of Covid cases over the 2020-2021 winter season.
He compares this with other large, heavily-populated European countries which returned to 'harsh lockdowns', such as the UK, Italy, France and Germany, at a time when the Spanish population was able to retain 'partial normality' without having to resort to a blanket shutdown.
Spain also managed to keep the majority of its leisure facilities open, including gyms, he recalls.
High vaccine rate makes the difference
In the piece in The Lancet, Spain's vaccination levels are cited as 'over 80% of the population', although in practice, the total is 78.7% of the national headcount; but it rises to 88.7% for the 'target population', or everyone aged 12 and over.
When taking into account those who have only had their first dose of the jab, the figure rises to 90.4%.
Anyone who has not had the jab and is aged at least 12 is now only without it because either they chose not to or were unable to attend their 'personal summons', and health centres nationwide are now booking residents in for appointments for jabs on demand where those who have not had one at all decide to go ahead.
Spain is mostly now using the Pfizer and Moderna formulae, which have not produced any known lasting, life-limiting or life-threatening side effects; those that do appear are bearable, and generally fade after a week or so at most.
A high number of vaccine refusals came when the under-60s were being jabbed with the AstraZeneca formula and a handful of recipients, estimated by the medical community to be in region of five or 10 per million, suffered blood clots which proved fatal.
Many of those who refused the jab at the time have since taken it up when they were offered a Pfizer or Moderna instead, and Spain ceased administering the AstraZeneca to those under 55.
The Lancet quoted head of infectious diseases at Sevilla's Virgen de la Macarena Hospital, Dr Jesús Rodríguez Baño, who said: “We still don't know the exact proportion of the population which we need to vaccinate to achieve herd immunity, since we need to have a better understanding of the length of time and level of protection afforded by the inoculation and by having caught and recovered from Covid-19.”
The dramatic fall in cases, hospital admissions and mortality since the restrictions were lifted has painted a very different panorama from the previous 'waves' of SARS-CoV-2, says Dr Rodríguez Baño, who stresses that the 'only plausible explanation for this' is Spain's high percentage of vaccinated residents.
Tweeting the article from The Lancet, Basque Country University professor Gorka Orive said that 'even though it's difficult to risk confirming it', the article in 'this prestigious science magazine' reflects on how the 'high levels of vaccination in Spain are allowing the population to live with the virus at present'.
Comparisons with other countries
The Lancet refers to the UK, where contagion rates have 'started to fall very slightly' after spiralling to 50,000 a day, and where 68% of the population are double-jabbed.
Tony Kirby recalls that Britain has ruled out a return to restrictions, since prime minister Boris Johnson is in possession of information that 'suggests cases are going to reduce very shortly without additional intervention'.
“Although it is not clear how,” The Lancet adds.
In the UK, masks no longer need to be worn in indoor areas or on public transport, and even before the requirement was lifted, anyone could claim to be 'medically exempt' from wearing one.
Proof was not needed if they were questioned, since medical information is considered personal data which nobody is obliged to share, even with law enforcement agents.
Spain, by contrast, only lifted the requirement to wear masks outdoors in summer, and even then, only where a minimum distance of two metres could be guaranteed between people, meaning everyone still, in practice, needed to carry one with them.
The requirement to wear masks in all indoor areas, including shops, public transport, and bars and restaurants except when in the act of eating or drinking, remains in place and is not expected to go away any time soon.
Fines start at €100 for failure to comply with the rule, which applies to everyone aged six and over, although the most likely scenario is that a person refusing to wear a mask will be denied entry to a premises or public transport or instructed to leave.
Very few scenarios are likely to attract 'medical exemption' from wearing a mask, but where this is the case, the non-wearer must have a doctor's note and show it upon request.
Mask rules vary across Europe, with different countries being more lenient than others, although anecdotal evidence has shown many continue to wear them 'just in case', especially as 'flu season is just around the corner, the weather pushes people indoors, and common colds may be preventable by wearing a surgical mask.
Denmark and Norway were also mentioned in The Lancet.
