Spain: Authorities Collide over “Flu-ization” of COVID

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As Spain’s Prime Minister, Pedro Sanchez, became the latest leader to call for COVID-19 to be treated as an endemic illness like the flu, regional health authorities warn that it might be too soon, going as far as calling it a “serious mistake,” an opinion echoed by the World Health Organization.

 

As the sixth coronavirus wave in Spain continues to slow – the number of daily cases is stabilizing, and so too are hospital admissions – the national government is looking to “lead” the change in the COVID-19 surveillance and control system. Arguing that lethality from the disease has fallen from 13 to one percent since the first wave, Prime Minister Pedro Sanchez explained in a radio interview earlier this month that the country has “the conditions to gradually, with precaution, open the debate at a technical level and European level, to start evaluating the evolution of this disease with different parameters than we have until now.”

As Spanish schoolchildren returned to class after the holiday break, Sanchez argued that “the situation is not what we faced a year ago.” His comments echo those made by British Prime Minister, Boris Johnson, last year when he said that his country must “learn to live with the virus.”

Public authorities must speak with caution because “flu-ization” could translate into a generalized relaxation… After so many years, we more or less know how the flu virus behaves, but the novel coronavirus is unpredictable

Enrique Ruiz Escudero, Minister of Health of Madrid

But, as debate over the “flu-ization” of the coronavirus gets traction, regional health authorities in Spain have raised concern about the new approach. In a recent interview with PharmaBoardroom, Minister of Health of Madrid Enrique Ruiz Escudero argued that while he agreed that the overall strategy should change if certain conditions are met, it is “not the right time” to speak about treating the coronavirus as the flu.

“Public authorities must speak with caution because “flu-ization” could translate into a generalized relaxation… After so many years, we more or less know how the flu virus behaves, but the novel coronavirus is unpredictable,” he said.

Overseeing the healthcare system of the nation’s capital, one of Spain’s largest, Ruiz Escudero contends that “big changes should be made once effective treatments for mild cases are widely available… Our current stockpile of approved medicines is not large enough to sustain a big wave of infections and hospitalizations.”

This cautious note is in line with the official position from the World Health Organization, whose director-general has insisted that the pandemic is “nowhere near over”, warning that new variants are still likely to emerge.

The WHO has also emphasized that the severity of endemic diseases is being downplayed. “Endemic in itself does not mean good, endemic just means it’s here forever,” the organization’s emergencies director, Michael Ryan, recently said, citing malaria as an example.

 

The proposed new surveillance and control system

The Spanish government entered the discussion with sufficient credentials: strict lockdown experience and one of the highest vaccination rates in the world – over 92 percent of the population over 12 years has been fully immunized. Early in 2020, Spaniards were ordered to stay home for over three months, not being allowed to go outside even for exercise for a few weeks.

The model being considered by the Spanish government would mirror the “sentinel” system used to monitor flu outbreaks, using sample data from selected doctors to predict and respond to disease waves instead of trying to count every case with the test-and-trace system.

“Now, given [Omicron’s] enormous transmissibility, it is a huge challenge to strictly comply with universal surveillance protocols. It’s becoming impossible,” Amparo Larrauri, who heads the surveillance group for influenza and other respiratory viruses at Spain’s National Epidemiology Center, told El País newspaper.


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