Spain plans ‘surgical’ measures to keep coronavirus under control

Spain plans to use “surgical” restrictions and improved detection to keep coronavirus under control once the country’s lockdown ends this month, but it cannot rule out more swingeing measures, the two most senior Spanish officials heading the battle against the pandemic have told the FT.

In a rare joint interview, Salvador Illa, health minister, and Fernando Simón, the chief epidemiologist leading the country’s fight against the virus, said that future outbreaks would be inevitable after the lockdown ended. 

But they argued that such outbreaks were set to be contained much more swiftly than before — when Spain suffered a volume of infections that gave it one of the highest death rates in the world, although cases have since sharply declined.

Mr Illa said that after emergency government powers lapsed on June 21, the government would use existing health legislation to respond to new outbreaks. He called this a “very surgical form of action” that would allow the compulsory quarantine of specific groups as well as restrictions on activities in affected areas. He compared it to measures that the government took in February, when it imposed a mini-lockdown on a hotel in Tenerife where coronavirus had been detected.

“Naturally, if we are talking about a generalised outbreak we would have to return to the lockdown mechanism, but where we are, with how the epidemic has developed, we don’t think this is going to happen,” Mr Illa said. “Still, we can’t discount it, obviously.”

Health minister Salvador Illa insists that Spain’s lockdown worked © J J Guillen/EPA-EFE/Shutterstock

Mr Illa and Dr Simón have been at the centre of enormous controversy in Spain about the lockdown — one of the toughest in the world — and the events that led up to it. 

There has also been mounting scepticism over Spain’s coronavirus statistics — particularly the official tally of deaths since the pandemic’s beginning. This total has now been “frozen” while the underlying figures are revised to correct flawed data corresponding to earlier stages in the pandemic.

The two officials said the country’s focus had shifted to identifying new sources of infection as quickly as possible, with individual rather than aggregate data, and then moving quickly to isolate infected people and their contacts.

Dr Simón said that at present about 50 per cent of all the country’s new cases were linked to other people who have previously tested positive for coronavirus. 

The goal is to get that proportion as close as possible to 100 per cent as the country prepares for three big challenges: the end of the lockdown, Spain’s reopening to international tourism on July 1, and the autumn flu season.

“If we can identify the origin of all of the cases, we can make sure that any outbreaks are limited and controlled,” said Dr Simón. “If not, it implies that we don’t know where the transmission is coming from, and it means it is getting away from us . . . We still have some weeks to accomplish this.”

At present, he said, there were only scattered outbreaks of the virus in Spain. He said that the value R, which measures the rate with which the virus spreads, had been below 1 for weeks and was as low as 0.3 to 0.4 if calculated from the first onset of symptoms.

According to the government figures, the number of people hospitalised over the past week with confirmed cases was only 139; just 12 people entered intensive care.

“The lockdown worked,” said Mr Illa. “We have taken some very tough decisions, but they have been efficient.”

At present, about 60,000 people with apparent symptoms are tested each week, of whom only roughly 5 per cent — some 3,000 people — are found to have Covid-19. Their contacts are then tested, about 10 per cent of whom are found to be positive. It is these people who account for about half of all new cases each week. 

Meanwhile up to 40 per cent of those testing positive are asymptomatic and appear to have been relatively uninfectious.

Dr Simón said that when international travel resumed, some imported cases would be inevitable — whether as a result of tourists arriving or Spanish nationals returning home.

“These cases will come; the important thing is to detect them quickly and manage them,” he said. He acknowledged that doing so will be more complicated than dealing with purely domestic cases, since it will involve tracing possible contacts from the plane to the hotel and at all points in between. 

But the most dangerous cases were a third category, in addition to domestic and imported cases: “those that we can’t find the origin of, that we suspect are spreading without our detecting”.

An employee mops the floor at the RIU Concordia Hotel in Palma de Mallorca. One of Spain’s biggest challenges is reopening to tourism © Jaime Reina/AFP/Getty

In preparation for the lifting of the lockdown, Spain this week unveiled rules for the “new normal” that will apply after June 21 — including the obligation to wear masks in public places where people cannot ensure social distance of 1.5m — down from a previous requirement of 2m.

The country is still looking at revising other rules — such as reducing quarantine for people in contact with the virus from 14 days to 10 or less, because of studies indicating that the virus is much less infectious after about a week. But the government is unlikely to move without international consensus on the issue.

Spain’s politics are convulsed over battles over how the authorities have handled the pandemic, both at the national and regional levels. A court case is proceeding over the government’s decision to allow an international women’s day demonstration in Madrid in March, as infections continued to rise. But Dr Simón and Mr Illa maintain that it was only the succeeding day that the scale of the contagion was apparent. 

“I have nothing to repent, we did what we had to do,” said Mr Illa. “I have a lot of confidence in the justice system.”