After weeks mired in controversy over the lousy data on the advance of the pandemic, the Community of Madrid will apply from this Monday a series of restrictions in 37 basic health zones. Measures, in the words of the regional president, Isabel Díaz Ayuso, “extraordinary but very necessary” and that are part of a “serological” strategy based on “detect and diagnose”.
Despite expectations, the new rules do not convince the neighbors or the experts, which point to the “conurbation” of the metropolitan area, the short period of application (14 days) and the doubts about whether they are accompanied by an increase in resources for those affected.
For Javier Segura, from the Madrid Public Health Association, “effectiveness will be limited when applied to 37 areas and not the rest of the region“. This doctor is clear:” Community transmission throughout the region is high enough to restrict mobility as in a Phase 1 relieved“.
“We doubt that the perimeter confinements can be executed,” he says. In her opinion, it would be necessary to act on three factors: housing, work and social conditions. “Enable housing alternatives to comply with quarantine and solve presenteeism“of those who cannot telework and have precarious contracts with “surveillance and sanctions” against employers being fired are some of the alternatives he proposes.
This doctor asks “an emergency social income, transitory, because the aid is not reaching the people, there is a cap “even to receive the Minimum Living Income. In your opinion,”the lack of social assistance forces mobility to look for life as it is “.
“It has been radical with the weak”
“It has been radical with the weakest. The measures do not attack the root of the problem in the conurbation that is Madrid and its metropolitan area, which form a social, economic and labor continuum. It is very difficult to isolate units of activity“, he maintains.
In his view, “there have been economic pressures not to stop, but it will not be effective and we will lose two weeks“, he concludes.
For Professor Fernando Rodríguez Artalejo, from the Autonomous University of Madrid (UAM), the restrictions “are already being applied in other places in Spain.” “It is a package of measures in which each separately is insufficient to control the curve, but acting energetically they can have a certain effect ”.
“It is very important to ensure that the measures are implemented and followed as designed and that massive tests are carried out quickly. It is not possible a priori know the magnitude of the effect or how long is necessary for it to manifest itself “, continues this professor at the Faculty of Medicine.
“You have to wait and see. If it’s not enough, these measures will have to be extended to other areas of Madrid and even intensified“, apostille.
For José María Molero, from the Madrid Society of Family and Community Medicine, “it’s hard to make a forecast“.” Sure it will reduce the transmissibility but we do not know by what percentage. It will depend on the compliance of the population. Although there will be surveillance and control, the population will not be confined as in the first part of the pandemic and the time will be reduced. Results are not likely to be as effective“says
“It is not enough to take a test”
Molero believes that screening by test quick to detect symptomatic and above all asymptomatic “is a good measure” and ensures that “whenever the population makes the quarantine, will reduce the risk of contagion within the areas and even outside “.
Despite this, he emphasizes that these tests and those made to the contacts of the positive ones “must be carried out outside health centers and by professionals other than the staff of these centers. “These centers, he adds, will correspond” the clinical follow-up of patients who test positive in the screening, but it must strengthen health centers in a real and effective way of these basic areas “.
In addition, he points out that as more cases are diagnosed, “it involves more work for these centers, not only with follow-up but also with bureaucratic activity management such as prescriptions or sick leave. “
In Segura’s opinion, “in addition to the risk of false positives and false negatives, it is not enough to do them if they are not accompanied by more resources“to meet the needs.