Spain seeks to lead a shift in Europe’s handling of Covid-19

New strategy would see virus managed more like the flu rather than as a pandemic

Children return to school after their Christmas holidays in Madrid this week. Photograph: Mariscal/EPA

Children return to school after their Christmas holidays in Madrid this week. Photograph: Mariscal/EPA

 

As Spain’s latest, record-breaking, wave of Covid shows signs of flattening, the country’s government says it is preparing to lead Europe in engineering a major change in the management of the virus.

Spanish daily cases hit about 180,000 earlier this week, the highest such figure since the pandemic began. The incidence rate has also reached new highs, surpassing 3,000 cases per 100,000 inhabitants over 14 days. However, the health ministry has reported that the current wave, Spain’s sixth, could soon subside.

When it does, the left-wing coalition government of Pedro Sánchez wants to pioneer an approach to coronavirus that stops treating it as a pandemic.

In an interview on Spanish radio this week, the prime minister said it was time to start seeing Covid as “an endemic disease rather than a pandemic”. He added that his government has already been in contact with several other European administrations with a view to bringing about what in Spain is being termed the gripalización (or “influenzation”) of Covid – that is, treating it like common flu.

“We have to go from an emergency-style vigilance to one of better quality and which is compatible with other respiratory phenomena,” said the health minister, Carolina Darias. She added: “Spain wants to lead this debate.”

Monitoring

The main change would be the way in which the virus is monitored, rather than how patients are treated. Under the current system in Spain and other developed countries, total numbers of Covid cases are counted each day and testing and tracing is carried out accordingly. 

The mooted so-called sentinel system would not seek to identify every case via testing. Instead, infection numbers would be extrapolated from samples, much the way opinion polls are taken. Also blanket restrictions would be lifted to be replaced by guidelines in order for individuals to be responsible for their own protection from the virus.

The semFYC federation of GPs agreed with the need for a new strategy.

“Let’s stop visiting and testing healthy people who have minor symptoms, let’s stop tracing and testing their contacts, let’s abandon confinement and quarantine,” it said in an editorial on its website. “All these measures, which made sense in the past, have been overtaken by acquired immunity [due to infection and vaccination] and the arrival of Omicron.”

After one of the world’s strictest lockdowns in the spring of 2020, Spain’s approach to restrictions has varied across its 17 regions. Madrid has taken a famously hands-off, economy-friendly approach, while other regions are currently implementing temporary measures.

A curfew is in place in Catalonia, for example, and a Covid passport is required to enter many public spaces in regions such as Galicia, the Basque Country and Andalucía. The only nationwide measure taken in response to the recent Omicron spike over the Christmas period has been the reintroduction of the obligatory use of face masks outdoors.

Sánchez’s government has also insisted on vaccination as an effective tool. Ninety-one per cent of Spaniards over the age of 12 have been fully vaccinated. 

Pilot project

Several of Spain’s regions have already started testing the sentinel monitoring method in clinics and hospitals as part of a pilot project, further fuelling the talk of a transition to a new, flu-like strategy nationwide.

Manuel Franco, a professor of public health at Alcalá de Henares University and an invited researcher at Johns Hopkins University, says debate in Spain about this shift has been encouraged by soaring cases triggered by the Omicron variant, which have made it increasingly difficult to monitor the numbers.

An advantage of dealing with a virus like the flu, he explains, is that its relatively predictable behaviour allows for the kind of proactive approach which has been lacking with Covid.

“With the flu we know months in advance what is going to happen in the autumn – that’s the same in Spain, Ireland or the UK or wherever,” he says. “We can check in advance which vaccine we need, how many doses and how many people will need the vaccine. We’ve become very savvy with this in many countries.”

However, he is not convinced now is the time to change tack.

Coronavirus is not at this point anywhere close to the seasonal behaviour of flu,” he adds, insisting that the “influenzation” of Covid “is something for the future, it’s not something we can apply right now”.

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