As already happens in the pandemic, a sanitary decision to make the use of face masks compulsory in health centers returned this week with different strategies to deal with the epidemic, which the Basque and Spanish governments fought.
The Ministry of Health has been recommending the wearing of masks but does not want to make their use mandatory. because?
— Indeed, there is evidence that masks act as a barrier to infection, which is why they have been used for more than a century. It effectively prevents the spread of microorganisms from one person to another. But the Ministry of Health’s order requiring mandatory mask wearing in health centers in response to the flu epidemic is not an effective measure in itself. The reason is that the virus is not just found in health centers or hospitals. Viruses are everywhere, in traffic, at work, in leisure spaces, on the streets, etc… Therefore, using barrier tools in a very specific area does not prevent the spread of the virus. Community.
You confirm that the Ministry has not advanced any arguments for unilaterally mandating the use of masks.
Such public health measures must have a technical basis, which means we must understand how the epidemic curve evolves, how the virus evolves, and how social and organizational interventions are implemented. The order to put on or take off a mask is not just an order from the person who writes it in the newsletter. This requires social intervention. Public health is not a matter of ideology or what one person thinks needs to be done. This is a technical matter that requires knowledge and guidance, and I believe this more technical part is not yet reflected in the Ministry’s order.
Why is it only enforced now?
That’s the problem. Increased influenza virus transmission has been with us for more than four weeks. The spread of the virus in the Basque Country has been increasing and progressing significantly since mid-December. Typically, the flu spreads after a few weeks. It can continue to grow for five to six weeks and then, although a specific epidemic peak cannot be foreseen, usually declines. That is why I say that the obligations now being introduced as a measure to stop the spread of the epidemic at community level raise questions. Clearly, health centers are vulnerable centers in the sense that patients come.
The ministry’s declaration must respond to situations of “exceptional risk or alarm to public health.” Is this the case with Bascardi too?
I think that creates a somewhat strange situation because we’re not in a situation of alert or alarm where special measures can be taken.
Is the Basque health system overwhelmed by influenza A or coronavirus?
Indeed, as the number of infections increases, there is greater pressure on emergencies and healthcare. Demand for services has been increasing as more patients visit primary care centers, emergency rooms and are hospitalized. But under such circumstances, it can be said to be within the expected range. Because while demand has increased, Osakidetza has also added capacity in its contingency plan, so called precisely because it is intended to meet the foreseeable spike in demand due to the arrival of respiratory viruses in the winter. This is part of the way the respiratory virus ecosystem works, and when temperatures drop, their circulation speeds up.
Is this a particularly deadly flu season?
These epidemics occur in cycles, and the current epidemic is no higher or more severe than other epidemics that occurred in the years preceding the pandemic. During the COVID-19 pandemic, because there was no influenza epidemic, the behavior of the virus changed. There was a competition among the viruses themselves, with SARS-Cov-2 winning and taking up all the space. There is no comparison to last year or the year before. It must be analyzed in conjunction with 2018 or 2019. Compared with those years, the situation is quite similar.
The Basque Country has 637.2 cases per 100,000 inhabitants, while in other communities the number of cases is well over 1,000.
Yes, but I don’t want to explain why some communities have fewer people and others have more. At Euskadi, we have been recommending facial masks since the end of September. Maybe we should aspire to make it another element of use and be able to develop the culture of Asian countries that use it regularly.
But the measure comes after more than four weeks of very high influenza rates.
That’s true, although the curve hasn’t started to fall yet. I think things are a little better, but we have to be cautious because, of course, the decline is not significant. The latest data from the Carlos III Health Institute, as well as comparative reports from communities, show a slight decline in the Basque Country’s population. But we are declining because viruses other than influenza, particularly bronchiolitis and COVID-19, have declined. The latest data on influenza still tells us that the virus is on the rise and that incidence rates are high. We are at a high point, but within expectations of these epidemic curves, and not unduly overloading the health system. Until we see this week’s data concretely, I can’t say where we are right now.
The state order is temporary because it will drop if positive cases of the respiratory virus decrease for two consecutive weeks.
It also seems a little confusing to us because if this order was issued in early December when the virus started to rear its head, that would still be about six weeks away. But now, predictably, in many communities, if they haven’t reached the top yet, they will reach it in a few days, and that doesn’t make sense. Maybe that’s why the rule is in place that if it drops after two weeks, masks will no longer be mandatory.