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Monge S, Latasa Zamalloa P, Sierra Moros MJ, Pérez Olaso O, García San Miguel L, Varela C, Rivera Ariza S, Vázquez Torres MC, Olmedo Lucerón MDC, González Yuste P, Soler Crespo P, Segura Del Pozo J, Gullón P, Carrasco JM, Martínez Sánchez EV, Redondo Bravo L, Pichiule Castañeda M, Purriños Hermida MJ, Hervada Vidal X, Huerta Gonzalez I, Margolles M, Vanaclocha Luna H, Ramalle Gómara E, Pérez Martín JJ, Chirlaque López MD, López Fernández MJ, Lorusso N, Carmona Ubago A, Rivas Perez A, Ramos Marin V, Criado Alvarez JJ, Castrillejo Pérez D, Góméz Anés AA, Frontera M, Macias Rodriguez P, Álvarez León EE, Díaz Casañas M, Lopaz Perez MA, Alonso Pérez de Ágreda JP, Navas Gutierrez P, Rosell Aguilar I, Arteagoitia Axpe JM, Gonzalez Carril F, Aparicio Azcárraga P, Simón Soria F, Suarez Rodríguez B. Lifting COVID-19 mitigation measures in Spain (May-June 2020). Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:11-17. [PMID: 36621243 PMCID: PMC9817760 DOI: 10.1016/j.eimce.2021.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/25/2021] [Indexed: 04/14/2023]
Abstract
INTRODUCTION The state of alarm was declared in Spain due to the COVID-19 epidemic on March 14, 2020, and established population confinement measures. The objective is to describe the process of lifting these mitigation measures. METHODS The Plan for the Transition to a New Normality, approved on April 28, contained four sequential phases with progressive increase in socio-economic activities and population mobility. In parallel, a new strategy for early diagnosis, surveillance and control was implemented. A bilateral decision mechanism was established between the Spanish Government and the autonomous communities (AC), guided by a set of qualitative and quantitative indicators capturing the epidemiological situation and core capacities. The territorial units were established ad-hoc and could be from Basic Health Zones to entire AC. RESULTS The process run from May 4 to June 21, 2020. AC implemented plans for reinforcement of core capacities. Incidence decreased from a median (50% of territories) of 7.4 per 100,000 in 7 days at the beginning to 2.5 at the end. Median PCR testing increased from 53% to 89% of suspected cases and PCR total capacity from 4.5 to 9.8 per 1000 inhabitants weekly; positivity rate decreased from 3.5% to 1.8%. Median proportion of cases with traced contacts increased from 82% to 100%. CONCLUSION Systematic data collection, analysis, and interterritorial dialogue allowed adequate process control. The epidemiological situation improved but, mostly, the process entailed a great reinforcement of core response capacities nation-wide, under common criteria. Maintaining and further reinforcing capacities remained crucial for responding to future waves.
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Affiliation(s)
| | | | | | | | | | - Carmen Varela
- National Centre of Epidemiology, Instituto de Salud Carlos III, CIBER Epidemiología y Salud Pública, Madrid, Spain
| | | | | | | | | | | | | | - Pedro Gullón
- APLICA Investigación y Traslación Soc Coop Mad, Madrid, Spain
| | | | | | | | | | | | - Xurxo Hervada Vidal
- General Directorate of Public Health, Autonomous Community of Galicia, Spain
| | | | - Mario Margolles
- General Directorate of Public Health, Principality of Asturias, Spain
| | | | - Enrique Ramalle Gómara
- General Directorate of Public Health, Consumption and Care, Autonomous Community of La Rioja, Spain
| | - Jaime Jesús Pérez Martín
- General Directorate of Public Health and Addictions, IMIB-Arrixaca. Murcia University, Region of Murcia, Spain
| | | | | | - Nicola Lorusso
- General Directorate of Public Health and Pharmacy, Autonomous Community of Andalusia, Spain
| | - Alberto Carmona Ubago
- General Directorate of Public Health and Pharmacy, Autonomous Community of Andalusia, Spain
| | | | | | - Juan José Criado Alvarez
- Health Sciences Institute of Castile-La Mancha, Autonomous Community of Castile-La Mancha, Spain
