- Spain is experiencing a resurgence of COVID-19 cases after lockdowns this spring had brought the disease under control.
- Experts say the spike has occurred because businesses reopened too soon and public gatherings were held without proper safety precautions.
- They add that Spain’s federal government has passed along responsibility for containing the virus to regional and local authorities, which has resulted in confusing messages to the public.
After one of the most intense lockdowns, Spain is now experiencing one of the most intense surges in COVID-19 cases.
It’s a situation that appears to echo the ongoing situation in the United States.
Spain had been one of the countries hardest hit by the COVID-19 pandemic this spring, but it had mitigated the virus’s spread during a 3-month lockdown.
Now, the country’s current resurgence could portend similar upticks elsewhere in Europe.
It also has parallels with and could hold lessons for countries like the United States, particularly in terms of the role of young adults in the spread, the effects of a decentralized public health response, and the struggle to reopen schools safely.
Spain’s lockdown was seen as one of the most draconian on the continent. People were required to stay inside aside from activities such as going to the grocery store, seeking medical treatment, and walking a pet.
Drones and police roadblocks were reportedly used to enforce the measures.
Those measures expired at the end of June. In the next 3 weeks, the rate of infection tripled.
On Aug. 21, new confirmed COVID-19 cases neared 10,000 per day.
In the week and a half since, new cases have declined a bit from that peak, but before the uptick began in early July, that figure had been 500 cases or lower for about 2 months.
A rapid reopening, especially in terms of nightlife and family gatherings, has been cited as partly to blame.
What Spain can teach us
Experts say one aspect of Spain’s resurgence highlights a lesson that countries like the United States will likely want to take to heart.
“In both countries, we have also seen a sharp decrease in the average age of those infected, from 60 to 37 years in Spain, and about the same in the U.S., and almost half of those who test positive are asymptomatic in both countries,” said Amira Roess, PhD, MPH, a professor of global health and epidemiology at George Mason University in Virginia.
That trend does underscore the fact that testing has expanded.
In addition, younger people are less likely to experience more serious cases of COVID-19.
But it could also mean that younger people aren’t taking enough precautions and could be accelerating the virus’s spread.
“It appears that the wave of infections in Spain may be due in part to increases in social gatherings, including at bars, and poor compliance with social distancing and mask-wearing recommendations. These are all trends that we are also seeing in the U.S.,” Roess told Healthline.
“It’s easy to say younger people are more likely to have a milder disease, not be hospitalized, and that’s true, but they’re not immune,” noted Melissa McPheeters, PhD, MPH, a health policy research professor and co-director of the Center for Improving the Public’s Health through Informatics at Vanderbilt University Medical Center in Tennessee.
McPheeters noted reports of children being hospitalized and the fact that they may be interacting with people who are more vulnerable.
Experts say stopping the spread by younger people requires rigorous testing and tracing, especially because they may be less likely to have symptoms.
“Even when you suppress (the virus) to a good degree, it’s kind of like those wildfire embers that are out there smoldering — and it doesn’t take much to restart that wildfire,” McPheeters told Healthline.
To find and smother those embers, she said you need a strong testing and tracing response.
Neither Spain nor the United States has enough contact tracers to effectively respond to outbreaks, according to Roess
Division of authority
That effort appears to have been become complicated in Spain because, like in the United States, there is a division of authority between federal and regional governments — and responsibility for fighting the virus has shifted back and forth.
The federal government took the lead in the pandemic response during the nationwide lockdown, but then reportedly returned powers to the regional governments, leaving confusion and a patchwork of policies.
That scenario may not be unfamiliar to Americans, who have seen their president dismiss the severity of the pandemic and say he takes no “responsibility at all” for the response.
Some states imposed strict restrictions early. Others imposed them later on and rolled them back earlier than experts said was safe, leading to a resurgence in the United States.
There has also been confusion over what the actual guidelines are and how much they matter.
In Spain, McPheeters said, once the lockdown was lifted, “the message that people received was ‘great, let’s go.’ But we need a more nuanced message than that… We can start to open up some things but need to be more careful in other areas — can’t just do it at all once.”
As for guidelines such as mask requirements, “people in the U.S. feel like the actions are restrictive, but we know scientifically that it works — wearing a mask, keeping distance works,” she said.
Confusing messages
The other parallel of this patchwork, decentralized approach from Spain might be just starting to play out now.
“The federal and local governments of both countries have had less than ideal responses to the pandemic, including releasing at times conflicting guidelines regarding whether schools should reopen and how,” Roess said.
McPheeters noted that in some places, like her home state of Tennessee, mask rules can vary from county to county — or even within a county.
While there’s a mask mandate in Nashville, neighboring Williamson County let their mandate expire earlier this week, she noted.
But McPheeters said the school district there stepped in to say that masks would still be required at public schools.
They will also be required for children over age 6 in Spain.
“I don’t think any of us really know what’s going to happen as we open schools,” McPheeters said.
“I think that what’s happening in Spain should be a caution to everyone that we need to open cautiously, need to open carefully.”
Roess noted that despite many schools in the United States opening with minimal in-person instruction, “many schools were quickly forced to close due to students and staff testing positive for the COVID-19 virus.
“Given the similarities between the COVID epidemics in Spain and the U.S., it is likely that schools in Spain will also have problems staying open and that many may have no choice but to suspend in-person activities,” she said.
“We are still learning a lot about this virus, but the evidence suggests that opening schools could mean that more transmission will occur in the community,” she added.
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