Spain exceeds one million cases

Spain has reached 1,005,295 cases of coronavirus this Wednesday, October 21, eight and a half months after the first positive registered, on January 31: a German tourist who was on vacation in the Canary Islands.

But not

there are a million infections, reality exceeds official data.

In the first wave, until the end of the state of alarm, 246,504 diagnoses were recorded, but the ENE-Covid study carried out by the Carlos III Health Institute estimated that at least 5.2% of the Spanish population had contact with the virus, or what is the same, about 2.5 million people.

In the second wave, 750,000 have been diagnosed.

But the Ministry of Health itself recognizes that it is possible that only between 60% and 80% of the total are being detected.

Thus, the real number of infections may be at least 3.5 million, although many experts believe that this figure falls short and may be around five.

This is the account of the pandemic through several people who suffered the disease in the four key moments of its expansion, and have lived to tell it.

January and February passed between disbelief and confidence that the virus would not reach Spain, or it would not be so bad.

However, it had already circulated uncontrolled through the Peninsula since mid-February, as revealed by subsequent studies.

The Torrejón de Ardoz hospital, in Madrid, registered the first serious covid 19 patient in Spain on February 27, because that night the case definition changed.

Until then, only those who had been in China or Italy or had had contact with infected from these countries were tested, but from that date on, people with pneumonia with no clear origin began to be tested.

“We did it to a patient who was already admitted and tested positive.

And from then on, our life changed, and everyone's.

This patient died 15 days later, ”says Mari Cruz Martín, head of the ICU at that hospital.

“It was explosive, and untimely, we didn't expect it.

It was like a tsunami, we heard something, we were getting ready, and suddenly, boom, it floods you.

We didn't think it would come like this, so suddenly.

Then we felt powerless, we ran out of resources, and we were not used to it, we saw quality standards drop.

The other thing I remember is sadness.

The other day a colleague told me that an admission had reminded him of March, because it was very abrupt, very fast and very serious ”.

1. First cases

Two days later, on February 29, Manuel Pedrosa, 63, arrived at the emergency room at the same hospital because he had had a high fever for days.

But they told him it would be a cold, the perception of the problem had not yet changed.

“Nobody on that date thought there was a virus;

I, no idea.

We went home.

But it was still wrong.

On March 1 there was a Madrid-Barça, and I have a season ticket, but I couldn't even go.

I got very sick, with a fever of 40, and on the 6th we went back to the emergency room.

They did the test and two or three hours later they told me I had the coronavirus, the truth sounded like Chinese to me.

They admitted me to the ward, but three days later I was breathing with difficulty and they already told me that they were admitting me to the ICU, that they would try an experimental treatment.

In the state I was in, whatever they told me.

I was intubated for 18 days, then tracheostomy, 43 days in an induced coma.

They told me that in a couple of moments they disconnected the respirator, but I couldn't, I was going backwards.

There were moments that they didn't give a penny for me.

I weighed 75 kilos and I lost 14, and even today I have only recovered eight, although I have recovered well, with almost no sequelae.

I only have pain in my left shoulder, I go to the physio ”.

He was released from the hospital on April 29.

At that time, doctors applied to the most serious patients a cocktail of drugs on which they hoped.

From a biological point of view it was plausible that they could help fight the virus, but there was no evidence that any did.

Time showed that most of them were useless, and many had side effects, according to Ricard Ferrer, president of the Spanish Society of Intensive, Critical and Coronary Medicine (SEMICYUC).

The clearest example is hydroxychloroquine, the drug promoted by the president of the United States at the time, which not only does not help anything against SARS-CoV-2, but also has toxic effects on the heart.

The only one that passed that first screening in the light of scientific evidence is remdesivir, with humble results: it does not save lives, but it seems to reduce the average stay in hospitals in a few days.

"Now we do more personalized treatments depending on the characteristics of each chronic patient, we maintain some anticoagulants, since thrombi and corticosteroids tend to form", explains Ferrer.

Manuel Pedrosa does not remember anything from those days in the ICU.

“I have, I don't know what to call them, dreams, delusions.

