As some Spaniards return to work today, experts debate whether it is still too soon

Spain’s non-essential workers, from sectors such as construction and industry, will today return to their workplaces after a two-week “hibernation” of the economy. For companies located in regions that observe Easter Monday, the return will be pushed to Tuesday. On March 30, the Spanish government introduced even stricter measures to the confinement put in place on March 14 in a bid to slow the spread of the coronavirus, and ordered the cessation of all non-essential activity in a bid to slow the movement of citizens down to a crawl. Offices, carpenters and factories, among others, all downed tools.

Today, Monday, however, many are returning to work, despite the reticence of some health experts and the opposition of some politicians. Catalonia is radically opposed to the idea and Madrid has doubts about the risk of a spike in infections. The debate among the scientific community, meanwhile, is seeking to balance this risk with the impact that, in public-health terms, it would have to maintain economic activity at a minimum.

The majority of the population of Spain remain in their homes – schools, bars, restaurants, cultural venues and leisure centers all remain closed

The Spanish prime minister, Pedro Sánchez, insisted on Sunday during a televised press conference that Spain is not yet at the deescalation phase. The confinement will continue, but will return to the original conditions when the state of alarm was implemented on March 14. That means that the majority of the population of Spain remain in their homes – schools, bars, restaurants, cultural venues and leisure centers all remain closed – but the economic activity that was halted with the hibernation decree will restart.

The coalition government, led by the Socialist Party (PSOE) with junior partner Unidas Podemos, is reactivating these sectors while strengthening protection measures, including the distribution of 10 million masks on points such as public transport and the publication of a guide to safely return to work.

But the debate about ending the hibernation period remains on the table. The Catalan regional government, for example, considers the move “imprudent” and “reckless.” The Madrid regional premier, Isabel Díaz Ayuso, voiced doubts about the strategy on Sunday during a conference call between the prime minister and regional governments, demanding to know the “how, where and when” of the planned distribution of masks. “Another wave [of infections] would be unforgivable,” she said.

The experts admit that the move comes in the midst of “uncertainty.” “No one knows if prolonging this five days more will have a huge benefit or if the economic impact will be more important,” explains Toni Trilla, an epidemiologist and member of the scientific committee that is advising the government. “No decision can be fixed or radical.”

The major reduction in movement already came when the state of alarm was introduced, when the government limited journeys and ordered residents of Spain to be confined to their homes. “From the moment it was announced that people had to stay home, urban mobility was reduced by 70%,” Trilla explains. “With the total confinement, it fell by another 10%. So we are not going from white to black. There could be 10% increased movement now and more infections, but the other 70% has to maintain the same conditions from before and not leave their homes,” Trilla says. Epidemiologist Joan Ramon Villalbí agrees: “Going from extreme confinement to a less extreme confinement involves a risk, but it’s a modest one,” he says.

We are going to deescalate the confinement without knowing how many people are affected nor how many people there are without symptoms

María José Campillo, Spanish Confederation of Medical Unions

Other experts, however, have their doubts. Margarita del Val, a virologist from the CSIC public research institute, calls the restarting of industrial activity “premature.” Health unions are also not keen on the idea. “We are still in the dark,” complains María José Campillo, the treasurer from the Spanish Confederation of Medical Unions (CESM), in reference to a lack of widespread testing among the population. “We are going to deescalate the confinement without knowing how many people are affected nor how many people there are without symptoms.”

Doctor Benito Almirante, the head of infectious diseases at the Vall d’Hebron Hospital in Barcelona, believes that the debate is more political than scientific, and points to the fact that the population is now more aware of the protection measures needed to curb the spread of the coronavirus. He also explains that the “communicable viral load is lower” compared to two weeks ago. That is, there are fewer people who can spread the virus.

What is needed, in his view, is to find out where the more than 4,000 daily infections still being registered in Spain are coming from. “Where are they?” he asks. “If they are in senior residencies, the control measures need to be different from confinement. If they are inter-familial infections, confinement is actually having a negative effect. If they are happening between essential workers, there is probably no way to avoid it.”

Whatever the case, the return to work either today or for everyone will not be the same as it was two weeks ago. The public is now conscious of the dangers, and citizens are aware of the hygiene measures needed. “There will be a return to economic activity, but lower than before and in more prudent and restrictive conditions in order to reduce contagion,” Trilla states. The government will be distributing the aforementioned masks and in the guide that it has published it recommends home working where possible, social distancing, and the disinfecting of objects that have been used outside the home, such as glasses and cellphones. It also calls for the use of masks among staff who work closer than two meters to one another, and that companies allow flexible timetables to avoid overcrowding at rush hour on public transport.

There are people who are living from day to day and after so much time with no activity, will not have money to buy food

Epidemiologist Joan Ramon Villalbí

However, the spokesperson from the CESM has doubts about whether safe distances can be maintained on buses, trains and the Metro. Jesús Cubero, the president of the Spanish association of senior residences, Aeste, is concerned that people will let their guards down “with the false sensation of safety from the use of a mask.”

But for the experts, the economic impact on health of continuing to halt activity is also of great importance. “The extreme confinement has serious consequences,” says Villalbí. “There are people who are living from day to day and after so much time with no activity, will not have money to buy food. This is also going to have consequences on health in the medium term and the psychological suffering will have an impact. This effect cannot be understated.”

Health experts also warn of the need for a return to normality in hospitals. “We are reaching a situation where there is a higher death and morbidity rate for things that aren’t coronavirus than for Covid-19,” Almirante explains. “At some point the country has to start working again. Society is in a situation where the economic problems will be more difficult to solve than the medical ones caused by the coronavirus. I’m worried, for example, about the health of children and adolescents, who haven’t left their homes in a month.”

Maintaining the hibernation will not defeat the coronavirus, the experts insist. “Even if it was for longer, the population remains susceptible to the virus,” says Javier Arranz, from the infectious diseases group at the Spanish Society of Family Medicine. “When [the economy] is opened, there will be more infections. We have made an effort to stop the wave, but life goes on. We have chronic patients in their homes that we have to see, hospitals that have stopped operating. And we need to get all of this moving.”

When the future is uncertain, there is always a risk, Trilla admits. But it can be a controllable and revisable risk. “There are no magic formulas,” he concludes.

English version by Simon Hunter.