Civil Guard agents carry out a control on the A-4 highway, in Madrid (Spain), this Friday.Joaquin Corchero / AFP7 / Europa Press / Europa Press
Marseille, the second largest French city, closed bars and restaurants on September 26, exceeding an incidence of 500 cases per 100,000 inhabitants.
In Paris the bars closed when he reached that threshold, a few days later.
As of this Saturday, Berlin imposes a night curfew: bars and restaurants will close at 10pm.
In a risk zone when reaching 100 infections per 100,000 inhabitants, the German capital prohibits, among other things, meetings of more than 10 people in the private sphere.
More restrictive measures and, above all, much earlier than those of Madrid.
Experts agree that the limitations guaranteed by the state of alarm declared this Friday are late and not very forceful, which contrasts with the political and legal mess that it has cost to impose them.
Health registers the second worst death toll in the second wave: 241
"They are criteria of commitment to try to reach political agreements," laments Ildefonso Hernández, Professor of Public Health at the Miguel Hernández University.
The incidence of 500 cases per 100,000 inhabitants that marks the threshold from which the restrictions apply is not “a significant barrier”.
That milestone should be "much earlier", he stresses, "and more so when an area does not have resources", as is the case of Madrid, which can no longer follow up on contacts of positive cases.
"Madrid has not made decisions regarding dealing with the pandemic in periods of low incidence, which is when it is necessary to do it," he adds.
Phase 1
The epidemiologist Daniel López Acuña, former director of emergencies at the World Health Organization (WHO), also believes that the measures should be more forceful.
He talks about going back to the equivalent of phase 1 by municipalities.
Pedro Gullón, a member of the Spanish Society of Epidemiology, qualifies the restrictions as “lukewarm”, and explains that the perimeter confinement is like a firewall.
Its objective is "that the incidence does not extend beyond Madrid, that it does not harm areas with lower incidence".
For this reason, he says, "in front of a bridge and with many people wondering whether to go on a trip, it made sense to try to prevent Madrid from acting as a source of spreading the virus to the rest of the country."
To reduce the incidence in Madrid there would be the rest of restrictions on activities: no more than six people get together, reduction of hours in bars and restaurants ... "Measures that will stop physical contact," he adds.
Very lax compared to what other countries are doing and that could tighten, for example, further limiting capacity, especially indoors, he proposes.
Perhaps we should consider closing the interior of bars, gyms, cultural events, he lists.
"We should move everything we can to the outdoors."
And it also points to teleworking: "Many offices are returning without financial need."
Amidst confusion and perplexity, these days citizens have received contradictory messages and changing instructions that, according to experts, make it extremely difficult to control the pandemic because they undermine trust in institutions.
The Madrid described this Friday by the Minister of Health, Salvador Illa (“there are not only outbreaks, there is community transmission”, “health care runs the serious risk of being overwhelmed”), did not seem the same as that of the Madrid Minister of Health , Enrique Ruiz Escudero ("our plan is working", "in 45 of the 46 basic health areas the incidence is decreasing").
Daniel Acuña asks that this "false dichotomy" that is part of the political discourse be ignored.
And it refers to the data: the Community of Madrid has an incidence of 541 cases per 100,000 inhabitants in 14 days.
Double the Spanish average, 258. A dozen neighborhoods, most of them in the south of Madrid, far exceed 1,000 cases.
More than 50 health zones are above 750.
The trend in recent weeks is towards stabilization and a slight decrease in infections in Madrid, but the situation, in absolute numbers, is "bad", defines Gullón.
And it has come to this situation because Madrid "did not do its homework when it should," adds López Acuña, who has been saying for weeks that the restrictions should have been imposed six weeks ago and "throughout the city."
This expert questions the measures proposed by Madrid, and which were in force for 12 days (between September 19 and 30), which consisted of preventing leaving and entering without just cause in 37 - later expanded to 45 - basic health areas with higher incidence, greater than 1,000.
Artificial segmentation
"To only interrupt mobility in areas with more than 1,000 without doing so in those with between 500 and 1,000 was to act fragmentarily, incoherently, and have a false notion of security by closing those neighborhoods, at the time the most economically depressed," he says.
"It is an artificial segmentation of the epidemiology of the disease that does not lead to good control," he adds.
And he describes the threshold used by Madrid as "beastly", "four times higher than what other countries have to worry about."
Hernández calls the ministry's measures late and scarce, but assures that those in Madrid "made no sense."
The basic health zones are units to distribute the health cards of the population that lives in them, he assures, "not units of social functioning."
“The plan was difficult to implement and not very understandable considering the economic and social movement of the city.
You can't cut neighborhoods in half ”.
Faced with the discourse of Madrid politicians, who affirm that their measures were working, the change in the trend of the epidemic in Madrid predates the entry into force of the zone plan.
Part of the decrease in incidence, moreover, may be due to the fact that Madrid is doing fewer PCR tests in recent days.
If you analyze less, you find less positives.
The sharp drop in incidence was what alerted the Ministry of Health at the beginning of the week, when it questioned the Madrid data.
The improvement is real, and it is noticeable in that the rate of new hospital admissions decreases, but it does not correspond to such a drastic drop in the rate of infections.
Andrea Burón, epidemiologist and member of the Spanish Society of Public Health and Health Administration, regrets that no action was taken earlier, which would have allowed much less restrictive measures that would affect fewer people.
"We have been in a pandemic for many months," he says, without having bet on improving epidemiological surveillance, strengthening primary care, information systems and facilitating compliance with isolations and quarantines.
"This is where you have to invest, it is the only way to stop it and not have to come to drastic measures," he says.
Information about the coronavirus
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- This is how the coronavirus curve evolves in Spain and in each autonomy
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- Search engine: The new normal by municipalities
- Guide to action against the disease