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Given the worrying growth in the contagion curve - on Friday another 3,000 positive cases and 12 deaths were recorded - the main Spanish medical associations this week demanded more actions from the Government to fight the pandemic and prevent a new collapse of the health system.

The Minister of Health, Salvador Illa, has responded with a new package of 11 measures and three recommendations "approved unanimously by all the autonomous communities" in the extraordinary Interterritorial Council that convened on Friday to try to stop the infections. Two initiatives that the experts consulted by this newspaper approve and consider that they will help to limit infections.

"Tobacco is always harmful to health, so any measure that makes it difficult for people to smoke is positive," says Antoni Trilla, head of Preventive Medicine and Epidemiology at the Hospital Clínic de Barcelona. "The main argument is that smokers stop using the mask while smoking and this lack of use in the short distance is dangerous so that restriction of maintaining at least those two meters of distance is welcome, reasonable and prudent because it respects the freedom of the who wants to smoke and protects those who do not ", sums up the professor of Preventive Medicine at the University of Barcelona.

Smoking patients

" These are timely measures that have already been demanded for a long time by both the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and other societies. At the beginning of the pandemic there were contradictory information in France that tobacco protected against Covid-19 but it has been seen in various studies that this is not the case. The disease worsens in smokers ", explains Eusebi Chiner, head of the Pneumology Service at the Hospital de San Juan and director of SEPAR Patients.

"On the other hand, tobacco smoke can act as a transmitter of particles or droplets and its consumption is associated with not wearing the mask and meeting with more people. A smoker also puts his hands to his face or mask six times more than a person who does not smoke, so they have a greater risk of contracting it, "adds Chiner, who believes that the ban on smoking outdoors may serve to reduce the number of social smokers .

As he recalls, "the Anti-Smoking Law was widely protested but it has been fully accepted and respected by practically everyone. We do not know how long we will have to continue to comply with the security measures due to the pandemic but I think it is difficult for this rule already have reverse gear, "he says.

"Covid-19 is a disease that mainly affects the respiratory system. Its main effect is pneumonia and with a diseased lung there is a greater risk that it will evolve worse, " says Cristina Martínez, from the Pneumology Service of the Hospital de Asturias. "There are two types of smokers, healthy ones and those with diseases derived from smoking. In general, chronic respiratory patients tend to take care of themselves and self-confine themselves, which has fortunately meant that we do not have an excess of chronic respiratory patients with Covid ", adds Martínez, who considers that a distance of two meters between people when one of them is smoking is adequate to avoid transmission.

More smoke-free spaces

"We consider it a great advance that throughout the country it is not possible to smoke in public places and that you can only remove your mask and smoke if you are two meters away," says Dr. Andrés Zamorano, president of the National Committee for the Prevention of Smoking (CNPT). "Now the important thing is that all the autonomous communities apply it in a homogeneous way ," says Zamorano, who considers that "these types of measures have to be very clear so that they are complied with and there may be sanctions. But the important thing is that people know that secondhand smoke can transmit smoke, "he says.

From the CNPT they see this measure as "a first step to expand smoke-free spaces, which should include bus stops, private cars, beaches, entrance to schools and proximity to hospitals, among others," he says. Zamorano.

On the possibility of going further and banning smoking on terraces and other open spaces where you stay longer, such as beaches, Chiner is in favor of "not being excessively drastic at first. I think that for now it is a good measure and It is possible that everything will arrive little by little. We know that the virus can remain in the environment, especially at distances of two or three meters, up to 30 minutes, and tobacco smoke is a vehicle that can drive it, so it is possible that further action will be taken shortly, "he says.

Trilla does not believe, however, that the smoke carries the virus: "It is more about exhaling air less than two meters, although it is true that the virus can remain in the air for a long time, especially in closed, non-ventilated spaces. Possibly someone with Covid who If you smoke at home, you will have a better chance of infecting those who are with you . "

The dangers of nightlife

The pulmonologist Cristina Martínez is in favor of closing nightclubs. "We are facing a disease that destroys all the previous paradigms and places us in a situation of uncertainty, so any measure to control the epidemic seems good to me. Health comes first and although the economy is important, nightlife does not seem like a essential activity right now, "he argues.

Eusebi Chiner is also in favor of the prohibition of nightlife: "It is hard to admit it but it is something elementary. Maintaining security measures in nightlife areas, at private parties, discos, especially at this time, is very difficult if not impossible ".

"Not only have there been outbreaks in nightclubs, people are infected in many places but it is known that in closed spaces where there are many people nearby there is a greater risk of contagion. Tracking people is very important and in these establishments, where many People come and go, if they ask you who you have been with, you will only be able to identify your friends, so now that we are in a phase with a high number of infections, it seems like a correct measure ", argues Antoni Trilla. " I understand that the sector says that it will be its ruin but it is a clear public health decision that will help prevent infections ."

"And if it is already difficult to track people who have gone to a nightclub, in a bottle that 30 or 300 people can go to, it is impossible, " says Trilla. "It is taken for granted that it is part of the youth culture but it was already prohibited before the pandemic. Now we must remember that this cannot be done and that the local authorities do their part to monitor that this prohibition is fulfilled as requested Minister Salvador Illa ".

Does this package of measures respond to requests from medical associations? "I think it is an important first step, although there is always a lack of resources in terms of the number of tests carried out, trackers, preventive measures and personnel, of course," says Chiner, who nonetheless believes that "we are going to have a winter quite hard and it is possible that more restrictive measures will have to be taken, perhaps limiting more places of leisure, visits to hospitals and residences ". From their point of view, there is no need to be afraid of further restrictions and confinements.

According to the criteria of The Trust Project

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