The perimeter closures isolate almost all the autonomies on the eve of the bridge

The feast of All Saints will be an epidemiological proof of concept.

With the data of the pandemic on the unstoppable rise (cases have grown by 71% in 15 days, and the incidence rate is at its second wave record, 452.63), the majority of regional executives have announced the closure of their borders or that they are in favor of doing so.

Even Madrid, according to its president, Isabel Díaz Ayuso, would enter into this dynamic.

But in its own way.

After a meeting this Wednesday with his counterparts from Castilla y León and Castilla-La Mancha in which he agreed to adopt the measure, at the end he appeared and just after stating that "people are fed up with controversies", he raised a new one: instead to confine until November 9, when the state of alarm ends, has asked the Government to do so for days, until the end of the bridge next Tuesday.

To do this, the current state of alarm must be modified, which provides that the measures will last seven days.

Asturias, Aragon, Castilla y León, Castilla-La Mancha, the Basque Country, Madrid, Murcia, Navarra, La Rioja and Andalusia have already confirmed the closure.

Also Ceuta and Melilla.

Catalonia and the Valencian Community are considering it.

They are more than 80% of the population.

The Balearic Islands will apply it in Manacor.

You will not be able to enter or leave them, but there will be no limitations for internal mobility, although other measures will continue to be in force, such as reductions in capacity, groups and the state of alarm.

Extremadura, Cantabria, Galicia and the Canary Islands remain, whose neighbors will be able to cross confined autonomies but not land in them.

Ayuso's original proposal has much of a symbolic act.

The announcement of the closure of the two neighboring communities, Castilla y León and Castilla-La Mancha, left it semi-isolated.

It is not the first time that Madrid, which maintains 32 confined sanitary areas, has organized controversies with the measures to be applied.

It made the first decisions to close zones on September 21, when its 14-day incidence rate was around 700 throughout the community and, in those areas, exceeded 1,000.

On September 29, it peaked.

Then, the Ministry of Health wanted to force him to take more restrictive measures and, after a meeting of the Interterritorial Council, decreed limitations for large cities with very bad indicators.

Castilla y León followed those recommendations, for example, but the translation of that agreement into Madrid law was flawed, and a court overturned the measures.

As a result, on October 10 a state of alarm was decreed.

Although in general the PP has been very critical of the government's management of the pandemic (when the first wave criticized the lack of freedoms and in the new normality that the government did not get involved), the seriousness of the situation has tempered the postures.

For example, Murcia, Andalusia and Castilla y León, with governments such as Madrid (PP and Cs), announced this Wednesday the perimeter confinement.

The Murcian president, Fernando López Miras, related the decision to the Todos los Santos bridge, in which there are numerous displacements that, he insisted, should be avoided at all costs.

Andalusia decreed the closure of the community in general and of three provinces (Seville, Granada and Jaén).

Asturias, the Basque Country and Aragón simultaneously close the community and municipalities.

“We are going to take this very seriously.

Let's redouble our responsibility ”, justified the Andalusian president, Juan Manuel Moreno.

But the perimeter closure raises questions.

It is the last cartridge.

So far, none of the measures taken (closures, capacity restrictions, timetables) have shown efficacy in this wave.

"The perimeter confinements try to avoid mobility between areas with the aim of reducing the transmission of the virus between areas that have a high incidence to other lower ones.

They are one more measure that tries to reduce social contacts, but it does not prevent cases from continuing to grow in the confined area if contacts are not reduced, so it is a very controversial measure and the evidence of its effectiveness is very limited ", says Carlos Arenas, from the Fundación Economía y Salud.

That is one of Ayuso's arguments, that there is no evidence on its effectiveness.

But Joan Caylà, from the Spanish Epidemiology Society, says that there have been cases, such as that of the seasonal workers in Lleida, in which it has worked.

Javier Rey, an analyst at Fundación Alternativas, agrees, but believes that its effect is one of “momentary control”.

Although it adds another property: "It is a deterrent."

José Manuel Freyre, also from the Alternativas Foundation and PSOE Health spokesperson in Madrid, defends it “well applied”: “It reduces mobility and contacts and thereby helps to control the spread of the virus, but, obviously, it has to go accompanied by public health and social measures.

And it must be feasible, affecting areas known to the population and controllable (cities, municipalities, communities) and not like in Madrid, which has put it in areas whose limits no one knows and whose control by the police is impossible ”.

"Where there are many cases it makes sense not to export viruses, and where there are very few not to import them," simplifies Joan Ramon Villalbí, from the Spanish Society of Public Health and Health Administration (Sespas).

But what if all regions are badly affected?

For example, the incidence is 460.93 in Castilla-La Mancha, 700.59 in Castilla y León and 430.04 in Madrid.

They are all unacceptable levels, but, ironically, according to these numbers, the one that would have to lose the most to stay open and receive visitors would be Madrid.

"Little usefulness"

The epidemiologist of the European University of Valencia Patricia Guillem sees them as "little use" if they are taken in very large areas with scattered incidents within them.

In addition, he says, the exceptions are so many (work trips, studies, to the doctor, to care for the elderly, for business) that he believes that "they will not be of great help", and less with how difficult it is to control.

The former leader of the WHO Daniel López-Acuña synthesizes both positions: perimeter confinements “make sense in Asturias, which has perimeter Gijón, Avilés and Oviedo, which have higher incidences so as not to spread the infection to councils with very low incidence.

It also makes sense to perimeter the entire Principality especially before the bridge to prevent the entry of tourists who could introduce the disease and increase the incidence within the community [Asturias has a rate of 355].

They do not make any sense and are a fallacy that gives false security and creates unnecessary asymmetries when it is done, as in Madrid, perimeter basic health areas with incidences a little higher than the rest of the areas of the same city.

In both types of zones there is community transmission and a large city with urban public transport cannot and should not be artificially separated with partial confinements within the city itself ”.

As of November 15, it will be seen if the curve of cases, which rises without stopping, accuses these restrictions.

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