Several major Spanish hospitals are starting to check patients being treated for bilateral pneumonia (i.e. in both lungs), and who do not have other causes such as pneumococcus or complications from the flu, for the Covid-19 coronavirus, health sources have confirmed to EL PAÍS.

The measure is being taken due to the conviction among health professionals that the “virus could have been circulating in Spain for several days” already. “If we haven’t detected it, it’s because we haven’t been looking for it, and now we need to take that step,” said a department head from a large Spanish hospital.

“A person can take between seven and 12 days to develop pneumonia due to the coronavirus,” explained a microbiologist from another major health center in Spain. “This is what started to be seen in Italy on Friday, but before that the virus had been circulating for some time. It is very likely that it will arrive in Spain and we are going to check for that now.”

Existing protocols are beginning to be swept aside due to the speed of events

The protocol being followed until now only allowed for specific tests to detect the SARS-CoV-2 virus, as the coronavirus has been designated, when patients met two criteria: they were suffering respiratory symptoms, and they had some kind of link (a trip, personal contact, etc.) with the epicenter of the epidemic in China.

This protocol is now starting to be swept aside, in some cases on the initiative of the health center itself and in others on suggestions from the regional public health services.

A large hospital with 600 to 1,000 beds can normally have one or two patients a day with bilateral pneumonia that has not been diagnosed due to the usual causes, “meaning that we could be talking about 10

Many health chiefs now believe that it will be impossible to stop the spread of Covid-19

0 to 150 patients in this situation in Spain,” a health source explained. “In fact, the large majority will be due to other illnesses. But they are a good sample to see whether there are already patients with pneumonia caused by the virus or if there are cases found in the coming days.”

Not all of the regions nor all hospitals have started to apply these new tests. “We are doing this kind of on the fly because of the speed of events in Italy, and the lack of agreement yesterday in the European Centre for Disease Prevention and Control [ECDC] has created a certain sensation of a vacuum,” explains a third hospital chief. “But it is a question of hours or days before they are all doing it.” The source, like the others, requested anonymity given the current “uncertainty.”

Sources with knowledge of the meeting on Monday by the ECDC’s advisory board – made up of public health chiefs from the EU’s member states – said that two major debates overlapped. The first, with Italy on one side, was concerned with maintaining the current criteria for defining cases and limiting the places considered to be at risk to the localities put under quarantine in the north of the country. Other states, meanwhile, wanted to expand the risk zone to the rest of Italy given the fast spread of the virus.

Impossible to stop

But many health chiefs now believe that it will be impossible to stop the spread of Covid-19. “If they couldn’t do it with the draconian measures imposed in China, which is thousands of kilometers away, it would be naive to think that we can do this with the virus on our doorstep,” the sources explained.

“It’s not that quarantines and other containment measures are not useful,” the same sources said. “They can give us more time and slow down the propagation speed. But you have to pose another scenario, whereby we assume that the illness is going to be here, the population will have to be educated and the hospitals prepared. That is what a number of countries were arguing for in the ECDC last night.”

“It is better to start to do all of this before the virus arrives or is diagnosed,” said the head of an infectious diseases department at a large Spanish hospital. “Doing it once the trickle of cases has begun and the population is alarmed is a lot more difficult.”

“It is important that the ECDC retakes the lead, because if not, countries will start taking measures unilaterally and everything will be a lot more complicated,” concludes the head of preventive medicine from another major health center.

Five cases of Covid-19 have been confirmed so far in Spain. The first two patients identified have already been discharged after being quarantined at hospitals in La Gomera (Canary Islands) and Mallorca (Balearic Islands). An Italian guest and his wife tested positive while staying at the H10 Costa Adeje Palace on the Canary Island of Tenerife, leading authorities to isolate the 1,000 or so guests at the hotel. And a fifth case was confirmed on Tuesday afternoon in Catalonia by the regional health authorities.

English version by Simon Hunter.