But I better not count them, because you don't get up from the chair.

Terrible nightmares.

I work with cars, and I remember being convinced that I had left a car at the ICU with a trailer to take me away.

When I woke up I realized that I could not speak and I had a tube that left a mark on my face, which is already disappearing.

But the worst thing is that when I woke up everyone was confined, my children came to see me and told me that there was no one on the street, that everyone was at home.

I was just crying and crying.

And I still cry.

I am very sensitive, it is difficult for me to assimilate it, why has this come?

For me it was a stronger stick to assimilate how the situation was abroad than what had happened to me.

I worry because I know what it's like to have a business.

In 2008, with the crisis, I had to fire 20 people and it was very hard;

and now with this, it costs me a lot ”.

In his case there was no trace of his close circle: only if someone close to him had had symptoms would they have been tested that those days were worth their weight in gold.

Spain had them counted and they were only used for those with a high probability of testing positive, thus leaving out all asymptomatic;

perhaps half of all cases, although the exact portion is not yet clear.

Pedrosa's wife passed the virus, but she found out later because she took a paid test out of her pocket, she had no symptoms.

Neither of her two children was infected.

Pedrosa wants to underline something: “A total thanks to the health personnel.

It is to remove the hat, I have no words.

Doctors, doctors, nurses, people who have risked their lives with me ”.

2. The first wave

By then, in March, the pandemic began to spill over.

Chon (Asunción) Fuster, from Barcelona, ​​was admitted to the Delfos clinic on March 18, derived from the Vall d'Hebron hospital, which was already saturated.

He was released on June 8, 83 days later, 71 in the ICU.

“I don't remember anything, of course, and thank goodness, if it wasn't an ordeal.

When I got there, it was pretty much there.

My memory is the day I went out in a wheelchair, all the nurses clapping, and I didn't know why, I didn't understand anything, saying 'champion' and things like that ”, she says.

Volcanic in nature, it has recovered well.

His daughter, Silvia Gallés, is the one who can count those three months: “She started with symptoms at the beginning of March and the doctor said it was a flu.

We put up with not going to the hospital, so they said it was better not to go, because you were contagious.

But we called another doctor, he did the oxygen test and said to stop the hospital immediately.

She arrived and went straight to the ICU.

She was exhausted, she couldn't handle her soul, she wanted to throw in the towel.

He was there for 15 days, but then he had to have a tracheostomy.

Also later caught a bacterial pneumonia in ICU.

We called every night, but we couldn't go see her.

Luckily a doctor who had operated on her once and knew her one day sent us a photo, after a month.

We appreciated it very much, we were very excited ”.

As in thousands of families in Spain, the Gallés family created a WhatsApp group with all their family and friends.

“He gave the war reports every day, as I called them.

That was very important, feeling accompanied, so many people who loved us ”.

Finally one day they let them go see her.

“To look out the window, as we said.

He blew us kisses, although after that he doesn't remember anything.

The nurse put her ear to the glass, I yelled at her and she told her what we were saying.

My brother Pitus had the idea one day to take an iPad to the hospital with songs that we chose from among all that he liked, Sinatra, Julio Iglesias, and so there he listened to music, to cheer her up, as well as letters and photos from everyone.

It seemed like it was going well, but one day they told us that it had relapsed, it was going very bad.

We were all depressed.

In April or May they told us that we could better say goodbye.

I remember looking for the will at home, thinking about the grave, everything, horrible.

But one day he opened his eyes, began to lift.

It was slow, they told us not to get too excited, with a lot of patience.

The problem was, I couldn't live without the breathing machine, and of course, you couldn't take the machine home with you.

Little by little she was breathing alone, until she was autonomous.

Then they transferred her to the plant, and finally they released her ”.

They brought cakes for all the doctors and nurses, from all shifts.

“They were spectacular, we will thank them for life, and they were so nice, the guardian angels.

They saved our mother, ”says Silvia.

There is another parallel story, that of Chon Fuster's husband, Juan Gallés, an 83-year-old businessman, who in the meantime tested positive, but was asymptomatic, and spent the three months alone at home.

