Santiago Moreno: "The outbreaks were inevitable, but we should not have reached community transmission"

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"The problem has not been the outbreaks, but rather that we have not controlled them and prevented the community transmission from being reached, which is where we are. The responsibility for having reached this situation must be shared between the civic spirit of the citizens and the proper monitoring of outbreaks to achieve containment. The first is difficult to control, but the second

. "

Not even the presence (virtual on the other side of the screen) of the director of Public Health of the Ministry of Health, Pilar Aparicio, has prevented the I National Congress of Covid-19 from starting this Sunday with criticism of many aspects of the management of the epidemic and pointing out the mistakes that Spain should not make again when facing this second wave.

Santiago Moreno, head of Infectious Diseases at the Ramón y Cajal Hospital in Madrid, in charge of the opening speech, has expressed himself thus, noting that "

. We know that these are not comparable data because now more PCR is performed on asymptomatic patients in contact studies or screening, but what is clear is that there is a community transmission. And if in March, with the confinement of the entire population, it took us two months to return to normal I don't want to think how long it will take now to do it without confinement. "

The head of Infectious at the Ramón y Cajal Hospital acknowledges that until it became known what was happening in Lombardy in the first wave, no one in Spain imagined what was to come, but, nevertheless, he has hinted that

, from the SARS experience, that a week's delay in the application of the measures could triple the cases.

"If the confinement measures had been applied only a week in advance, our epidemiological series would have been really different. And surely we could have avoided that delay. That is something to learn from," Moreno said.

A health worker draws blood from a woman in Arroyomolinos, Madrid.EDUARDO PARRA / EUROPA PRESS

Lack of leadership

In his opinion, institutional leadership has also been lacking "and is still lacking", and protocols have been left over "because there has been no institutional recommendation that had such force that health centers and hospitals did not feel that they had to make their own protocol" on how Act.

In addition,

"with recommendations beyond the doctors' point of view, for example when someone with a clinic was refused a PCR if they had not had direct contact with a positive. "

Chanting the

has acknowledged that there have also been errors in clinical performance, not only in Spain, in which "drug treatment has been based more on impressions than on evidence.

With a critical spirit, Moreno, who ended up in intensive care after being infected in the first wave, has acknowledged that in terms of research

and has criticized that "we have been unable in Spain to mobilize large institutional resources to . that investigation

: a symbolic gesture was good, but a profound change must be made in the assessment of research if we want to

get somewhere ,

"has ruled.

A different situation from March

Moreno intervened in the congress that is being held virtually just a few minutes after the general director of Public Health of the Ministry of Health, Pilar Aparicio, for whom the current situation "is very different from that of the start of the pandemic, which shook so early and explosive to our country, both in detection capacity, as in severity of diagnoses, lethality and hospital occupancy. But

Aparicio has put figures on the table to avoid showing that the situation of the epidemic is far from that of March in his opinion:

, with an average of 60,000;

Of the cases that were detected, almost 55% required hospital care, while at present there are less than 5%, and between 40% and 50% are asymptomatic.

The fatality is also very different since at the beginning of the epidemic it was 12-13%, while since May and until now it has dropped to 1%, with the global average standing at 5.5%.

Link with nature

Although the situation is not epidemiologically comparable and although knowledge has advanced enormously in these six months of pandemic, the director of Public Health and Environment of the World Health Organization (WHO), María Neira, has already warned that

if public policies are not adopted to reinforce the triangle between human health, animal health and the ecosystem.

"In 60% of the new viruses we have seen that they come from human contact with wild fauna with which there should have been no relationship", and that it has been caused either by excess travel, or by deforestation, droughts or situations that they transcend human health care and epidemiological surveillance.

Looking at these deep causes,

and invest in essential services such as drinking water: "The first recommendation in this pandemic is to wash your hands frequently But half the population does not have access to drinking water or soap, "he harshly sentenced.

Resisting the urgency of the coronavirus epidemic displacing what is important, Neira has also pointed the finger at fossil fuels: "

. Let's hope that when we remove our mask we can continue to breathe clean air. "

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