On April 8, 2020, 5,715 elderly people living in Madrid residences had died from the pandemic, but the Community of Madrid continued to maintain its plan to assist them in those homes lacking health resources instead of in hospitals.
That day the regional government held a crisis meeting and EL PAÍS has in its possession a minute of the assembly that reflects how the workers of the Ministry of Social Policies spent their days trying unsuccessfully to find doctors to save lives.
A senior official in that department complained that they called the phones of 146 health insurance companies on a list that the Ministry of Health had given them, but the answering machines jumped.
When they responded, many refused to collaborate, because they had already been recruited by hospitals and health centers.
The recommendation of the Minister of Health, Enrique Ruiz Escudero: "Print more tension when calling."
It was no use that the then Deputy Minister of Social Policies, Javier Luengo, asked Escudero to send them urgently to the residences of doctors of the Ministry of Health.
The day before, Escudero had announced in a radio interview that the pandemic was subsiding and that they were preparing to “start the withdrawal” and “return hospitals to normality.”
But, despite this improvement, the residences had to settle for that list of toilets specialized in work accidents.
The record obtained by EL PAÍS shows unknown details of the conflict within the Government of Isabel Díaz Ayuso that weighed down the response in the residences, the epicenter of the health crisis almost two years ago.
The document also provides more evidence of the failure of the "medicalization" of these centers, the objective that the Community of Madrid had devised at the beginning of the crisis to avoid the collapse of hospitals.
The regional Executive's plan had been written in mid-March in triage protocols that denied the right to hospital care to the vast majority of the 50,000 residents, the most fragile population.
The Minister of Health of the Community of Madrid, Enrique Ruiz Escudero, presents his plan for the coronavirus on March 12, 2020, which includes the "medicalization" of nursing homes. RRF (Europa Press)
The meeting was part of the shock plan for residences that Ayuso announced on March 26, when public opinion was already aware of these non-referral protocols, which excluded elderly people with dependencies who lived in those centers from hospitals.
The news of those days was alarming: corpses accumulated in basements and agonizing deaths.
Instead of revoking the plan for residences designed by her counselor Escudero, the president announced that he would assume a single command as coordinator of three ministries, two in the hands of the PP (Health and Interior) and one directed by Citizens (Social Policies).
But the response remained insufficient and was hampered by clashes between departments of one political stripe and another.
These disagreements were already evident before the shock plan.
The Minister of Social Policies,
Alberto Reyero had not been informed of the plan for triage and medicalization of residences and was left out of key decision-making.
When he asked the central government for help, Ayuso crossed him out with a cross.
Luengo, Reyero's representative at the meeting, reproached Escudero that the profile of the health insurance companies did not seem ideal, according to the minutes.
He probably thought that these doctors are specialized in writing work accident reports and not in treating bilateral pneumonia.
The document reflects that he also informed him of the resistance offered by these health workers to being recruited, despite the fact that they were theoretically obliged by law to obey the orders of the health authorities.
The Social Policy officials in charge of the calls found that many of the 146 doctors on the list had already been enrolled days before by the Ministry of Health and refused to move to the residences.
Javier Luengo, Deputy Minister of Social Policies during the coronavirus crisis in residences, in a file photo. Andrea Comas
The hour and a half meeting, led by Escudero, was attended by 14 people.
Nine were positions of Health and only two of Social Policies.
Two representatives of the employers' association of residences Aeste and a position of the Ministry of the Interior also attended.
The minutes of the assembly, written by an advisor to Escudero, do not include the literal tenor of each intervention, but a paraphrase, but the clashes between the members of Health and those of Social Policies are evident.
Luengo complained that nursing homes were receiving a lower level of medical care than the rest of the population.
To the right hand of Minister Escudero, the Deputy Minister of Health Ana Dávila, advised him "to be more concerned about the lack of toilets in residences."
But the demands of the Ciudadanos men had no effect.
Escudero's subordinates defended the plan as it stood.
Regarding the mutual doctors, the general director of Human Resources for Health, Raquel Sampedro, responded to Luengo that "the profiles are not always the most suitable in an emergency situation."
Escudero, in addition to asking for “more tension”, added that they had to make do with the toilets that were available: “The profiles are never the most suitable, but it is a pandemic and you have to use whatever resource is available.”
