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ARCHIVED - Spanish Health Ministry and Madrid agree covid restrictions which can be applied nationally
All cities with more than 100,000 inhabitants would adopt the same restrictions should they meet the key criteria
This could effectively lead to a broader confinement of Madrid.
Madrid continues to report the highest number of Covid-19 cases in Spain; on Wednesday morning the latest total was 2,917 cases detected in the last 24 hours and 46 deaths, bringing the total number of cases detected by PCR to 237,472 positives and 16,374 deaths to date.
With 3,222 hospitalisations,478 patients in ICU, and 16,282 positives in home isolation, the city continues to report not only the highest figures but also the greatest pressure on its health resources, with just under 25% of wards filled with covid patients, but nearly 42% of its total ICU capacity occupied as well, more than double the rate of Navarra, the nearest region to Madrid in terms of its hospital pressure.
On Friday the regional Government extended restrictive measures to encompass 45 health areas of the capital city, but this only affects around 1 million people, or 15% of the population of Madrid and the national Government says Madrid is not doing enough to stem the spread of the pandemic.
The national government has threatened to intervene if the Madrid Government does not take further measures to halt the spread of the virus, and could even go so far as to declare a state of health emergency in the capital if the regional Government refuses to do more, although it is widely accepted that the national government is reluctant to take this measure. The declaration of state of emergency was the mechanism used to lock Spain down in the first wave of the pandemic, but control was handed back to the regional governments after the 21st June at the end of the de-escalation, the regional presidents arguing that they could do a better job of managing the virus at a local level themselves, based on the demographics and specific circumstances within each individual region.
Since the beginning of August the number of cases has increased to such an extent that the phrase “second wave” is now commonly used to describe the situation in many of the autonomous communities, which are fighting to control the virus at a regional level, with varying levels of success.
The arguments focus around the IA rate, or accumulated incidence rate, which calculates the number of cases per 100,000 of population. On Friday, when the disagreement between the national and Madrid governments intensified, the average across Spain was 282 per 100,000; at that point Madrid, was recording an average level of 721.
The graphic below, produced by the Andalucia regional Government, gives a visual idea of the current situation.
The national Government sets an IA rate of 500 as being the point above which additional actions should be taken by a regional Government, but the Madrid government refutes that and says it will only act in areas above 1,000.
Madrid has 286 health districts, and 200 of these have IA rates over 500. In 47 health districts the IA rate is over 1,000 and in eight areas the IA rate is 1800. In the 200 areas with an IA rate of more than 500 are 4.7 million people, three out of every four who live in the capital, yet the Madrid Government is only taking additional measures in 45 areas, only affecting 1 million people, hence the disquiet in the national Government which has repeatedly requested that the regional Government declare a state of emergency and ask for help. The Madrid Government however, is defiant , and says that the measures taken are “adequate”, the president saying, “rather than confining Madrid our mission is to help people” and that “the solution is to locate the 1% who are infecting others and let the 99% continue with their lives.”
On Monday talks began to try and find a solution to the problem, which ran on into Tuesday, and late on Tuesday afternoon it was announced that an agreement had been made between the Ministry of Health and the Madrid Government to implement restrictions in ALL healthcare areas with more than 100,000 inhabitants where the accumulated incidence rate exceeds 500 cases per 100,000 head of population within the last 14 days, “implementing measures to limit mobility, social contact and capacity”according to the Minister of Health.
Madrid has claimed that the government is trying to discriminate against the capital city by insisting that larger areas of the capital be confined, as other areas of the country also meet this criteria, so the agreement is designed to eliminate any accusations of discrimination, particularly political discrimination and would apply a “one rule for everyone” set of criteria which would apply right across the country.
This would then mean that larger areas of Madrid could be confined.
There are 63 areas with more than 100,000 inhabitants potentially affected, most of them in the Community of Madrid and in Catalonia.
