Rafael Ibarra

Madrid

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Jeffrey Lazarus is head of the Health Systems Research Group of the Barcelona Institute of Global Health (ISGlobal) and associate professor at the University of Barcelona and author of a report published in «Nature Medicine» that is highly critical of the actions of most governments in the face of the Covid-19 pandemic. The collective failure of governments to control the global spread of SARS-CoV-2, they claimed in this article, is “disappointing but predictable.”

Lazarus and the other authors speak of a lack of union between countries, overconfidence and the consequences of widespread cuts in the financing of public services.

-Are we ready for a new Covid-19 outbreak?

-The world, of course not. Europe, at least the western countries, are much better prepared than a few months ago, at the start of the pandemic. But the question is how are we going to respond to a regrowth?

The key, we now know, is social distancing. As for the health system, including the Spanish one, it is better prepared than a few months ago; We know the great importance of hand hygiene and the use of masks and other protective measures. Health professionals are also more prepared, but, it should not be forgotten that they need to rest, physically and mentally. They could not cope with a huge impending regrowth.

-How do you rate the response of the European Union (EU)?

-In my opinion, the EU did not take seriously enough the situation that was happening in China. It was not the first time that a virus had emerged as a threat in Asia, in China in particular, and in the end nothing serious had happened. Europe, and the world in general, paid little attention to this new threat. The network of experts, international and national, has failed. The World Health Organization (WHO), which generally responded well, activated the pandemic alarm late, almost three weeks. And the countries did not react uniformly; each one did it in his own way. It is of course clear that the EU countries have not acted in a coordinated way.

Denmark acted very quickly. The country closed in 12 hours. Spain took several days to confine the population, when they already knew that they had to. We should have acted earlier.

-Which countries or countries have best tackled the pandemic?

-New Zealand, Australia, Denmark, Germany or South Korea. It is also possible that China, but we have less information. For example, in my country, Denmark, we acted very quickly. The country closed in 12 hours. Spain took several days to confine the population, when they already knew that they had to. We should have acted earlier.

-What have these countries done better than the others?

-In all of them there are several common elements: the confinement and isolation of the population, rigorous information to the public about the situation and the tracking and monitoring of cases. As we emphasize in the Nature Medicine article, for there to be a collective response to the pandemic, it is essential to rigorously inform public opinion. It is a responsibility of the authorities. If the entire population is aware of the severity, the majority will be confined to their homes with responsibility.

Assessment parameters of the countries in response to the pandemic, by points
Country assessment parameters in response to the pandemic, by points – Nature

-Which countries have done worse?

-USA, UK and Brazil are at the top of this list. In my opinion, there has been an absence of leadership.

-And how has Spain done it?

-The Government declared a state of alarm two days late and that had consequences. And part of the population did not take it seriously. This is directly related to the importance of transmitting a rigorous message to public opinion that generates trust and individual responsibility. It is clear that at first it was not done well. They saw what was happening in Italy, they talked to them and the WHO, and it was not learned.

The government declared a state of alarm two days late and that had consequences.

-The article mentions that health systems must be protected. In this sense, what would the role of primary care be like?

– There is something that we are going to discover in the coming months and they are the effects on the health of the general population, apart from Covid-19, which has had the closure of the AP. It should have played an essential role in explaining the situation of the pandemic to the population.

Do you think this pandemic has been a trial and that something worse will come?

-When the H1N1 flu pandemic, the so-called swine flu, appeared in 2009, I worked at the WHO, and we thought that this epidemic was going to be the worst. Then came the SARS one and we thought the same thing again; and now that of SARS-CoV-2. Does this mean that more will come? Globalization has this price. But in Europe and America we are not yet aware. It is time to start making changes. If not, we already know what can happen to us.

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