Carolina Darias: "The measures of Holy Week are the learning of the third wave"

Carolina Darias (Las Palmas de Gran Canaria, 55 years old) received the portfolio of Minister of Health on the day that the highest accumulated incidence of covid cases was recorded in Spain.

It was January 27 and there were 899.9 diagnoses per 100,000 people in the previous 14 days.

Since then, the trend of contagions has not stopped decreasing and she has maintained a continuity line with her predecessor, Salvador Illa, in which she tries to avoid confrontation and seek consensus.

But in this interview he slides that in the recent past mistakes were made that he now wants to avoid, such as the Christmas measures, after which the third wave arrived.

With her eyes fixed on the curve and on vaccines, the minister says she is hopeful that there will not be a fourth wave in Spain.

Ask.

What evolution do you foresee in the coming weeks?

Answer.

We are entering a valley area.

The cumulative incidence at seven days tells us that this is going to be the scenario.

Q.

Will there be a fourth wave?

R.

We will work so that no.

It is the objective of those of us who make up the Interterritorial Council: to continue working so that the accumulated incidence, in the best of scenarios, continues to decline, albeit slowly and, if not, to continue.

P.

The objective of the ministry is to lower than 50 cases per 100,000 inhabitants.

If May 9 is not achieved, will you raise the state of alarm?

R.

I want us to focus on the current and immediate scenario, which means continuing to maintain a very gradual de-escalation.

It is very important to learn from lived experience.

P.

The measures of Easter are much stricter than those of Christmas.

Does it imply acknowledging that they were wrong?

R.

What it implies is that we adapt decision-making to experience.

It is clear that after Christmas we have had a very important increase in cases, hospitalizations and ICU admissions.

The measures that we have adopted in the Interterritorial Council have to do with this diagnosis and with learning from the third wave.

Q.

Before Christmas, EL PAÍS consulted with a score of experts, with medical societies, and they all anticipated what would happen with those measures.

Why didn't the ministry do it?

A.

We were at a low incidence, one of the lowest since the summer.

The important thing today is to look ahead, to the future and give a message of certainty to citizens.

The policy is to give certainty and confidence, from a coordinated action, from a common minimum of understanding of those who are at the forefront of health responsibility, and that is what we have wanted to do now with that great agreement for the feast of San José and Easter.

Q.

How do you explain to Spaniards that someone who lives in another country can go to the Canary Islands and someone who lives in Madrid cannot?

A.

We have very strict measures, requiring a negative PCR 72 hours before arrival.

What's more, we have restricted flights from the UK, Brazil and South Africa to protect the epidemiological situation especially in the face of variants.

And in addition, we have established quarantine orders for people who come from countries with high incidence.

A foreigner from the EU who comes will only be able to go to the community they are in and will have the same restrictions as any Spanish citizen.

P.

But it is difficult for citizens to accept that foreigners can go anywhere in Spain and they cannot.

R.

We cannot close our country outside the EU.

There are some control measures in airports that are working, quarantine, and measures of course that are within the established scope and the EU recommendations.

P.

Madrid has announced that the closure of the community imposed by the Interterritorial Council will appeal to justice.

R.

This minister is not going to be with those who face, but with those who add, with those who want to advance.

I believe that the legal controversy in this case is sterile.

It is mandatory both

de jure

and

de facto

, because we are facing a declaration of coordinated actions and because, in any case, the entire country will be closed perimeter.

I want to make a call to understanding, because together we advance further and go further.

And that has been the majority sentiment of all the councilors of different political backgrounds.

The protagonist cannot be the one who disagrees.

P.

The royal decree of the state of alarm says that the presidents of the communities are the delegated authorities.

THE COUNTRY has consulted with several jurists who support this point.

R.

There is a statement of coordinated actions that is mandatory.

The practically unanimous agreement of all the advisers and advisers was that, to continue saving lives.

And I also believe that there is a vast majority of citizens that are convinced and aware of the need to stay in our autonomous community.

Q.

How is your relationship with the Community of Madrid?

R. He

is excellent with each and every counselor.

I speak to them several times a week.

Q.

When Madrid takes initiatives of this type, doesn't it undermine your confidence?

A.

Confidence is not affected by me.

Each one knows how to act.

Q.

Are you convinced that vaccines will arrive to immunize 70% of the population in summer?

A.

We knew that the first quarter was going to be a limited arrival.

And we know by contract that from the second quarter there will be a significant increase.

The projection cannot be linear because there is going to be a jump.

We are at a very important turning point and a horizon of hope.

We are seeing in residences a spectacular drop in fatality among those over 65 years of age.

The quality of life and happiness that has been returned to the elderly, to both health and non-health workers ...

Q.

Do you know how many Janssen vaccines will arrive in April?

A.

No, they have not yet given us the delivery.

They have told us that it would start from the second half of April and that the increase will be significant from May and June.

• Health and the communities approve the closure at Easter and San José, but Madrid rejects it

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Q.

Is it normal to know with a dropper how many arrive?

R.

I would love to have the data.

We have joined all the EU contracts, but the deliveries are communicated by the companies with the periodicity they estimate, according to their own plans.

We do know that each time Pfizer anticipates the arrival much more and, in addition, we communicate it well in advance to the communities so that they can make their forecasts.

And with the rest of the companies, as they communicate to us, we transmit it.

Q.

When will people over 80 years of age finish their vaccination?

A.

