Lorraine Williamson
A Madrid court is investigating two former health officials over triage protocols that allegedly prevented elderly care home residents from receiving hospital treatment during the first wave of the COVID-19 pandemic.
Thousands died in nursing homes amid restricted hospital access
In March 2020, during the height of the pandemic’s first wave, nursing homes across Madrid were overwhelmed. Thousands of residents died. Moreover, many were reportedly refused hospital care based on guidelines issued by the regional government.
The protocols excluded people with advanced dementia or high levels of physical dependence. This exclusion occurred despite these individuals suffering serious COVID-19 symptoms.
Who is being investigated?
The court has summoned Carlos Mur and Francisco Javier Martínez Peromingo for questioning. Mur was then Director-General for Medical and Social Care Coordination at Madrid’s regional health service (Sermas). He signed the first versions of the triage instructions.
Martínez Peromingo succeeded Mur in the role and continued with the implementation. The court is examining whether their actions amounted to discrimination against elderly or dependent individuals.
Families seek accountability
A recent legal complaint was filed by 109 bereaved families. They acted just before Spain’s five-year statute of limitations was due to expire. The complaint focuses on potential denial of public services based on discriminatory grounds.
Earlier legal efforts—focused on charges like manslaughter or dereliction of duty—were dismissed. This latest move marks a shift in strategy.
Controversial protocols contradicted national guidelines
Between 18 and 25 March 2020, the regional government issued written instructions to nursing homes advising that severely dependent or mentally impaired residents should not be referred to hospitals. These protocols were inconsistent with national health policy.
Doctors and care workers faced an ethical dilemma. Many were torn between adhering to official guidelines or following their medical judgment and moral obligations.
Families demand justice and memorialise victims
Organisations such as Marea de Residencias and 7291: Verdad y Justicia have long demanded justice. A memorial service will take place on 1 June at Madrid’s COVID-19 victims monument.
Ramona, whose mother died in a nursing home, responded to the court’s move: “We’ve waited years. Maybe this is the beginning of justice.”
Ayuso’s role remains under scrutiny
Regional president Isabel Díaz Ayuso gave a short response. “The case was closed three years ago. It’s only reopened because the prosecutor changed position,” she said.
She declined to address questions about her own involvement or that of her administration. Ayuso’s pandemic strategy, particularly regarding elderly care and hospital admissions, has drawn widespread criticism.
Political figures call for broader investigation
Gaspar Llamazares, doctor and former MP, called the triage protocol “a legal and ethical disgrace.” He argues political leaders, not only civil servants, should be held responsible.
Other public figures echo this sentiment. They say full transparency is needed over how the policy was developed and who authorised it.
As the case unfolds, attention will return to one of the most painful chapters in Spain’s pandemic response—when some of the country’s most vulnerable citizens were left without access to critical care.