This is how the Covid 'miracle' was created in Madrid: antigen testing, restrictions and "individual responsibility"

UNDER REGISTRATION

• VIRGINIA GOMEZ

  Madrid

• ROBERTO BÉCARES

  Madrid

• ALBERTO HERNÁNDEZ (GRAPHICS)

  Madrid

• MAITE VAQUERO (GRAPHICS)

  Madrid

Sunday, 8 November 2020 - 03:14

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• Live.

  Follow up to the minute the last hour about the coronavirus

September 29

.

The epidemiological situation in Madrid opens all the newscasts.

The accumulated incidence (AI) of the virus at 14 days reaches

,

in the region.

The first measures of restriction of mobility and activity applied by the Government of Isabel Díaz Ayuso have only taken a week and the results have not yet been seen.

The health minister, Enrique Ruiz Escudero and his team call for

calm, claim that begins to have

tores that point to optimism

, that the situation is "under control", but the Government of

Pedro Sanchez

He has been focusing on Madrid for several days and pressing for more measures to be taken.

In the end, a few days later, he ends up imposing the criteria that support

the closure of the region

in the Interterritorial Health Council, but

the curve was already going down

.

That September 29, the region led the nationwide infections with almost 800 cases of AI.

Only Navarra, with 686 cases, followed closely

.

The rest of the Autonomous Communities were below 500. Today, just 40 days later, Madrid has completely reversed the situation.

The AI ​​at 14 days is

364 cases per 100,000 inhabitants, almost 60% less

than in the peak week (September 14-20).

Madrid has gone from being the leading European region in infections to being the

fifth Spanish community by the tail

, only behind the Balearic Islands, Galicia, the Canary Islands and Valencia.

If the seven-day AI is taken into account, the data is even more surprising.

Madrid has

one of the lowest incidences of the main European capitals

: 160 cases, below Brussels (623), Paris (499) and Berlin (162). What happened?

How has Madrid managed to reverse the situation, go from being the leading region in infections to being an example when we face the moment when the coronavirus can do more damage, the arrival of winter?

According

Antonio Zapatero

, Deputy Minister of Public Health and Covid-19 Plan, the methodology applied by the regional government in the Basic Health Zones, which allows them

know in detail the incidence through streets and portals

, has been key to controlling this wave. Thanks to this system, restrictions on mobility and economic activity have been imposed only in those areas where cases have soared, which is "more effective than doing it in larger areas", according to Zapatero , and it has been achieved that in just six or eight weeks, areas of

Vallecas, Villaverde, Carabanchel or Usera

, which reached 1,200 and 1,300 cases per 100,000 inhabitants, have reversed their situation, now registering just 200 or 300 infections, he explains.

But for the Deputy Minister of Public Health

«The main thing in the change in trend» has been the incorporation of antigen tests

, a test that yields results in 15 minutes, compared to the days that PCR takes, and that allows "immediate isolation of the infected patient and cut transmission."

Since the end of September, Madrid has carried out

about 600,000 of these teas

t, «the most in Spain».

Of these, about 270,000 were screened residents of the most affected areas.

In parallel to the fall in the number of cases, other important aspects give clues about the improvement of Madrid.

Hospitalization in the ward has decreased by 27%

from the peak week (13.9% of the beds are occupied) and

that of ICU, 6.7%

(43% are full), although they are expected to fall "more strikingly in the coming weeks."

The

pressure on emergencies

40% and in Primary Care, more than 60%.

And the

number of deceased

newspapers, which exceeded fifty at the end of September, now ranges between 35 and 40. Despite everything, the deputy councilor insists on being "cautious", aware that

"CCAA that were well a few weeks ago have had an explosive behavior"

and that the rules that the Madrid government has imposed - which "do not apply to everyone," he says - remain for the moment not being fully complied with.

For

Jose Jonay Ojeda

, epidemiologist and public health expert, it is still too early to certify the consolidation of the downward curve, although he admits that the

decrease in hospital pressure

-There has been a reduction of 1,000 Covid patients admitted in just under a month- sends a positive signal, since

"It is a more solid and reliable data"

than AI to witness improvement. According to this expert,

Knowing the keys to Madrid's success is "the million dollar question and it will only be known with time"

, although he considers several hypotheses.

Like the health officials of the regional government, he believes that the use of antigen tests "may have helped people to have information more quickly" and comply with "isolation" before those who undergo PCR. "Madrid with antigens have had

a more aggressive strategy than other CCAA

», Points out Ojeda, who even so states that these tests do not have« the same reliability with asymptomatic patients »as the PCR and appreciates that sometimes« massive screenings have been carried out in population groups where there was a low prevalence of contagions », therefore its use may not have been as decisive as the regional government points out.

However, it acknowledges that

"Many cases of contagion do not escape him"

to the regional health authorities "when we see that the income figures are controlled". A second factor that could explain the better situation in Madrid has been "individual responsibility."

"With so much emphasis not only from the Administration but also from the media on" the rebound, there has been a

"Deterrent effect"

which has caused many people to take many precautions again.

Another explanation that "falls within the scope of hypotheses," points out this expert, is that in some population groups where contagions are centered in this second wave, mainly "the younger population, who have more social contacts," may " be reaching some

immunity levels that make it harder for them to spread

», Alluding to herd immunity.

Finally, Ojeda indicates that

the efficiency of the restrictions for Basic Health Zones is still up in the air

, since, as a study by the Polytechnic points out, the exceptions that allow going out and coming in mean that in some of them mobility has been reduced very little, which is

a priori

one of the main contagion factors.

"There have been no major differences between the basic areas with restrictions and those without"

, he assures.

However, Salvador Tranche, president of the Spanish Society of Family and Community Medicine (Semfyc), sees the causes of the fall of the curve in Madrid from another perspective.

Although he acknowledges that the decisions made by Madrid "are working", the Ayuso government, he assures, must "continue to make an effort" because until now

"It has not managed well the outbreaks or the resources in Primary Care and Public Health"

.

And he warns, faced with "a certain social relaxation", that "the situation is dynamic" and that

"ICUs can be filled in three days"

.

For Tranche, the decrease in cases

"It is due to the fall of social relations" since "Madrid made decisions before other CCAA"

rather than conducting tests, which, although "they have helped", have been insufficient.

“You have to diagnose more, report quickly, and enforce quarantines.

It's the only way"

says the president of Semfyc, who assures that "testing by neighborhoods contributes little" and that it is preferable to focus on close contacts and their circles.

"If the disease is not controlled and professionals are hired, there will not be enough beds," he concludes, referring to the construction of the new pandemic hospital.

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