The de-escalation is being a ‘cafe for everyone’, or so it seems. Not all Spanish territories are leaving confinement due to the coronavirus pandemic at the same rate, nor are the requirements being applied in the same way everywhere. Neither are homework being done with equal devotion and dedication. As much as, for example, Madrid has ostensibly complained about not having been able to go to phase 1 from the first moment, technical reports on which the Ministry of Health relied to regulate the process in Spain, they demonstrate that the last autonomous regions to be unconfined, the Community of Madrid, Catalonia and Castilla y León, accumulated a incidence of cases much higher than the average for the rest of Spain. Almost double in the case of the Spanish and Catalan capitals.
The reports on which the controversial pivot has moved to phase 1, made public late at night on Monday by the Government of Pedro Sánchez, after some communities demanded them out loud, also show deficiencies in the diagnosis of the new cases and the follow-up of their contacts, an insufficient capacity in the laboratories or the lack of professionals in the three regions.
The Community of Madrid presents a cumulative incidence in the 14 days prior to the publication of the last report (the incubation period of the disease) of 35 cases diagnosed per 100,000 inhabitants and Castilla y León of 41, while the Spanish average it is 20 new positives per 100,000 inhabitants. In Catalonia, the report differentiates between the health region of Barcelona, where 34.8 cases are detected by the mentioned population volume, the South Metropolitan region, with 31 positives, and the North Metropolitan region, with 21 cases and therefore close to the Spanish average. In other words, if only epidemiological evolution had been taken into account, the area that encompasses cities such as Badalona, Sabadell and Terrasa, Mataró and Granollers could have de-escalated at a faster rate.
Despite that, the Generalitat preferred to be cautious and not separate Barcelona from this area. However, next Monday the Health Department wants the three health regions to unify, to allow Mobility between its municipalities.
Various criteria
The reports published by the Ministry of Health on the decisions that allowed or did not advance to phase 1 make it clear that the ability to carry out a early diagnostic, as well as the possibility of performing PCR on all people with symptoms between 24 and 48 hours, is one of the key criteria in allowing the de-escalated, but not the only one. The aforementioned incidence has also been taken into account in the last 14 days and since the start of the pandemic, Beds available in hospitals to cope with a flare-up or mobility in the regions. None of the criteria has indicators Defined and conclusive, so the reports are different from each other. Health already warned that the phase change would obey quantitative and qualitative requirements, interrelated with each other.
Despite this, there is a constant: “The recommendations”. Health allows or not the phase change and always apostille aspects to improve. So in Catalonia considers that there is “a high level of integration between the different institutions involved in case management & rdquor ;, although it calls for” improving & rdquor; the proportion of cases that undergo PCR, since in primary care it only reaches 21% of people who present symptoms compatible with the coronavirus, while in hospitals it is 100%, the objective also in the CAP.
PCR for suspects
In the health centers of the Madrid’s community The diagnostic test is carried out on a much higher percentage, of 43% of the suspects, although when they requested the advance for the first time, they were only performed on 32%, so the Government requested improvements in the diagnosis. And, in his latest report, he insists that although the number of tests and the personnel that monitor cases and their cases have increased, contacts, it is convenient to “continue with the efforts& rdquor; made.
Refering to Valencian Community, which also protested that Health did not authorize the passage of several of its sanitary areas on May 11, the report justifies the decision in the low rate of PCR tests, only to 20% of the suspects, as well as problems in the control of mobility. This motif and the “elevated & rdquor; virus incidence rate were also the causes that caused Malaga and Granada continue in phase zero one more week, so they did not de-escalate at the pace of the rest of the Andalusian provinces, as requested by their regional government.
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