At the current time, the biggest city that meets these criteria in Spain is Madrid and another nine areas from the surrounding region: Parla, Fuenlabrada, Alcobendas, Torrejón de Ardoz, Getafe, Alcorcón, Leganés, Móstoles and Alcalá de Henares, although potentially the following could be included in the future should they meet the criteria.
• Madrid: 3.266.126
• Barcelona: 1.636.762
• Valencia: 794.288
• Sevilla: 688.592
• Zaragoza: 674.997
• Málaga: 574.654
• Murcia: 453.258
• Palma: 416.065
• Las Palmas de Gran Canaria: 379.925
• Bilbao: 346.843
• Alicante: 334.887
• Córdoba: 325.701
• Valladolid: 298.412
• Vigo: 295.364
• Gijón: 271.780
• Hospitalet de Llobregat: 264.923
• Vitoria: 251.774
• A Coruña: 245.711
• Elche: 232.517
• Granada: 232.462
• Tarrasa: 220.556
• Badalona: 220.440
• Oviedo: 219.686
• Cartagena: 214.802
• Sabadell: 213.644
• Jerez de la Frontera: 212.749
• Móstoles: 209.184
• Santa Cruz de Tenerife: 207.312
• Pamplona: 201.653
• Almería: 198.533
• Alcalá de Henares: 195.649
• Fuenlabrada: 193.700
• Leganés: 189.861
• San Sebastián: 187.415
• Getafe: 183.374
• Burgos: 175.821
• Albacete: 173.329
• Santander: 172.539
• Castellón de la Plana: 171.728
• Alcorcón: 170.514
• San Cristóbal de la Laguna: 157.503
• Logroño: 151.503
• Badajoz: 150.702
• Salamanca: 144.228
• Huelva: 143.663
• Marbella: 143.386
• Lleida: 138.956
• Tarragona: 134.515
• Dos Hermanas: 133.968
• Torrejón de Ardoz: 131.376
• Parla: 130.124
• Mataró: 128.265
• León: 124.303
• Algeciras: 121.957
• Santa Coloma de Gramanet: 119.215
• Alcobendas: 117.040
• Cádiz: 116.027
• Jaén: 112.999
• Ourense: 105.233
• Reus: 104.373
• Telde: 102.647
• Girona: 101.852
• Baracaldo: 100.881
However, agreement must be reached with the health authorities of the remaining 16 autonomous regions, and this will be sought in the weekly Inter-territorial Health Committee meeting taking place on Wednesday afternoon.
Although Health Minister Salvador Illa, says that the agreement of all of the autonomous governments is not legally necessary, it would be "desirable" politically, for them to do so, and his department takes it for granted that there will be an agreement, because the majority of regional representatives expressed their "good disposition" towards the idea to the Minister on Monday.
This does not rule out, however, that the Madrid Government of Isabel Díaz Ayuso will not find other reasons to object to a more uniform approach and will present further points of disagreement.
And in any case, the central government is already facing the refusal of the Generalitat of Catalonia to apply the homogeneous plan, "we have not needed any agreement with anyone to act. We have made decisions, we will continue to make them and we do not feel challenged by these agreements with Madrid," said the Catalan Minister of Health, Alba Vergés.
Her stance has been echoed by the Basque Country, which is not surprising given the strong separatist agenda of both regional governments, and Asturias.
What are the measures proposed?
The three criteria for apply the uniform restrictions are that the area of more than 100,000 inhabitants must:
-Have an accumulated incidence rate of more than 500 cases per 100,000 inhabitants over the last 14 day period.
-The percentage of positive PCR tests must exceed 10%.
-35% of intensive care beds should be occupied by covid patients
The proposed restrictions (which are subject to amendment) are:
- A perimetral confinement of the area (ie no-on in, no-one out other than for essential reasons)
- Access to parks and gardens closed
- Capacity in hostelry businesses limited to 50% and no consumption permitted at the bar
- Businesses must close by 10pm
- Public and private gatherings limited to 6 people
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