Chaos a month later
The minutes of April 8 show how the chaos continued a month after the beginning of the deaths in residences.
At the beginning of the meeting, the senior official who signed the protocols, the general director of Social and Health Coordination, Carlos Mur, provided the balance of deceased and warned that information on the residences was still lacking (474 active centers at the time).
Despite the fact that the Ayuso government had sold the shock plan as a before and after, the truth is that the elderly in residences continued to be abandoned to their fate for weeks.
As they could not find toilets, the Ministry of Health acted desperately to "medicalize" the residences.
For 12 days, until April 6, “Operation Bicho” worked, the frivolous name used by the daughter of an Ayuso adviser who was put in charge of fifteen toilets.
The Community ordered that team to stop the day that EL PAÍS revealed the case of inbreeding.
Firefighters, Civil Protection and the military made visits to residences to disinfect them and remove bodies, but health reinforcements did not arrive permanently.
Mur details how the Samur had visited eight residences and primary care, another ten.
The transfers to the hospital were produced with a dropper: 57 that day, despite the fact that there were thousands of people in need.
According to the letter of the protocols, only people without dependencies were likely to be admitted to hospitals, but in practice there were hospitals that imposed an absolute blockade and others that filtered by age (only those under 75 years of age).
Escudero's anger
Another conflict at the March 8 meeting was due to an announcement that same morning by Vice President Ignacio Aguado, of Ciudadanos.
The Community was going to enable two hotels for the elderly from healthy residences, as "clean areas" in which they could be safe.
Escudero did not like the news because, he said, he had not been warned.
He asked Luengo several times about it.
At first he avoided the subject, and later, he replied that they had considered those hotels for healthy "when they started working in the medical residences, or whatever you call them."
The technical secretary general of Social Policies, Miguel Ángel Jiménez, came to Luengo's aid: "Perhaps there has been a breakdown in communication somewhere, because there has been talk in several areas."
Escudero replied: "If at some point there was talk, it was precisely to rule out that option."
According to him, the hotels that had been decided to create were "medicalized", intended for the sick.
He made them ugly that they had bypassed his authority, since he was the only health command in the region.
"If you have the health authority over the residences, this is a resource that is now out of the control of Health," he warned them.
According to the minutes, Escudero was annoyed when he found out at Vice President Aguado's press conference.
“If you have a daily coordination meeting, how do you have it?
The minimum was to raise it, report this new resource, and report its announcement”, he protested.
"I honestly don't get it," he told her, according to the record.
“And above all, I can't understand why it wasn't talked about here.
It would be the least."
The clash between the Ministry of Escudero and that of Reyero escalated in the days following that meeting on April 8.
Three days later, the person in charge of Social Policies sent a letter to the head of Health in which he reproached him for the lack of help, referring to the list of 146 mutual health workers: “The fundamental problem in the Community of Madrid is that they do not It has just considered the users of the residences as a priority group within the competence of the single health command.
That is why, instead of sending doctors, you send lists”, says the letter, published months later by InfoLibre.
Alberto Reyero, Madrid counselor for Social Policies during the coronavirus crisis in residences, in a file photo at the Madrid Assembly.Mariscal (EL PAÍS)
Finally, the whole world got to see the conflict between the two councilors on April 14.
Reyero, a serene man, decided to take the step of denouncing the situation in public, on Cadena SER.
He did it after hearing triumphant declarations from several members of the Madrid PP.
The mayor of Madrid, José Luis Martínez-Almeida, announced that the city council of the capital was going to send municipal toilets to Castilla y León.
“It is time for Madrid to show solidarity,” Almeida said.
Reyero revealed to the people of Madrid what representatives of the employers' association would later confirm, among others: the medicalization was fictitious.
In the SER he said that his government had not sent the promised medical reinforcement, despite the fact that the hospitals already saw the light at the end of the tunnel.
"I do not understand that now that there is talk of sanitary withdrawal, these people are not used in residences," said Reyero, who used the same term, withdrawal, that Escudero had used.
What alleviated the situation in the residences was not the medicalization, but finally, after the relief of the hospital situation, the elderly patients were admitted again.
After almost two years, the families of the victims continue to demand justice, although with little success.
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