The mountains will go into labor, a ridiculous mouse will be born (“The mountains will give birth, a ridiculous mouse will be born”). Horacio already said it in the Epistle to the Pisons The Ars Poetica, 21 centuries ago. And that is what we have experienced with the measures adopted after the last conference of presidents and presidents.
If someone expected strong measures that would transmit security and confidence to the public, they will have been disappointed. The measures have been minimal, to say the least.
Technicians who have been advising on possible measures are also disappointed. The technical roadmap is clear and has been expressed in very different ways, and by various scientific societies such as the Spanish Society of Epidemiology (SEE) and the Spanish Society of Public Health and Health Administration (SESPAS).
Using the masks outdoors
The recovery of the mandatory nature of the mask outdoors has been the “star” measure, the result of the agreement between the presidencies of the different territories in Spain. Of course, thank goodness, exempting its use during individual sports or during non-sports activities carried out in natural areas and provided there is a safe distance from other people who are not cohabitating.
It is a measure that has little technical support. See, for example, the US CDC’s mask use guide (updated October 25, 2021). It clearly states that “in general, it is not necessary to wear masks outside.” They only except consider doing it in areas with a large number of covid-19 cases, in outdoor environments with high numbers of people, and for activities in close contact with other people not fully vaccinated.
In Spain, this mandatory measure outdoors was in force for almost a year. It was eliminated on June 26, 2021. In the meantime, the most necessary one: the use of the mask indoors. Its effectiveness is clear, but the correctness of its use remains little analyzed. It is common to observe that, when entering a restaurant or a bar, those who wear a mask immediately remove it, sometimes even before sitting down, because they are going to consume food or drinks. In this case the effect has been compared with the one who wears a helmet when walking and takes it off when getting on the motorcycle.
1. Incorporation of health personnel
Also, in the same Royal Decree-law, rules have been issued to enable the incorporation, for a year, of retired “professionals who practice medicine and nursing”, to carry out “tasks aimed at the fight against COVID” (This is what the norm says: in masculine). And also to authorize “on an exceptional and temporary basis” the hiring of health professionals with foreign specialist degrees in Health Sciences, obtained in non-member states of the European Union.
Therefore, the lack of health personnel (it should be noted that only medicine and nursing, not other professional categories) is recognized in the National Health System and it is about doing something to remedy it. But, at the same time, we are witnessing the non-renewal of the contracts of the personnel who were incorporated through “COVID contracts”.
2. Acceleration of vaccination
To this end, it is proposed to intensify the coverage of the third doses and the setting of deadlines for each age group. And also for those under 12 years of age.
It is something that was already underway in all the autonomous communities. The additional measure established to achieve this is the incorporation of military vaccination teams.
3. Incorporation of the military in public health surveillance
Finally, the incorporation of more military teams as “trackers” is also proposed (it would be preferable to call them teams to reinforce public health surveillance, which is what they are).
In this way, the structural weakness of the public health structures in this country is also recognized. Although the measure is still a patch. Stronger and faster actions are needed in their execution.
Meanwhile, we are still waiting for the “State Center for Public Health” established in the General Law of Public Health of the now very distant 2011. The prior public consultation of the preliminary draft of its Law was published on September 24, without there being any further news. Despite having public reports that can be quickly incorporated into the process.
Acting according to the situation in their own territory, something that is commendable, some autonomous communities have adopted, immediately after the conference of presidents of autonomous communities, additional measures to try to control transmission, some more successful than others.
It is true that the image may be of little institutional cohesion. But it is not necessary, or even surely recommended, that the measures be unique for the entire territory of the State.
For these measures, not much advertisement was necessary. Although institutional cooperation should always be welcome.
A greater vision, focus and population strategy is lacking. Many appeals are made, from the governments themselves, to individual responsibility, leaving the action in the hands of each person (take your own test and, depending on the result, be responsible deciding whether or not to go to a dinner, etc …).
It is more necessary than ever for the public health approach to be present. And the one-world vision is still necessary. Let us remember, once again, that we will not be safe until everyone is.
Óscar Zurriaga, Associate Professor. Department of Preventive Medicine and Public Health (UV). Serv. Epidemiological Studies and Statistic. Sanit. (Valencian generalitat). Unit Joint Research on Rare Diseases FISABIO-UVEG. CIBER Epidemiology and Public Health, University of Valencia
This article was originally published on The Conversation. Read the original.