ESPAÑA: The Coronavirus in Spain

Madrid, Spain – 2019: Lessons From a Deadly Place

Last thing I remember
I was running for the door
I had to find the passage back
To the place I was before
“Relax”, said the night man
“We are programmed to receive
You can check out any time you like
But you can never leave”

–The Eagles

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I am an American professor living in Madrid, Spain. In February I watched closely as illness and death swept through nearby northern Italy. It was one of the worst things I had ever seen. Their hospitals were over run, and they looked like something out of the 19th century. Despite Italy’s proximity to Spain, I could not imagine such scenes playing out here. In Spain, the trains run on time.

In early March, my university notified me that one of our students had contracted the Wuhan Coronavirus in Italy and returned to school. Two days later a second student returned from Italy reporting symptoms. The next day our University began conversion to on-line teaching for all courses. Two days later the Spanish government announced the closure of all schools except for on-line classes. By March 12th the Wuhan Coronavirus caused 120 deaths in Spain. Madrid was and would continue to be the hardest hit.

The Government Acts

The next day, March 13th, the Spanish Prime Minister announced the beginning of the strictest lockdown procedures in the world. People were ordered to remain inside their homes. Like most European capitals, people in Madrid live in small apartments, so that was a huge demand. The government allowed limited exceptions that offered little relief.

All businesses were ordered shuttered except for healthcare services, pharmacies, and grocery stores. The supply chain that supported the exempt businesses could also continue to operate. They also mandated employees to perform work at home if possible. People could only leave their apartments to work, buy groceries, or go to the pharmacy. The government required using smaller food stores, the few larger food stores that sold other merchandise were to close the non-food sections.

A New Madrid

The day after the government’s mandate, Madrid went from being one of Europe’s most vibrant capitals to a ghost town. There were no people or cars on the streets. It was quiet, no music could be heard from the cafes that line the sidewalks. It was surreal. For the next two months it would not change.

Spaniards obey the law. The government also put in place harsh penalties for violating their dictated rules. They consist of either a stiff fine (€601- €30,000) and sentences of three to eighteen months in jail. Consequently, compliance was assured. To my knowledge there were no protests, just the opposite. Throughout the lock-down, every night at 20:00 (8:00 pm) people throughout Spain came to their balconies and clapped for five minutes. They clapped to applaud the health care and other essential workers – to say thank you. A different culture.

The Wuhan Coronavirus Strikes Home

I was stricken with the Coronavirus the day the lock-down was announced. I knew from the Mayo Clinic that I had its symptoms and assumed then I had the virus. Spain has socialized medicine, I had been to one of the government’s hospitals for a routine test previously. It brought to mind the poor care we hear about at the Veterans Administration. Before I left, I said to my wife: I would rather die than spend one night in this place.

Everything I had read suggested most people survive the virus, and I had been serious about the hospital, therefore I decided to recover at home. For the first few days I was not that sick and continued my research. That was short lived. Every day I got worse. After three weeks I thought I was going to die. Thankfully I survived it.

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The Real Cost of “Free” Medical Care

The lock-down was not working. With 75% of the population of Italy we would soon surpass their number of cases. As the number of illnesses rapidly increased the government began rationing medical care. The elderly were denied care. Not through callous stupidity like New York would later do, but rather through intentional triage. Here they just sedated the elderly. Patients with other illnesses were denied treatment as well.

As the stories of the hospitals emerged, I also saw pictures of them. People were packed together everywhere even in the hallways, it looked draconian. Apparently it was bad, people began “escaping” Madrid hospitals and being arrested, sometimes hundreds of kilometers away. I thought the elderly are lucky – give me sedation too.

Private Health Care

Every day I got worse. Finally, I thought I would be dead in a week. I did not know how I could get any sicker, yet everyday brought a new level of misery. About three weeks into this misery, my wife announced that I was going to a private hospital that she had found.

She secured admission and an ambulance was soon at the door. I was taken to an isolation area. Nevertheless, I had a fully furnish private room, was free to wear my own clothes, and my wife brought in my computer equipment and other stuff that the staff delivered.

After further testing and x-rays they added advanced pneumonia to my diagnosis. The seemingly endless string of IV drugs worked miracles though. After a week I was told I was no longer contagious and moved to another nice room where I could have visitors. I was also told my lungs suffered a lot of damage, though reversible. After three weeks I was released, but the lung treatments will last a while longer.

Of course, there is no such thing as free health care. Those that work pay for those who do not. My payroll deduction for the free health care exceeds what I pay for the insurance that covered my private hospital stay. The thought of escape from the private hospital never occurred to me, I was grateful.

Systematic Failure

While the failure of socialized medicine was predictable (it had just been witnessed in Italy). The failure of the lock-down was not. By comparison with other countries Spain’s more stringent lock down did little. Spain, despite its small population, experienced one of the highest infection rates. They even surpassed Italy’s, who was caught unprepared. Only the U.S., Russia, and Brazil have incurred more cases, countries with three to six times the population of Spain.

In contrast with Spain, the U.S. lock-down was mostly commercial. The personal restrictions do not compare with Spain’s. Yet Spain’s record is far worse. The U.S. and much of the west is killing its economy, based on theory with no evidence that mass isolation works. Expensive theory.

It appears the U.S. is committing economic suicide. It is time to reverse course, what we are doing is not working. We do not need more isolation –but we need to work. In the US, this strategy has upped the demand for “Medicare for All.” No government-run health care system has been able to handle this crisis in a humane manner, and most have resorted to rationing. On the other hand, the US’s private health care has not run into the rationing problems that have plagued Europe.

Dr. Jack Daniel, PhD
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