There is growing concern that the coronavirus has been in Spain for days and we have not noticed

While cases in Spain continue to increase and the first case of coronavirus in Catalonia is confirmed, in recent hours, newspapers such as El País have reported that "several large Spanish hospitals have begun to search for the SARS-CoV-2 coronavirus" in patients admitted for pneumonia that does not have bacterial origins and does not have the typical complications of influenza.

This decision would supposedly be due to a not-so-far-fetched working hypothesis: that the coronavirus has been circulating in the country for several days and that no one has simply noticed, because the strict protocols of the Ministry of Health prevent the cases in question from being investigated. So, while we wait for more details about what is the first case of the Peninsula, we have asked ourselves, is it possible that the SARS-CoV-2 is already moving around Spain and no one has noticed?

The first case in Catalonia

Arturo Martinez

As confirmed by the Ministry of Health, Catalonia would have activated the coronavirus protocol for a patient who tested positive in Barcelona. The patient, a 36-year-old Italian woman residing in Barcelona, ​​had been between 12 and 22 February in northern Italy and was admitted to the Hospital Clinic on Monday. At the moment, the National Center for Microbiology is preparing to carry out the confirmation tests and the Catalan health authorities have started the procedure to check if there are more cases related to it.

The Secretary of Public Health, Joan Guix, explained that, although the protocol will be constantly modified to adapt to a dynamic situation, all the patient's contacts will have to be quarantined at home under monitoring in case symptoms appear. "The alert in this situation is because it is something new but not due to gravity," said Assumpta Ricard of the Catalan Health Service.

Infections under the radar

Macau Photo Agency

It's possible? At a theoretical level, the truth is that yes. Today, official protocols make it clear that two strict criteria must be met to mark a case as "coronavirus suspect": the clinical one (a table compatible with an acute respiratory infection or a fever with no known focus) and the epidemiological one ( basically having been physically in an area with an active outbreak or having had contact with a possible infected in the 14 days prior to the onset of symptoms).

While the virus was confined to the Chinese province of Hubei, that epidemiological control was simple. From there came the famous two weeks of quarantine that was requested in many contexts from people who had traveled to the Asian country. However, as the virus begins to appear in different parts of the world, screening becomes less effective.

After all, if someone had arrived at a Spanish hospital with mild pneumonia last week after their trip to northern Italy, the doctors would have looked for the epidemiological link with China and ignored everything else before giving them regular treatment. against the most common viral pneumonias. In other words, the virus could have been transmitting under the radar of the health authorities.

The Italian case This was exactly what happened in Italy, that the virus had been circulating for at least a couple of weeks before anyone thought about the possibility that the cases of pneumonia that reached the hospitals could be related to COVID- 19. That is why the 283 cases were quickly reached and the situation has caught them by surprise: because the virus had them many days of advantage.

Is it a possibility to consider? Yes it is. Since the beginning of the crisis, Fernando Simón, the director of the Coordination Center for Health Alerts and Emergencies of the Ministry of Health, has been saying that it is possible that we may have indigenous cases at some point. The appearance of an outbreak in the European Union does not make it more likely.

What do the authorities say? At this time, they are still weighing measures and it is expected that the Inter-territorial Health Council, which has been convened by Salvador Illa, the health minister, will discuss this matter at its meeting this afternoon. Sources in El País estimate that listing all bilateral pneumonia with unusual causes as 'suspected cases' only required the order of 100 or 150 extra tests.

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