| | | | - Atanasio A Góméz Anés
- General Directorate of Public Health and Consumption, Autonomous City of Melilla, Spain
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Monge S, Zamalloa PL, Moros MJS, Olaso OP, Miguel LGS, Varela C, Ariza SR, Torres MCV, Lucerón MDCO, Yuste PG, Crespo PS, Pozo JSD, Gullón P, Carrasco JM, Sánchez EVM, Bravo LR, Castañeda MP, Hermida MJP, Vidal XH, Gonzalez IH, Margolles M, Luna HV, Gómara ER, Martín JJP, López MDC, Fernández MJL, Lorusso N, Ubago AC, Perez AR, Marin VR, Alvarez JJC, Pérez DC, Anés AAG, Frontera M, Rodriguez PM, León EEÁ, Casañas MD, Perez MAL, Ágreda JPAPD, Gutierrez PN, Aguilar IR, Axpe JMA, Carril FG, Azcárraga PA, Soria FS, Rodríguez BS. Lifting COVID-19 mitigation measures in Spain (May-June 2020). Enferm Infecc Microbiol Clin 2021; 41:S0213-005X(21)00195-6. [PMID: 34274154 PMCID: PMC9791371 DOI: 10.1016/j.eimc.2021.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/19/2021] [Accepted: 05/25/2021] [Indexed: 01/11/2023]
Abstract
INTRODUCTION The state of alarm was declared in Spain due to the COVID-19 epidemic on March 14, 2020, and established population confinement measures. The objective is to describe the process of lifting these mitigation measures. METHODS The Plan for the Transition to a New Normality, approved on April 28, contained four sequential phases with progressive increase in socio-economic activities and population mobility. In parallel, a new strategy for early diagnosis, surveillance and control was implemented. A bilateral decision mechanism was established between the Spanish Government and the autonomous communities (AC), guided by a set of qualitative and quantitative indicators capturing the epidemiological situation and core capacities. The territorial units were established ad-hoc and could be from Basic Health Zones to entire AC. RESULTS The process run from May 4 to June 21, 2020. AC implemented plans for reinforcement of core capacities. Incidence decreased from a median (50% of territories) of 7.4 per 100,000 in 7 days at the beginning to 2.5 at the end. Median PCR testing increased from 53% to 89% of suspected cases and PCR total capacity from 4.5 to 9.8 per 1000 inhabitants weekly; positivity rate decreased from 3.5% to 1.8%. Median proportion of cases with traced contacts increased from 82% to 100%. CONCLUSION Systematic data collection, analysis, and interterritorial dialogue allowed adequate process control. The epidemiological situation improved but, mostly, the process entailed a great reinforcement of core response capacities nation-wide, under common criteria. Maintaining and further reinforcing capacities remained crucial for responding to future waves.
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Affiliation(s)
| | | | | | | | | | - Carmen Varela
- National Centre of Epidemiology, Instituto de Salud Carlos III, CIBER Epidemiología y Salud Pública, Madrid, Spain
| | | | | | | | | | | | | | - Pedro Gullón
- APLICA Investigación y Traslación Soc Coop Mad, Madrid, Spain
| | | | | | | | | | | | - Xurxo Hervada Vidal
- General Directorate of Public Health, Autonomous Community of Galicia, Spain
| | | | - Mario Margolles
- General Directorate of Public Health, Principality of Asturias, Spain
| | | | - Enrique Ramalle Gómara
- General Directorate of Public Health, Consumption and Care, Autonomous Community of La Rioja, Spain
| | | | | | | | - Nicola Lorusso
- General Directorate of Public Health and Pharmacy, Autonomous Community of Andalusia, Spain
| | - Alberto Carmona Ubago
- General Directorate of Public Health and Pharmacy, Autonomous Community of Andalusia, Spain
| | | | | | - Juan José Criado Alvarez
- Health Sciences Institute of Castile-La Mancha, Autonomous Community of Castile-La Mancha, Spain
| | | | - Atanasio A Góméz Anés
- General Directorate of Public Health and Consumption, Autonomous City of Melilla, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
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