The Madrid regional government on Friday ordered 213 private and public senior centers to be closed in a bid to avoid further contagion of the novel coronavirus. The measure was taken after the deaths of two elderly people in centers in the region, one in a home and another in a center for seniors. The government has justified the move on the basis that this section of the population is particularly vulnerable to the Covid-19 disease.
On Friday, Madrid regional authorities reported a death and 15 new coronavirus cases at a senior daycare center in Valdemoro, in the south of the Madrid region. Four of the patients have been admitted into intensive care. This was the second senior care center in the region to register a death after a 99-year-old woman died on Tuesday at La Paz residence in Madrid. Ten other residents and a nurse at the center have tested positive for the virus.
The closure will take effect from Saturday onward and will last for a month. It will be extended depending on the progress of the epidemic. The order will not affect day centers, which differ from senior centers in that they assist dependant persons. Nor will the move affect the more than 400 care homes in the region. These centers have upped precautions against Covid-19 by taking measures such as installing disinfectant hand gel by entrances and bathrooms.
An 87-year-old man died on Friday from the new coronavirus at a hospital in Zaragoza, bringing the number of deaths in Spain from the epidemic to five. Since the beginning of the outbreak, SARS-CoV-2 has caused 345 infections in Spain by the latest official count, which was released around midday on Friday by the central Health Ministry.
Health Minister Salvador Illa traveled to Brussels on Friday to meet with European counterparts and discuss how the coronavirus crisis should be handled. “We don’t know when [the peak] will occur, we’re still in an upward phase,” he said about the spread of Covid-19 in Spain. “It will depend on many things, and therefore I cannot anticipate it. I can say that we are following this daily, with one meeting in the morning and another one in the afternoon, and we adopt measures depending on the situation.”
Elderly at risk
The five people who have died in Spain were between 69 and 99 years of age, underscoring how the coronavirus is particularly affecting the elderly. Studies in China show that the mortality rate from Covid-19 is zero for children up to nine years of age, lower than 0.4% up to the age of 40, and climbs to as much as 15% for those 80 and upwards.
Regarding the mortality rate that could be expected in Spain, experts feel that it will not be as high as other countries. “It will come close to 1% of all diagnosed cases,” said Benito Almirante, head of infectious diseases at Vall d’Hebron Hospital in Barcelona. “We are working with the hypothesis that the disease will keep up its current intensity for five to seven months more, then probably ease up for a while until the virus returns in the winter.”
Undetected for weeks
Health experts note that the virus must have arrived in Spain weeks ago, although it remained undetected until recently as the protocol for testing was initially restricted to people with symptoms who had traveled to China, where the outbreak began. The criteria were changed in late February, leading to a steady trickle of reported cases.
“What we are seeing now are the most serious cases of the infections that took place several weeks ago,” says Antoni Trilla, head of preventive medicine and epidemiology at Clínic Hospital in Barcelona. “How many [infections] were there? For now we don’t know. And when did they start? We don’t know, either. These deaths indicate that the virus arrived earlier than anyone thought.”
The dynamics of the SARS-CoV-2 virus that causes the Covid-19 disease are such that it can easily go undetected after reaching a new country. Typically, young and middle-aged people, who travel more than the elderly, are more likely to contract it. “They are also the ones who will have the mildest symptoms and be less likely to resort to the health system,” adds Ignacio López-Goñi, a professor of microbiology at Navarre University.
Experts estimate that by the time that deaths occur, the virus has been circulating for at least four weeks. “The deaths and the most serious cases are just the tip of the iceberg, which we are beginning to see now,” said Pere Godoy, president of the Spanish Epidemiology Society (SEE).
Spain vs Italy
The great concern for Spanish health authorities is whether the country will follow a similar path as Italy, which has already confirmed nearly 4,000 cases and 148 deaths.
“The main thing is to reduce the circulation of the virus,” notes Joan Ramón Villalbí, a former president of the Spanish Society for Public Health and Health Administration (Sespas). “Isolate the patients, study their contacts, confine everyone suspected of contagion... It’s the only way to contain the virus.”
Pere Godoy says the population must understand that these measures break the transmission chains and prevent the virus from reaching the most vulnerable people, the elderly. “Isolating yourself today can save lives tomorrow,” he says.
English version by Susana Urra.