Spanish regions stockpiling medical supplies in preparation for new Covid-19 outbreaks

After an initial scramble to purchase hard-to-find medical supplies amid the coronavirus pandemic, Spain’s health authorities have reported somewhat easier procurement conditions and a growing reserve of equipment to deal with future spikes.

The supply of protective gear has been one of the weak points in the country’s management of the Covid-19 crisis, which hit Spain particularly hard. The official death toll is 27,650, while nearly 124,000 people have been hospitalized.

The health crisis caught Spain without a strategic reserve of medical supplies. By the time authorities reacted, the international market was already saturated. Desperate procurement officials rushed to place orders, and occasionally ended up with subpar material.

We’ve all been scammed at some point. Now we have personnel that’s become specialized in checking the material and determining whether something looks suspicious

Jon Guajardo, Basque healthcare manager

On March 22, Prime Minister Pedro Sánchez announced the creation of a strategic stockpile of personal protective equipment (PPE) and medication to deal with future pandemics as soon as the country develops “the capacity for self-supply.”

In the meantime, the Health Ministry has so far spent over a billion euros on medical equipment, including 140 million units of products that it is keeping at an undisclosed location. The ministry has also signed emergency contracts with four airline operators, and there are three weekly Madrid-Shanghai flights that deliver the shipments of medical supplies.

Regional governments – which have devolved powers over healthcare – are also stockpiling their own protective gear to make sure that they qualify to move forward in the four-phase deescalation plan devised by the central government.

Deescalation

Once a week, regional authorities have to report to the Health Ministry with an updated list of their existing supplies of face masks, PCR testing kits, eye gear, gloves, gowns, cotton swabs and hand sanitizer.

Having sufficient medical equipment to deal with a potential new surge in coronavirus cases is a condition for transitioning towards a “new normality” that is expected to arrive in late June at the earliest. Many regions of Spain are currently in Phase 1, which allows for limited social interaction and business activities. Madrid and Barcelona remain in Phase 0, while a few islands in the Canaries and the Balearics moved to Phase 2 on Monday.

Central authorities have just sent a letter to regional health chiefs asking them whether they have enough supplies to cover their needs for five weeks, and offering to send them equipment if they do not.

“Save for the odd exceptional situation, they [the regions] all have enough reserves,” said Fernando Simón, head of the Coordination Center for Health Alerts and Emergencies at a news conference on Sunday. “A few of them have only just enough.”

Regional authorities have criticized the government’s early decision, taken when the state of alarm was decreed on March 14, to centralize purchases rather than allow the regions to buy their own medical supplies. Central authorities say that these government purchases were just meant as additional support for regional governments, who were not prohibited from making their own purchases.

Procurement war

The stockpiling comes at an enormous cost. The region of Castilla-La Mancha, with a population of over two million, nearly 700,000 of whom live in the province of Toledo, needs 300,000 surgical masks a week.

“We have been at war,” says Luis Ruiz Molina, the regional secretary general for health services. “Buying is easier now, but prices are stuck at a high level and have not gone down.”

And it is still difficult to buy from manufacturers in China, where “products that were supposed to arrive today finally get here four or five days late.”

Alfredo Martínez, the contingency plan coordinator for the region of Navarre, says they have enough stock for a new spike, but “there is still tension to secure the material. When you don’t have problems with one product, you have them with a different one. The problem is the international market.”

We have been at war. Buying is easier now, but prices are stuck at a high level and have not gone down

Luis Ruiz Molina, head of health services of Castilla-La Mancha

Gloves are the problem right now: a box of 100 units that used to sell for three euros now costs up to €12. One of the Health Ministry’s latest contracts was for 17 million gloves, which cost €6 a box.

Faced with these issues, most procurement officials are now seeking local manufacturers. In Castilla-La Mancha, 57 companies have switched production and four of them have applied for health authorities’ approval to make face masks. And a Basque cooperative named Oiarso last month signed a contract with the Health Ministry to start making 10 million face masks a month for six months.

“Current consumption is very high and will remain so for a long time,” said Jon Guajardo, manager of the Galdácano healthcare area in the Basque province of Vizcaya. “We’ve had a lot of donations, and thanks to that we’ve managed to stay afloat.”

Guajardo adds there is “tremendous speculation” with prices, not to mention the defective products. “We’ve all been scammed at some point. Now we have personnel that’s become specialized in checking the material and determining whether something looks suspicious. We check everything before using it.”

English version by Susana Urra.