The first of these has vaccinated 76% of its headcount, and Norway has 69% of its population inoculated.
But both have taken the same line of strategy, Tony Kirby reveals: They have opted not to apply restrictions to life, work and leisure, and instead to 'live with' Covid-19 as an 'endemic winter virus'.
In Spain in particular, contagion rates have, to date, appeared to spike in the colder season and reduce in late spring, summer and early autumn.
At present, Spanish health authorities are administering a third dose of the Covid-19 vaccine to residents aged 70 and over at the same time as their 'flu jab, and has already given a third injection to elderly people in care homes and to the immune-compromised.
It does not seem that the general population will be given a third jab just yet, although this – along with the possibility of immunising children aged 11 and under – is still under review.
Related Topics
EUROPE and, particularly Spain, have spent most of 2021 speaking about 'herd immunity' as the final breakthrough in the Covid-19 battle, which they set at 70% of the population's being vaccinated – yet outbreaks continue across the continent, and contagion and mortality rates in the UK appear to be on the rise.
Prestigious science journal The Lancet analysed whether European countries have achieved the much-desired 'herd immunity', and Spain was highlighted as an example of its success in keeping Covid rates low.
Incidence of the virus in Spain is currently 49 per 100,000 people, or 0.049% of the population, and The Lancet partly attributes this to high levels of vaccination – at present, 88.7% of residents have had both doses.
Spain's short, sharp total lockdown was key
Author of the piece, Tony Kirby, says the next few weeks and months will be 'crucial' in ascertaining whether strategies followed by the different European countries have turned out to be the right ones for controlling SARS-CoV-2.
He firstly highlighted the 'harsh lockdown' enforced in Spain between mid-March and mid-May 2020, thought to be the most restrictive in Europe and on a par with the confinement decreed in the Chinese city of Wuhan where the first Coronavirus cases of this type were detected.
Leaving the house could only be for 'essential errands', such as care duties, animal care, shopping for necessary goods, attending important appointments linked to legal and financial affairs, medical appointments or collecting prescriptions, but only one person was allowed out at a time, meaning couples could not go to the supermarket, and as children had no legitimate reason for being out of the house, were literally living between four walls for nearly three months unless they had to accompany a parent because there was no other adult at home to look after them.
Babysitters were, obviously, not allowed, or even cleaners, except for where a person was elderly or disabled and physically unable to do essential housework, and building work was limited to what was absolutely vital, such as emergency plumbing, fixing leaky roofs, and ensuring hot water, heating and electricity was working properly.
Dog-walking was limited to a 200-metre radius, after completing an 'essential errand' everyone was required to go straight back home - police would even check the date and time on supermarket receipts - going out for walks or even standing in one's front door was illegal, and for those living in apartment blocks or on urbanisations, communal areas were entirely off-limits unless they had to be crossed to reach the outside world.
Nobody was allowed to leave their town for supermarket shopping if they had a store in their own municipality and, in theory, could even be given a strong warning for using one that was not the nearest to their house.
Tony Kirby said these apparently draconian emergency measures immediately meant Spain coped better and reduced infection rates more than much of the rest of Europe, and from then on, the situation had 'largely gone better' for Spain than for its neighbouring countries.
His article points out that the majority of Spanish regions were even able to keep parts of their hospitality industry open, at least in the daytime and even during the massive outbreak of Covid cases over the 2020-2021 winter season.
He compares this with other large, heavily-populated European countries which returned to 'harsh lockdowns', such as the UK, Italy, France and Germany, at a time when the Spanish population was able to retain 'partial normality' without having to resort to a blanket shutdown.
Spain also managed to keep the majority of its leisure facilities open, including gyms, he recalls.
High vaccine rate makes the difference
In the piece in The Lancet, Spain's vaccination levels are cited as 'over 80% of the population', although in practice, the total is 78.7% of the national headcount; but it rises to 88.7% for the 'target population', or everyone aged 12 and over.
When taking into account those who have only had their first dose of the jab, the figure rises to 90.4%.