We would like you to finish vaccinating in this month of March, not much further than this month of March.

Q.

Will the system have the capacity to administer all vaccines when they arrive en masse?

A.

We are working with the communities on the operational plans.

I am very confident in the capacity of our National Health System.

We know that one of our great strengths is healthcare professionals and the healthcare network.

We were able to vaccinate 14 million Spaniards against the flu in eight weeks and, therefore, all confidence in that strength.

However, if it were necessary to expand capacities, it would also be done.

Q.

Would hiring be done?

R.

We would have to go hand in hand with the communities, but that is not going to be a problem.

P.

There are not too many toilets to hire.

R.

There are other acting capacities, such as extending hours, through mutual insurance companies ... There are several options that will have to be assessed.

Q.

Are they being valued?

R.

It will be valued in due course, but in principle the idea that I would like to highlight is the strength and capacity of the National Health System.

If we have learned something from this crisis, from this pandemic, it is the value of the public to get out of it and above all, the need in the future to be able to improve and expand these capacities.

Q.

Are infrastructures such as pavilions necessary?

R.

The autonomies are working with it to see their capabilities, to expand them.

And I know that many are occupying these larger spaces to prepare future scenarios as of April for an important arrival of vaccines.

Q.

There are countries that are lifting restrictions on those vaccinated.

Does Spain work in that sense?

R.

In Spain we work together with our European environment on a vaccination certificate.

There is already consensus regarding the technical requirements that it must have and regarding sanitary use.

For example, if a person receives the first dose in one country and, for work or other reasons, they have to move to another in the EU and receive the second dose there.

We are now working on other possible uses.

When we have a significant percentage of vaccination, the objective will be to facilitate other uses with this certificate.

Q.

Give me an example of what could be given to a vaccinated person.

R. It

could be a facilitator of mobility for the summer, but we are working on it.

We are working so that it can be one of the possible uses of the certificate.

Q.

But there is no evidence that the vaccine completely prevents infection.

R.

We always go hand in hand with scientific evidence.

We will be working on the possible use, but always with the protection measures that we know prevent the spread of the virus.

For example, the use of a mask I think is here to stay.

I don't know if definitely, but yes for a long time.

Q.

Will we continue with a mask this summer?

R.

I do not know if until the summer or not, but I do believe that the use of the mask we will have to maintain it, because until we have the entire population vaccinated, we will have to continue with the culture of care.

Q.

Have you considered stopping the AstraZeneca vaccination, as other countries have done?

R.

In Spain we go hand in hand with the European Medicines Agency [EMA, for its acronym in English].

On the 11th, he met to analyze the thromboembolic events that have arisen in some EU countries.

And he released a statement in which he said that until now, and with all prudence, there was no causal relationship between the events and the vaccination.

Therefore, Spain will go as usual, hand in hand with the EMA, which is the one that gives us guarantees.

P.

Five communities have stopped vaccination with a batch.

Doesn't this generate mistrust?

R.

As long as the EMA does not say otherwise, we have maximum confidence in vaccines and also maximum tranquility in the sense that until now the causal relationship has not been proven.

Think that there are millions of people in the world who are inoculated with vaccines.

And that these serious adverse effects are rare cases and that they also occur in people who have not received the vaccine.

Q.

Spain is one of the few countries in Europe that continues to restrict the AstraZeneca vaccine to those under 55 years of age, why are we lagging behind?

R.

We are going with the rhythm and the roadmap that we have set for ourselves.

The vaccine conference and the Public Health Commission agreed on the principle of prudence and, consistent with the scientific evidence, made the decision to apply it until the age of 55, because the AstraZeneca clinical trial reached that age.

The idea was to review it on Thursday, but given the news we learned about, we decided to wait for decision-making and review it when we have a clearer horizon.

Q.

But the EMA licensed the AstraZeneca vaccine for people 55 and older.

Why in this they do not go hand in hand with the organism?

R.

We go hand in hand with the clinical trial.

It has also been done based on the arrival of vaccines.

Groups that perform essential functions are being vaccinated in a significant amount and I believe that this also contributes to mass immunization.

Q.

The pandemic will end one day.

What are your plans for ministry then?

R.

I have appeared this week in the Congress of Deputies and have announced the general lines of the ministry, which include expanding and improving the capacities of our National Health System.

It means expanding healthcare capacities, preventive capacities, professional development capacities, health intelligence capacities.

Also the capacity for equity and cohesion and, above all, the capacity for adaptation and resilience.

All these capacities have to place primary care as the backbone of the system and develop and implement the primary and community care strategy.

The approach to chronicity or the mental health strategy, which seems fundamental to us, especially as a consequence of the pandemic.

But it is also very important to us to focus it, not only on the intervention of the disease, but especially on the prevention and improvement of healthy habits.

Q.

Are you going to create a state public health center this year?

R.

We are working to have it as soon as possible.

We have to strengthen everything that affects the improvement of public health, make a national health system that is stronger, more resilient and more proactive, and contribute to that EU of health.

Q.

Are you going to strengthen the competences of the Interterritorial Council of the National Health System as a decision-making body?

R.

The decentralized State has withstood the stress test that this pandemic has entailed.

There is a need more than ever to coordinate.

Therefore, the Ministry of Health, also in this pandemic, has credited the impulse to coordination, to that joint action of all the autonomous communities, from the utmost respect to the area of ​​competence of each one, but also from the need to have to do joint actions.