In this pandemic, epidemiology is gaining a fame similar to that of economics: a science that predicts the past.
In Spain, few were right about the outbreak of the virus between winter and spring, most were wrong about how it would behave in summer and, at the dawn of autumn, it is rare who dares to make very sharp forecasts.
It is even difficult to figure out how we got here.
We know many of the elements that failed for the country to be at the forefront in contagions in its environment, but no one can explain the enormous difference with the neighbors: an incidence rate that multiplies by more than two the French, by six the Portuguese, by eight the Italian and the British, by 12 the German.
As in the economy, the evolution of an epidemic is influenced by the behavior of society: how citizens act and what measures their leaders take.
For this reason, in the coming scenario, the advance of the virus will modulate decisions, which in turn will contribute to increasing or decreasing the curve.
Autumn is anticipating complicated.
It has all the characteristics to be it: return to work, school, return to closed spaces, other seasonal viruses that can contribute to putting the health system in check.
But nothing is written.
Between certain social limitations and more severe confinements, between some tightness in hospitals and the collapse, there is a huge distance that will depend on how the virus evolves in the coming weeks.
In the opinion of Álex Arenas, a physicist and researcher at the Rovira i Virgili University and an expert in mathematical models, in the epidemic the key is timing and in Spain, he says, "all decisions are late."
“That is why we are in the situation we are in.
Homework was not done in summer, not enough trackers were hired, massive PCR tests were not carried out to arrive with a lower incidence of return to activity and now another time error is going to be made: we are going to open schools in places with triggered incidents and we are going to have to close at the end of the month ”, ditch.
The diagnosis of what has led us here is shared by many specialists.
Where is here?
At an incidence of 216 cases per 100,000 inhabitants when the expected was not to exceed 50, something that no community meets, not even Asturias, the best located, which this week exceeded that rate.
Not enough trackers were hired;
the already depleted primary care, the pillar to contain the epidemic, was decimated by the holidays and was completely surpassed in July and August;
A key focus was neglected, such as the temporary workers, who live in a precarious situation (both housing and work) suitable for infections.
Nothing that could not have been foreseen.
Added to this are conditions intrinsic to Spanish culture, which create a favorable place for the spread of viruses with the characteristics of SARS-CoV-2.
“You have more broadcast opportunities here.
Socially, the Mediterranean people get together more, we talk in a heated way, which generates more drops, we go out more ”, lists Alberto Torres, Spanish Society of Preventive Medicine, Public Health and Hygiene.
But Spain is not unique in this regard.
Do we have the worst managers, are we the most unconvincing and do we have the worst characteristics for the epidemic?
For this there are no clear answers.
There are even those who resort to chance: somewhere the second wave had to begin.
And if the prediction of the past is complicated, any approach to the future runs the risk of being wrong.
He dares with an Arenas, who believes that the lack of forceful measures will reverse the return to school.
And also Juan José Badiola, director of the Center for Encephalopathies and Emerging Communicable Diseases at the University of Zaragoza.
The data from this last week have shown that although the incidence of the virus continues to grow, its increase is not as vigorous as that of July and August.
“There seems to be some stabilization.
I believe that this will last a few weeks and that the measures that the communities are taking will cause the infection rate to drop after a few weeks ”, adds Badiola.
These measures (more limited capacity in shops and hotels, limits on social gatherings, etc.) are coming, and they will have to be modulated depending on the extent to which they achieve their objectives.
The eye is on hospitals.
The confinement that began in mid-March and its hardening (with the hibernation of the activity two weeks later) was done because the ICUs were not giving more of themselves.
According to the latest report from the Ministry of Health, 7% of hospital beds were occupied by covid-19 patients, which gives a wide margin of growth, especially considering that the vast majority of diagnoses in this second wave they are mild and do not require hospitalization, as a result of a greater capacity to carry out tests, not because the danger of the virus has diminished.
But do not trust.
The key is in growth.
In Madrid, the most affected community, ICU occupancy has practically doubled (from 126 patients to 243) in just two weeks.
If the progression continued in a linear fashion, they would be collapsed in a few weeks.
It doesn't have to be that way, Arenas clarifies.
"This would be the maximum level of growth, but depending on the measurements and movements it can go down," he explains.
As long as the intensive care units have the capacity to admit more patients, there will be no draconian restrictions.
Few epidemiologists imagine that what happened in March will happen again.
"There may be limitations to many activities, even mandatory telework, but such a confinement does too great a damage to the economy," says Pedro Gullón, from the Spanish Epidemiology Society.
In the worst case, Alberto Torres adds, many of the spring restrictions, such as avoiding walks, “are absolutely unnecessary,” he emphasizes.
Information about the coronavirus
- Here you can follow the last hour on the evolution of the pandemic
- This is how the coronavirus curve evolves in Spain and in each autonomy
- Download the tracking application for Spain
- Search engine: The new normal by municipalities
- Guide to action against the disease