When the Covid-19 pandemic reached the US, it did so – as it usually happens in that country – in a big way. New York became the epicenter of it and the incidence of new cases and the increase in mortality was such that it was plan to build mass graves in the middle of Central Park.
The situation seemed even worse than in the capital of Spain, Madrid, which lived the peak of the pandemic only two weeks before the city of skyscrapers.
This was recalled on Twitter by the Spanish epidemiologist Miguel Hernán, who has wondered how two cities that in March were surprised by a pandemic and had to decree a lockdown They have come to September in such a different way.
Look at the shape of these curves.
New York and Madrid had similar epidemics until they spectacularly diverged.
In March, both cities were caught by surprise and shut down because of #COVID19.
In September, the situation is under control in NY and alarming in Madrid.
– Miguel Hernán (@_MiguelHernan) September 11, 2020
“Look at the shape of these curves. New York and Madrid had a similar epidemiology until they diverged spectacularly. In March, both cities were surprised and confined by Covid 19. In September, the situation is under control in New York and it is alarming in Madrid, why? “, Asks Hernán.
The expert, one of the scientific advisers of the Ministry of Health since the pandemic began in Spain, goes on to explain thatWhat has New York done and what Madrid to have arrived in September in such a different way.
First, Hernan points out the similarities between both cities. Both are large, densely populated, with a significant public transport network, and many visitors. In both cases, the Covid 19 explosion rendered the contact tracing system useless and overwhelmed hospitals. In both, a confinement was required to reduce the disaster that the disease was posing for public health.
By the time June came, both cities had managed to reduce the number of new cases, direct consequence of confinement. But just a month later, in July, new cases began to grow in Madrid, reaching one of the highest incidents in Europe. In New York, however, no increase has been detected since the end of the lockdown.
It could be argued, Hernán points out, that the new cases of Covid-19 are not the best parameter to define the epidemic severity of the new coronavirus. Is it possible that the most cases are asymptomatic or show only slight symptoms?
To answer that question, Hernán proposes looking at the hospital occupancy. And what you see is devastating: there is no problem in New York and there is – and it seems only the beginning – in Madrid.
While in the american city there are no Covid-19 patients in the ICU (If there is a case, it would not reach 1%), in Madrid it is estimated that 30% of intensive care beds are already occupied by Covid patients.
Differences between cities
After objectively describing the situation, Hernán breaks down the differences in the management of the pandemic that are divided into three aspects: the contact tracing, the number of tests carried out and the speed at the time of reopening the two cities.
Regarding the first aspect, before reopening the state of New York it already had 30 trackers per 100,000 inhabitants, which is tracked in 6,000 trackers in New York. In contrast, in Madrid there were 200 trackers in July and there are around 700 now.
Regarding the tests carried out, despite how much the Spanish and regional governments presume about the amount of tests they do, it is known thatThe number of raw tests is not the parameter to measure whether enough tests are done.
It’s the positivity rate which determines that the tests are being done correctly or, otherwise, that they serve to detect more cases, confine them and prevent transmission. The WHO established the adequate percentage of positivity at less than 5%.
Well, in April more than 70% of the tests carried out were positive both in Madrid and in New York – although it is true that at least in Madrid very few tests were carried out. But now when there are no more excuses for missing tests, New York didn’t reopen the city until the rate was below 5% and is now between 1 and 2%.
In Madrid a parameter of positivity was not put as a condition before opening and the current percentage is over 20%, more than four times what the WHO recommends.
Regarding the control of places especially conducive to contracting Covid-19, it is more than proven that indoor restaurants are one of the main focuses. There also Madrid and New York, which has not yet allowed its opening And it will do so on September 30, but with certain conditions.
On that date the allowed capacity will be 25% -although it will increase to 50% on November 1-, there will be no bar service -Goodbye to waiting for the guests having a drink at the bar-, strict protocols will be followed and you will have to leave the phone to report anything.
Does something similar sound to you in Madrid? Impossible, because in the capital of Spain opened in June at 60%, with bar service and virtually no special protocols.
Thus, the city of skyscrapers has safely opened. “It has done without overloading hospitals and it has confirmed its credentials as a serious place to do business, “Hernán writes very critically.
The epidemiologist also rules out that the current low incidence in New York is due to the fact that they have acquired the famous group immunity. The reason: seroprevalence studies have given similar figures in both cities. Without a doubt, Madrid has a mirror in which to look at itself and it would be better if it did so as soon as possible.