Óscar Zurriaga: "I think the elimination of masks in transport can begin to be considered"

He measures every word he says when asked about masks, vaccines, forecasts of new waves of Covid or outbreaks of monkeypox, but not when it is about...

Covid-19 Spain will maintain the mandatory mask on public transport and planes
Health The State Public Health Center becomes an Agency and the bill will have to return to the Council of Ministers

He measures every word he says when asked about masks, vaccines, forecasts of new waves of Covid or outbreaks of monkeypox, but not when it comes to talking about the epidemiological situation in Spain.

In that there is no room for half measures: "

The profession is very precarious with salaries

that are not appropriate and with a great lack of possibilities to develop an active professional career in almost all the fields of epidemiology in which we can consider ourselves".

Óscar Zurriaga has assumed the presence of the

Spanish Society of Epidemiology (SEE)

at a decisive moment, in which the World Health Organization begins for the first time to talk about the end of the pandemic, but in which it is time to rethink structures, recover the rhythm of disease control that Covid hampered and prepare the disease surveillance for the future.

He has assumed the presidency of the Spanish Society of Epidemiology with internationalization plans.

Does Spanish epidemiology have much to envy to that of other countries? From a technical point of view we have nothing to envy.

We are at a very similar level and, on many occasions, even at a higher level.

But from a professional point of view, however, we do have much to envy because

the profession in Spain is very precarious, with salaries that are not appropriate

and with a great lack of possibilities to develop an active professional career in almost all the fields of epidemiology in which we can consider ourselves. Are you not satisfied with the offer of MIR positions that have been decided to do in your area after what happened with the Covid? ?The specialty that concerns us there is Preventive Medicine and Public Health and obviously we are not happy with the situation, but not so much because of the places that are offered but because of those that are not filled.

Those who attend these training places do not usually see the attractiveness of the specialty and this happens because professionally the subsequent places are not the most attractive.

To the extent that this improves, we will get more people who want to opt for this specialty. Just a few days ago a report was published in the

Lancet

which attributes more than 17 million deaths in the world, including Spain, to poor management of Covid, which could have been avoided.

Weren't our surveillance structures well prepared? I haven't read the report yet.

But what we do know is that, in surveillance in Spain, many regional and national administrations have not opted for public health in general or for surveillance in particular.

And, therefore, it is not surprising that the time has come when a greater effort has to be made, as was the Covid,

that effort has had to be made based on more time dedicated to it and also leaving many other issues on hold.

and devoting himself almost exclusively to Covid.

And all that that has stopped being done, and that is now beginning to recover but very timidly, has been parked for two years. What has been stopped doing in epidemiology or monitoring during Covid? depth of virtually all other diseases.

Of communicable diseases, where only emergencies have been attended to, and we have the sample

in monkeypox, which, when it arrived, there have been difficulties in being able to carry out surveys

and that has happened to us with other diseases that require a greater effort, such as tuberculosis. Should we fear significant spikes in communicable diseases due to this lack of surveillance during these two years? Surveillance has not stopped, but it has not been done with the depth that was due.

The data we have is more or less consistent with the previous series, but it has not been possible to carry out in-depth surveillance because the units do not give more than themselves.

What we are not knowing for sure is what has fallen by the wayside and that may suddenly appear as a serious problem.

For example,

in terms of sexually transmitted diseases we already needed better surveillance before the pandemic and that has not been done in these two years.

;

The minimum has been done and, therefore, there we can find important holes that end up generating problems that we are not aware of now. And in non-communicable diseases? That has been completely parked, because practically the only thing that has been monitored in the last two years it has been Covid and very little of the rest, so right

now we have some tremendous gaps that it is essential that we fill in surveillance of non-communicable diseases

and health determinants, which is not being done in a regulated manner in this country.

We have great hope in the new State Public Health Agency, the Surveillance Strategy and the decree that should be published shortly so that with these tools it can be resumed.

But all this will not be possible if the decision-making levels do not make a firm commitment to having a budget, decent jobs and a professional career for all epidemiologists. He said that he has high hopes for the State Public Health Agency.

Are you satisfied with the text of the law that will regulate it?

Do you trust your political independence? From the Spanish Society of Epidemiology we have presented allegations to the text.

It draws our attention that it is a very meager project in terms of articulation and with little detail and, therefore, what we

demand is that there be greater detail

, for example,

of the structure that the future agency is going to have

, of how the management staff is going to be selected. The text contemplates the technical excellence of the staff. But that excellence can only be achieved if the positions are adequately paid and if the selection process is as transparent as possible.

There is a great deal of faith in the future statute of the Agency and

we do not know how that statute will develop

We believe that some of these issues are important and should already be included in the law. What can this new State Public Health Agency really be expected to do? The text talks about the functions of the agency.

And we believe it is appropriate that it expand the functions that were included until now in the law for the state center of public health, that center that the General Law of Public Health spoke of and that since 2011 had not been put into operation.

But we ask that there be some other function that is contemplated for the agency.

What extra functions are you referring to? For example, the text of the law foresees that the evaluation of the Public Health Strategy is among the functions of the agency, but other strategies that must necessarily also fall within the functions of the Public Health Strategy are not mentioned. Agency, such as the Public Health Surveillance Strategy.

How is it possible that this strategy is not mentioned?

And also other strategies.

How is the Agency not going to say anything about tobacco, perinatal health, obesity...?

The Agency must be able to pronounce on these issues and eventually should also participate in the development of these strategies and evaluation should fall into its functions. Will the Agency allow the data chaos that has been experienced during the pandemic to end? In the systems of information, there is a lot of talk about interoperability, but little about what skills there will be in data collection, analysis, protection... It is essential that this is contemplated by the agency and is mentioned in the law even if it is not developed. The memory of the law foresees 14 million for the new Public Health Agency.

Will it be enough? The report includes a budget that values only the places that are going to be transferred to the agency and some basic operating expenses.

This year the General State Budgets already had 9 million for the agency, which we assume will not be executed

because we believe that there will not be time to approve the project before December 31.

We assume that this endowment will carry over to next year, but we don't know.

It would be enough for the places to be well endowed and assigned because they would be covered if that is the case. Just a few days ago the debate on masks was reopened.

Are you in favor of its elimination in transport? In the same way that not introducing measures when the situation was much worse was a mistake, maintaining measures when the situation is better does not make much sense.

Why is the most iconic measure, masks, still necessary?

They are still necessary in health centers and nursing homes where the most vulnerable people are.