Spain is by far the country with the highest number of coronavirus infections among healthcare workers, according to available official data.

A report published on Thursday by the European Centre for Disease Prevention and Control (ECDC) underscores that 20% of registered coronavirus cases in Spain are healthcare workers, compared with 10% in Italy as a whole (in the hard-hit region of Lombardy the percentage rises to 20%). In the United States, infected healthcare workers represent 3% of total cases, while in China they are 3.8%.

Healthcare professionals went to war without protection Daniel López Acuña, Andalusian School of Public Health

Although the ECDC study uses Spanish figures from April 21, more recent data confirms this trend. On Friday, the Health Ministry reported that 35,295 healthcare workers are infected, 940 more than on Thursday. In Italy, the second most affected European country, there are just under 18,000 infected healthcare workers, according to figures released on Tuesday by Italian health authorities.

Besides the more than 35,000 health professionals, an EL PAÍS estimate based on available regional statistics shows that nearly 12,000 employees of senior residences and other care centers have also been infected. But the real figure is probably much higher due to under-reporting. The Basque Country, Navarre and Castilla y León do not offer figures from care centers, while Madrid only reports those from public residences, which represent a fraction of the total.

Lack of measures

The high number of infections among health personnel in Spain is due to the absence of “the indispensable safety measures” that should have preserved their health, according to the Spanish Medical Colleges Organization (OMC), a regulatory body for the medical profession. The OMC also notes that 37 healthcare workers have died of coronavirus in Spain.

“There weren’t face masks for the workers. And when the masks arrived, many of them were defective. At this point in time, not all doctors and professionals have been tested yet. You cannot confront an epidemic of this magnitude in these conditions,” says the organization, which is planning to pursue legal action in cases involving defective face masks for healthcare workers.

Manuel Cascos, president of the nurses’ union Satse, also blames a lack of protective gear and testing kits for the high prevalence of infections among health personnel. “This was the determining factor,” says Cascos.

The union estimates that between 60% and 65% of affected healthcare workers are nurses. “The lack of foresight and diligence by the relevant health authorities has put healthcare professionals in a position of great defenselessness, where they remain to this day,” says Cascos.

Satse said it will report this “deplorable situation” to the World Health Organization (WHO), the International Labor Organization and the European Commission, among others.

A known risk

“Healthcare professionals went to war without protection,” says Daniel López Acuña, a former WHO official who teaches at the Andalusian School of Public Health. “First they got infected, and later, without knowing it because many of them were asymptomatic, they infected colleagues and patients.”

López Acuña sees “an aggregation of factors” behind the enormous impact of the coronavirus on Spanish healthcare personnel. “Many health facilities did not have enough protective gear. The recommendations to use masks were not uniformly issued at the beginning of the epidemic. And the very limited number of tests performed at the beginning prevented us from knowing what proportion of health professionals were infected.”

“But to me, the determining factor, the one that has multiplied and made worse all of the above, is the asymptomatic transmission of the virus,” he adds.

You cannot confront an epidemic of this magnitude in these conditions Spanish Medical Colleges Organization

José María Martín Moreno, a professor of preventive medicine and public health at Valencia University, laments the fact that authorities did not adopt the lessons learned from the SARS and MERS epidemics early on. “The risk for health professionals was a known factor. But for some reason, the system was not made ready in time.”

Yet despite these shortages, he adds, professionals at health centers and senior residences continued to perform their work “out of ethics, professionalism and a sense of duty.” This in turn raised the probability of contagion.

English version by Susana Urra.