"We brought him the food in bags, because he cooked, little, we left it at the elevator door", says Silvia.

"It was very hard.

In two moments they told me to prepare for the worst, ”recalls Juan Gallés.

“I got a depression, which is normal.

But I held on to the realization of how fortunate I was, and that many people were much worse off.

I decided that I had to survive, if the virus ate me, my family would collapse.

My wife had to meet me here when I got home.

And it came back.

But of the three married couples that we normally always go out to dinner, out of six people, three died.

But life goes on".

His wife, Chon, 76, is already in top form: “Scared?

I'm not afraid.

I go out with a mask, I would go to play cards with my friends every afternoon but that has gone down the drain, and now you can't even take a slice ”.

"Grande Chon", that's what we put in the messages, concludes his daughter.

Juan and Chon belong to the group of the most vulnerable.

If the virus has made anything clear since we know it, it is that it is cruel to the elderly.

But even among them it is fatal in most cases.

In the first wave, one in five of those who tested positive in the age group over 80 died.

Many did so without diagnosis, especially in nursing homes.

Surely it will take time until there is a more rigorous estimate of the deaths that the covid will leave in its wake, but what is clear is that the 34,210 that Health records fall short.

This year's excess mortality, that is, deaths above the expected average, now exceeds 50,000.

Not all of them have died from the coronavirus, but it is likely that most have, either directly or indirectly, because they were not treated at the time, because of hospital saturation or fear of going to a health center .

However, the coronavirus is not a death sentence, nor for the elderly, the second wave is making it clear.

Now that there is much more diagnostic capacity, that many mild cases are identified, it is seen that more than 90% of positives older than 80 years recover.

3. The de-escalation

Summer came and the pandemic subsided.

The de-escalation began.

But the contagions began to quietly increase and spread throughout Spain.

Also to the corner where Beatriz García, a 38-year-old journalist, had been held since March with her husband and 13-month-old daughter.

On March 11 they went to a town in León, in El Bierzo, to a home of their parents.

Without daycare, with both teleworking, it was the best.

“We took a suitcase for the weekend, we thought we would be there for 15 days, and in the end we stayed for seven months.

It was a very quiet life, we went out very little.

In August, one day, the girl hit her head, it was nothing, but then she vomited, she cried a lot and on August 15 we went to the emergency room.

By protocol they did a PCR, because then in El Bierzo there was hardly any incidence and everything was working very well, and it was positive ”.

The couple also took the test and she tested positive, her husband did not, and the three of them slept in the same room.

“I had only noticed a headache, which I joked on the Slack at work: I don't think that with the hermit life that I lead in town I have caught it.

When they gave me the result I started to cry, I really felt at that moment a slab, I could only think who had infected it, because the girl was positive, and everyone had been holding her, kissing her, and I felt horrible guilt .

Then they all tested negative and I was so relieved.

I think it will happen to a lot of people.

More than worrying about how you are, the problem is to think to whom you have been able to transmit the disease ”.

They were told that they had to keep her and the girl in isolation for two weeks.

Since the house was on two floors, they settled on the top.

“They left my food on the stairs.

We would go down to the garden for a while every day, but it was three very hard weeks, because I was very tired, with a headache, and I couldn't lie down on the bed to sleep, which is what my body asked me, I had to be with the girl, play with her, because she was the only one who could.

My daughter was very good, she had incredible energy.

Any kindergarten virus has been worse.

One day I lost my sense of smell, because by changing her diaper I realized that she didn't smell anything, and in fact then I never knew when to change her (laughs).

I ran to the bathroom, opened a bottle of cologne and felt nothing, absolute nothing ".

For days he was haunted by the doubt of where he had been infected, because he had barely left.

“I scratched a lot.

It generates a feeling of guilt: I have done something wrong, and the girl has it.

Here the system worked very well, I saw on Twitter everyone complaining about Madrid and I had three PCRs.

They also tracked down my family, everyone I had contact with, but they all tested negative.

Also two friends who came from Madrid passing through and with whom we went to eat one day near Ponferrada.

And suddenly one day my sister calls me and tells me that they have closed that restaurant because of an outbreak, that they were infected in the kitchen and the waiters.

