Discussion
This Spanish perspective is a very small contribution. Pandemics are, by
definition, of worldwide dimensions and COVID-19 is one generating still
unknown damage and damping social and economic development. Other
specialties are now reporting diverse experiences from most of affected
countries (1), aiming at describing the impact of the SARS-CoV-2 on
organ failure.
However, the contributions of physicians and HCW from all over the world
to understand, diagnose and treat the disease, COVID-19, are just a
small part of a problem of extraordinary dimensions. Amidst the
pandemic, it is time to start thinking of seeking for responsibilities
at the highest level. Because of such a worldwide problem, many
professionals around the world are voicing what could have been done in
preventing the spread of the disease. It is clear that this pandemic hit
countries and governments unprepared. However, the governmental actions
widely differed contributing to diverse degrees of local spread despite
the repeated warnings of the WHO (10).
The very recent contribution of Chaudhry et al (30), analysing data from
the top 50 countries ranked by the number of cases, literally concluded
that “the findings of this country level analysis on COVID-19 related
health outcomes suggest that low levels of national preparedness, scale
of testing, as well as population characteristics such as obesity,
advanced age and higher per capita GDP are associated with increased
national case load and mortality”. This is critical to understand the
behavior by country and region. Low levels of national preparedness are
only related to government actions, fundamental in the control of local
extension of the disease. This includes, among other, the timing of
implementation of measures. In the case of Spain is known through each
and every media, that the Spanish government did not prepare for the
epidemic. As it is also literally stated in the editorial by Carriazo et
al (1), it failed to limit public mass gatherings and astonishingly and
actively promoted a large demonstration in Madrid on 8 March that was
led by Deputy Prime Ministers Carmen Calvo and Nadia Calviño and by
Ministers Irene Montero, Fernando Grande Marlaska, Isabel Celaá, Arancha
González Laya and Carolina Darias. A number of them and others like the
wife of the Prime Minister, became infected (31). Some of the cabinet
members as Deputy Prime Minister Pablo Iglesias did not follow the
recommendations in terms of confinement (32). The attitude of the Public
Health representative, Fernando Simón, without opposing the large
demonstration or in other words, supporting its go-ahead, led to the
country ranking highest in deaths per capita. In the case of Spain, more
blatant is that nobody publicly said a word about the MOH 2007 measures
addressing a flu pandemic, published after the SARS of 2002 (33).
Remember, those responsible have names like this article’s authors.
The medical community, physicians and HCW, have done their duty and
beyond. Many have stayed on the road. Cardiac surgery has also
responded, as it is clear from this special issue of the Journal. As we
have also recently said (34), it is time for those responsibly to
honestly (sic) addressing the society. The time hopefully will come when
we must discuss about accountability, legal responsibilities, and
eventual criminal charges of those responsible for the disaster due to
inappropriate handling of the crisis (1). Let us see what comes;
however, as also stated by us (34), what we foresee is living with
uncertainty, mortality and more state security protocols, with the
pandemic being an excuse for absolute control of our lives. It also will
be the need to guarantee the protection of citizens facing abuse from
the State.