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Table of Contents
Year : 2020  |  Volume : 2  |  Issue : 2  |  Page : 122-123

COVID-19: Spain is Not Different

Department of Legal Medicine, Psychiatry and Pathology, Complutense University; President, Juan José López-Ibor Foundation, Madrid, Spain

Date of Submission16-May-2020
Date of Decision29-May-2020
Date of Acceptance08-Jun-2020
Date of Web Publication14-Aug-2020

Correspondence Address:
Prof. Maria Ines Lopez-Ibor
Faculty Medicine, Avda Moncloa, 28040 Madrid
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/WSP.WSP_27_20

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How to cite this article:
Lopez-Ibor M. COVID-19: Spain is Not Different. World Soc Psychiatry 2020;2:122-3

How to cite this URL:
Lopez-Ibor M. COVID-19: Spain is Not Different. World Soc Psychiatry [serial online] 2020 [cited 2023 Feb 6];2:122-3. Available from: https://www.worldsocpsychiatry.org/text.asp?2020/2/2/122/292116

A disaster has been defined as an event that exceeds the adaptation capacity of the social group. The novel coronavirus has revealed the fragility of human lives and of our societies; we have realized that most of what we have been taken for granted: our time, our freedom, or even the way we related to others can be changed dramatically by a virus. Social fragility is one of the causes and the consequence of this pandemic.

In Spain, the first case was reported on January 31 in La Gomera, a very small island in Canarias; a male tourist that had been in touch with a Wuhan citizen became unwell, all his contacts were put in quarantine, and the case was solved with no major impact.

However, on February 13, a Mobile World Congress was canceled; up to 100,000 participants were expected to attend to this meeting in Barcelona, at the end of February. At this time, our prime minister and the health authorities have considered that the risk was very low, and that our country has enough resources to treat patients and to prevent contagious, and therefore, it was not understood the reason for this cancelation. However, just 2 weeks later, the first severe case of COVID-19 infection was confirmed (February 27), a 77-year-old woman who lived in Madrid Community; at that time, 27 persons were infected in Spain, and three cases have not had any contact with people from Italy or China. Social distance was recommended but no one took it seriously, probably due to our lifestyle and the way we related to others.

The WHO on March 11 confirmed that COVID-19 was a pandemic;[1] in Spain, 2200 were infected, and then we realized that we were going to face a tragedy.

On Saturday, March 14, the Spanish government imposed a nationwide quarantine.

Every hospital was transformed to attend only patients of COVID-19 and emergencies, and several new facilities were open in weeks. A hospital in IFEMA, which is the biggest convention center in Madrid, was ready to attend patients in a week.

All other medical consultations except oncology, gynecologist, and emergencies were postponed, and half of all general practitioners were sent to the hospitals to attend these patients, and psychiatric patients were sent to monographic hospitals.

One of the main problems since then, is the shortage of protective personal equipment for health workers, and, as a result, many of them were infected, up to 36,000. This is probably one of the reasons of why Spain is more deeply affected, as well as not been able to do many polymerase chain reaction test, and as a result, the number of new infections were not controlled.

After 40 days of quarantine, more than 22,000 people have died and up to 220,000 infected. Many of them had not taken even the possibility to have had access to health services, especially those who lived in old-age homes.

Now, we can say that our health system is working with no major pressure, and in the next weeks, normal medical activities will continue, and authorities are starting to think that probably at the end of May, most of the normal activities can be restarted.

The second phase of the pandemic is the social and economic consequences. Everyone of us will be directly or indirectly affected. Spain is a very solidarity country, and there are many people, charity, and churches that are helping those people with more difficulties or poverty, but nearly 2,000,000 workers lost their jobs since then.

Psychiatrists and other mental health professionals are becoming now increasingly important; we did not have previous experiences on the mental health consequences of quarantines or pandemic, but we have experience in other disasters such as terrorism. We know that more than 30% of the people exposed to a disaster will have some symptoms, and up 10% will probably develop a mental disorder, such as posttraumatic stress disorder. We are not sure if these data will be applied to this situation but undoubtedly is going to have a very serious impact on the mental health of the general population, especially in those who had been infected and had to be isolated in the hospital, or families that did not have the opportunity to accompany the beloved person in the end of her/his life.

Health professionals will be also affected and that they will need support not only now to help them to overcome stress, fear, frustration, sadness, or fatigue but also in the long term to prevent them to have a more serious mental disorder.

We are providing psychological first aid as first line to help the general population to deal with emotional acute distress, which is offered by specialists (psychologist) and by trained and supervised community workers in the health and social sector.

In this pandemic, those who are currently suffering from a mental illness are probably at more risk of relapse, there are less possibilities to attend to a consultation, admissions in the hospital which is putting a lot of pressure in families. Resources such as daily telephone contact or telemedicine are now used as a routine to follow patients and make sure they are receiving their treatment.

We are now working in a different way, we cannot wait for patients to come to our offices asking for help or treatment, we are trying to identify them previously, and we are implementing more prevention programs, using more new technologies that will allow an immediate and safe response.

We not only need to train the general population health professionals in acute stress response but also find ways to protect the emotional well-being. Community self-help and social support should be strengthened, by creating more community groups, and we have to learn from previous experiences in the low- and middle-income countries that have implemented very successful programs to help stressed patients by training grandmothers to listen to them, a program developed by Dr. Chivanda in Zimbabwe, or programs developed by Prof. Murthy in India, to fight the stigma of mental illness by training mothers.

Emotional instability, stress reactions, anxiety, trauma, and other psychological symptoms are frequent after the disaster; most affected people will recover with time and help, and it is an opportunity to social psychiatry to help the people and society, in general, to become more resilient. Mental health is crucial for the social and economic recovery of individuals, societies, and countries. Social psychiatry has an important role to help individuals and societies to become more resilient after the COVID-19 pandemic.

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Conflicts of interest

There are no conflicts of interest.

  References Top

World Health Organization. Mental Health and Psychosocial Considerations during the COVID-19 Outbreak. Available from: https://www.who.int/publications-detail/mental-health-and-psychosocial-considerations-during-the-covid-19-outbreak [Last accessed on 2020 May 01].  Back to cited text no. 1


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