Spain and Covid – the view of a foreign medical practitioner

by Deborah Cater
Quiet Spanish beach due to covid

For a personal impression of life in Spain and Covid, InSpain.news asks Dr Jan Otto Landman to share his views with us. He lives and works in Spain (Costa del Sol), arriving more than 20 years ago. His medical practice is in Torremolinos.

Quiet

Our practice in La Carihuela (Torremolinos) on the Costa del Sol is still unusually quiet. Because of Covid few tourists come, many hotels, bars and restaurants are closed. It is a pity that so few tourists can enjoy the blue skies and the warm spring sun.

Positive tested patients

Last week we started COVID rapid tests at the practice. We did the first test on a patient who had had nausea and stomach complaints with a fever of up to 38.5 for a few days. Two days of nausea treatment had not worked and the fever had not gone away. COVID can also start with just stomach complaints, so we did a quick test. Positive. We referred the patient to the hospital for a PCR test. This was also positive. Because the gentleman was normally in good physical shape, he was sent home to go into quarantine for 10 days.

Last week we had a lady admitted to the hospital with a cough and (also) abdominal complaints, she turned out to have a positive PCR test and a COVID pneumonia. She has since been found in good condition.

Relaxation during the Christmas festivities

In the first weeks of December, the number of new infections in Spain was relatively low and in Andalucía the figures were even better. At the time, Spain was one of the countries with the lowest infection rates in Europe, which led to relaxation around the holidays (here from December 24 to January 6). Critics predicted a spike in infections after the holidays and proved to be right.

The number of infections increased tenfold. Increasing pressure on hospitals led to critical situations in some regions. However, due to the stricter measures, the number of new infections has decreased sharply and a less strict regime seems possible in the short term. Easing measures to provide some relief to the population around the holidays in exchange for restrictions afterward, there was certainly something to be said for it. And it proves once again the effectiveness of measures. 

COVID vaccination in Spain 

Vaccination is a race against time. The sooner a large part of the population received vaccinations, the sooner we regain our freedom; the more people and companies will survive and the fewer people will lose their jobs or run into financial difficulties. The British, whose COVID policy was often debatable, did understand vaccination. Meanwhile, more than 15 million people in the country have been vaccinated and they hope to reach 20 million by the end of February!

The vaccination campaign in the UK could be completed before the summer if there are sufficient vaccines. In Spain vaccination seems to be going reasonably well, though slower. More than 2.5 million people have now been vaccinated. Also several mayors, hundreds of civil servants, a minister in Murcia (and his wife) and some top people of the Guardia Civil…. Not that they are vulnerable or working in the front lines against the virus, not that. Just corruption. The minister in Murcia has been fired, the top man of the Guardia Civil kept the honour to himself. 

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Different vaccines and age groups 

There are now three approved vaccines, Pfizer-BioNTech, Moderna and Astra Zeneca. After the problems with Astra Zeneca deliveries, Spain has only approved this vaccine for people between 18 and 55 years old. It is considered insufficiently proven that the vaccine is also effective in the elderly. Due to the small number of elderly subjects in the Astra Zeneca studies, no reliable conclusions could be drawn for this age group.

Germany also has an age restriction. South Africa has banned the Astra Zeneca vaccine because it appears to have limited efficacy against the South African variant. The next vaccine that could be approved is from Janssen Pharmaceuticals (Johnson & Johnson). One vaccination is sufficient for this vaccine. 

Vaccine delivery struggle 

Western countries struggle over deliveries from pharmaceutical companies that do not keep their agreements. The virus mutates and vaccines may have to be adjusted. With bad luck, there will soon be a mutation that the vaccines will not work against. Or we need a new adjusted vaccination every year. Annoying for us, great for the pharmaceutical companies.  

What about effective drugs against COVID? 

In the meantime, you hardly hear anything about the development of effective drugs against COVID. For example Ivermectin, Vitamine D and hydroxychloroquine appear to be potentially successful agents; inexpensive, safe and potentially very effective. Strange right? Or not, with a drug you only treat the sick, with a vaccine everyone, much more attractive for the pharmaceutical industry.

We are becoming increasingly vaccine-dependent because we citizens have been handed over to multinationals by our passive governments. Governments would rather cut back on healthcare and science than support our top scientists in drug research, which, in time could be more accepted and cost-effective. Unfortunately, ‘Big Pharma’ decides, and as long as there are no effective drugs, vaccination is indeed the best option.  

Interests and inequality 

By the summer, most Western countries may be well advanced with their vaccination campaigns. Then we have our freedom back. In many developing countries it will be a few more years before this is achieved. Because, in fact, we as Westerners in the world behave a bit like the corrupt civil servants in Spain; our own interests prevail. In the meantime, the virus continues to proliferate in those poorer countries with the chance that a new variant will emerge to which our acquired immunity has no answer. And of course, that variant will come to Europe and we start again. Not a bad prospect for ‘Big Pharma’ and its shareholders.  

In the meantime let’s hope it won’t happen that way. Be careful, enjoy – if possible – the Spanish shunshine and stay healthy! 

Jan Otto Landman, MD, PhD

 

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