Italy remains the world's worst-hit country, with more than 7,500 dead. Italian authorities, though, indicated Wednesday that their outbreak may have peaked, with the daily death toll dipping to 683 in the previous 24 hours.
In Spain, experts anticipate the situation will get worse before it gets better. That's a daunting prospect for the country's overstretched, exhausted health services.
“There are some hospitals which have already collapsed,” said Oriol Mitjà, an infectious-
disease specialist at Germans Trias i Pujol Hospital in Barcelona. “They have to make a decision when to admit a patient to intensive care or not, and the criteria is mainly by age, so some elderly people are not prioritized.”
Mitjà said his team expects the country’s intensive-care beds to be completely filled by the end of the week.
Among those who have been hospitalized is Spain’s deputy prime minister, Carmen Calvo.
Spanish television has broadcast images of sickened patients sleeping in hospital corridors, while staff complain that medical supplies are so low they’ve been forced to use plastic garbage bags as protection instead of gowns.
Madrid has been forced to turn an ice-skating rink into a morgue to cope with the dead.
In one particularly macabre development, Spanish soldiers found the bodies of elderly people abandoned in nursing homes.
The intensity of the outbreak in Spain — which identified its first mainland coronavirus case only a month ago — drives home the notion that Italy is no outlier, epidemiologists say. Across Europe, hundreds of millions of people face severe restrictions on their daily lives, as authorities attempt to battle community transmission. But some countries, including Spain, have been criticized for being too slow to intervene and to mandate social distancing.
Spanish authorities imposed restrictions on trips outside the home a little under two weeks ago. While city streets are largely deserted, and many companies have asked employees to work from home, that is not mandated, and commuter trains are still running, albeit at 50 percent of their services.
“What has happened in Europe, not just Spain, is we underestimated this virus,” said Mitjà, who has pushed for a further tightening of the restrictions on movement.
Health authorities have been scrambling to add capacity. This week, the military set up a provisional hospital with 1,300 beds at a Madrid convention center in just 24 hours.
Spain has about 6,000 critical-care beds, of which 3,166 are being used to treat coronavirus patients, according to Spanish authorities. Hospitals have delayed nonessential surgeries in an effort to free up beds, but it is unclear how many of those beds remain available.
Fernando Simón, who heads Spain’s coordinated emergency health response, said it is difficult to determine exactly where Spain is on the coronavirus curve, but he expects the peak of new cases is “very close.”
Still, he told health-care professionals to brace themselves, as there is a delay before that peak is reflected in the number of patients arriving in hospitals. “We are in the tough week,” Simon said.
The Spanish government has faced particular criticism for failing to ban mass events as the virus took hold, especially the decision to press ahead with a 120,000-
person women’s march in Madrid on March 8.
“There were thousands” of women in attendance, said Mitjà. “That could have been the trigger and the reason why Madrid is the number-one place affected. We did not work quick enough with control strategies.”
Calvo, the deputy prime minister, had urged people to attend the march. Other high-profile attendees — including the prime minister’s wife, Begoña Gómez, and two other female ministers — have since tested positive.
Some experts have also pointed to Spain’s particularly social culture and love of late-night gatherings as factors that may have helped the disease take hold.
Lockdown measures in Spain have reduced transmission rates, Mitjà said, but they remain high enough to sustain the virus, with each infected person passing the virus on to an average of 1.7 people.
Covid-19, the disease that develops from the novel coronavirus, is particularly dangerous for the elderly and has swept through the country’s nursing homes. The military took control of all residential facilities this week, making chilling discoveries when they did so. In a television interview, Defense Minister Margarita Robles said soldiers had found elderly residents abandoned by staff and left “dead in their beds.”
“We are going to be extremely firm with this kind of negligence,” she said.
But staff members have complained they do not have the proper protection to tend to the sick or move bodies. More than 22 people died at the Santa Hortensia nursing home in Madrid, according to Spanish media reports.
The availability of such protective supplies has been a persistent complaint during the outbreak.
“This is an overwhelmed system,” said Angela Hernández Puente, deputy secretary general of the Madrid doctors union AMYTS. She said front-line medical workers had been “overworked and overextended for weeks now.”
“They are angry,” she added. She said that two family physicians had died after contracting the coronavirus, and she expected more deaths of medical workers to follow.
A group of national medical associations sent an open letter to Spanish authorities Tuesday, decrying the lack of protective equipment.
“We health workers find ourselves in a situation of complete insecurity and lack of protection while conducting our duties of assistance and prevention . . . given the inadequate and very risky health conditions, and the lack of protective material and equipment supplies necessary to guarantee the precise safety of ourselves, as well as the patients,” they wrote.
With the international medical market struggling to keep up with demand, countries in Europe have turned to China for assistance. Spain’s health minister, Salvador Illa, announced Wednesday that the country had purchased $467 million in medical supplies from China, including 950 ventilators, 5.5 million testing kits, 11 million gloves and more than half a billion protective face masks.
According to the Spanish Health Ministry, about 14 percent of those who have tested positive are medical workers. Spaniards gather on their balconies at 8 p.m. each evening to applaud the country’s health and security services.
About 10 to 15 percent of health workers in Catalonia are reported to be sick or in isolation. At La Paz hospital in Madrid, 426 medical professionals cannot work, according to Hernández. That makes up 22 percent of the hospital’s doctors and 28 percent of nurses.
Hernández said she was surprised other countries were not acting more decisively. President Trump has said he wants to see the United States “opened up” by Easter, with the churches full.
“There are countries that, even when given the clear case of what’s happening in Spain, are not learning the lessons,” she said.
Morris reported from Berlin.