Anyone who has not had the jab and is aged at least 12 is now only without it because either they chose not to or were unable to attend their 'personal summons', and health centres nationwide are now booking residents in for appointments for jabs on demand where those who have not had one at all decide to go ahead.
Spain is mostly now using the Pfizer and Moderna formulae, which have not produced any known lasting, life-limiting or life-threatening side effects; those that do appear are bearable, and generally fade after a week or so at most.
A high number of vaccine refusals came when the under-60s were being jabbed with the AstraZeneca formula and a handful of recipients, estimated by the medical community to be in region of five or 10 per million, suffered blood clots which proved fatal.
Many of those who refused the jab at the time have since taken it up when they were offered a Pfizer or Moderna instead, and Spain ceased administering the AstraZeneca to those under 55.
The Lancet quoted head of infectious diseases at Sevilla's Virgen de la Macarena Hospital, Dr Jesús Rodríguez Baño, who said: “We still don't know the exact proportion of the population which we need to vaccinate to achieve herd immunity, since we need to have a better understanding of the length of time and level of protection afforded by the inoculation and by having caught and recovered from Covid-19.”
The dramatic fall in cases, hospital admissions and mortality since the restrictions were lifted has painted a very different panorama from the previous 'waves' of SARS-CoV-2, says Dr Rodríguez Baño, who stresses that the 'only plausible explanation for this' is Spain's high percentage of vaccinated residents.
Tweeting the article from The Lancet, Basque Country University professor Gorka Orive said that 'even though it's difficult to risk confirming it', the article in 'this prestigious science magazine' reflects on how the 'high levels of vaccination in Spain are allowing the population to live with the virus at present'.
Comparisons with other countries
The Lancet refers to the UK, where contagion rates have 'started to fall very slightly' after spiralling to 50,000 a day, and where 68% of the population are double-jabbed.
Tony Kirby recalls that Britain has ruled out a return to restrictions, since prime minister Boris Johnson is in possession of information that 'suggests cases are going to reduce very shortly without additional intervention'.
“Although it is not clear how,” The Lancet adds.
In the UK, masks no longer need to be worn in indoor areas or on public transport, and even before the requirement was lifted, anyone could claim to be 'medically exempt' from wearing one.
Proof was not needed if they were questioned, since medical information is considered personal data which nobody is obliged to share, even with law enforcement agents.
Spain, by contrast, only lifted the requirement to wear masks outdoors in summer, and even then, only where a minimum distance of two metres could be guaranteed between people, meaning everyone still, in practice, needed to carry one with them.
The requirement to wear masks in all indoor areas, including shops, public transport, and bars and restaurants except when in the act of eating or drinking, remains in place and is not expected to go away any time soon.
Fines start at €100 for failure to comply with the rule, which applies to everyone aged six and over, although the most likely scenario is that a person refusing to wear a mask will be denied entry to a premises or public transport or instructed to leave.
Very few scenarios are likely to attract 'medical exemption' from wearing a mask, but where this is the case, the non-wearer must have a doctor's note and show it upon request.
Mask rules vary across Europe, with different countries being more lenient than others, although anecdotal evidence has shown many continue to wear them 'just in case', especially as 'flu season is just around the corner, the weather pushes people indoors, and common colds may be preventable by wearing a surgical mask.
Denmark and Norway were also mentioned in The Lancet.
The first of these has vaccinated 76% of its headcount, and Norway has 69% of its population inoculated.
But both have taken the same line of strategy, Tony Kirby reveals: They have opted not to apply restrictions to life, work and leisure, and instead to 'live with' Covid-19 as an 'endemic winter virus'.
In Spain in particular, contagion rates have, to date, appeared to spike in the colder season and reduce in late spring, summer and early autumn.
At present, Spanish health authorities are administering a third dose of the Covid-19 vaccine to residents aged 70 and over at the same time as their 'flu jab, and has already given a third injection to elderly people in care homes and to the immune-compromised.
It does not seem that the general population will be given a third jab just yet, although this – along with the possibility of immunising children aged 11 and under – is still under review.
Related Topics
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