It was on August 8, but there we ate four, sharing tapas, octopus, and only I got it.

We ate indoors, that was the mistake, it was very hot, there was very strong air conditioning.

I think it was because I was the one who talked the most to the waitress ”.

Ponferrada, then hardly affected, will be confined from midnight this Thursday.

The conscientious search carried out on Beatriz was not the norm throughout Spain.

The summer began with less than half the trackers needed, and public health services couldn't keep up.

Most experts agree that this, together with an insufficient reinforcement of primary care, have been two of the great culprits that Spain has been the spearhead of the second wave of the pandemic.

Salvador Tranche, president of the Spanish Society of Family and Community Medicine, assures that the May and June speech of the authorities, starting with the President of the Government, of giving prominence to health centers so that they could serve as a containment dam against the virus was not accompanied by media.

They were those destined to diagnose early and quickly and to be the first link in the search, but they have been saturated practically since July, when half of the family doctor staff went on vacation without being covered in most cases.

Now, they are "jaded", in the words of Tranche.

“You come home after seeing 50 or 60 patients with the feeling that you have not done quite well.

And citizens have the impression that they are not being cared for because they call their health centers and they do not answer them.

There are fights at the doors every day ”, he assures.

4. The second wave

The end of the summer caused the pandemic to explode again.

The outbreaks were happening.

Aragon began to rebound in July, from there it went to Catalonia, but in both communities the situation seemed to be controlled after a few weeks.

Meanwhile, in Madrid it was growing slowly, but continuously.

By September it was already the epicenter of the epidemic in Europe.

Lázaro González, 50, a doctor in Alcobendas, in a nursing home and in a private clinic, began with symptoms on August 30.

He went to get tested at his health center - as a doctor and working in a nursing home he had priority - and decided to stay home.

"It was the worst moment, the result took a week," he recalls.

He tested positive, just that day he began to feel worse and went straight to the ER, to the Santa Sofía de San Sebastián de los Reyes.

He entered on September 7 with bilateral bronchopneumonia and was always on the ward.

He left on the 15th. "But because I'm a doctor, if I wait two more days I'll go straight to the ICU."

This same Monday, more than a month later, he took a serological test again and continues to test positive, but he has already been discharged and on Tuesday he returned to work.

“I have had such varied symptoms that if a patient tells me about it, I don't believe it: I have had neurological effects such as problems articulating a word, I thought it but couldn't say it;

or loss of instant memory, that I forgot what I was doing;

also insomnia, I slept for two hours, I thought I was short of breath ... A week after leaving the hospital, on discharge, I lost my sense of smell ”.

He believes that prevention is the basis and nothing has been done: “There has been very bad epidemiological management, it is not traced.

If you only attend to those who have symptoms, you don't get anything ”.

He does not know where he was infected, but it was not in the residence where he works, where there are no cases.

His wife, brother-in-law and son, the people he lives with, have only had mild symptoms.

But González is asthmatic, hypertensive and obese.

"From the outside you don't get an idea, you think you will be asymptomatic, but whoever passes it sees it differently, it is a very serious thing."

The million (official) cases have reached Spain at a time of vertiginous rise, shortly after a few weeks of declines in incidence that gave rise to some hope.

But the data is breaking records again.

The actual incidence is still a long way from that of late March and early April.

Health estimates that by then some days it was possible to touch 100,000 infections, when the maximum that was reported was just over 9,000.

Now there are days that have exceeded 15,000, and the Ministry of Health estimates that the actual figures will not be much above 20,000 those same days.

The deaths of this second wave have not exceeded 300 on any day, while in the first they exceeded 900 in the worst days.

The actual incidence of the first and second waves, then, is still not comparable, but it is, increasingly, comparable.

And if the measures that are being taken do not have a drastic effect, we will be closer to seeing a similar situation.

Hospitals are better prepared to deal with it, but they still have a limit.

"ICU beds have been increased, but the real problem is that of human resources, intensivists are not trained from one day to the next," says Ricard.

Information about the coronavirus

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- Guide to action against the disease