Spain asked in February that Europe lower the alarm: “The virus will not have a high impact”

It was still a month away from the weekend when the pandemic in Spain exploded. The European Center for Disease Control and Prevention (ECDC) was close to updating its assessment of the risk that the new coronavirus detected in China could present to the countries of the European Union and the United Kingdom. A week earlier, on January 31, the World Health Organization (WHO) had declared an international public health emergency for the coronavirus outbreak in China’s Hubei province. On February 5 at 2:38 p.m., the office of Epidemic Intelligence of the center sent an email to the contacts of each member State – in Spain, they manage it from the Center for Coordination of Health Alerts and Emergencies (CCAES), directed by Fernando Simón – to send them a draft with the new evaluation of the risk. At that time, seven European countries already had imported cases, although all were controlled and community transmission of what was then known as 2019-nCoV was ruled out and would later be called SARS-CoV-2. In that first draft, both the risk of infection and the impact on infected people were considered low. That same day, at 16:07, the CCAES replied to the email: “We agree with you that the risk in Europe is currently under. ” In addition, they asked the office about which areas were considered to be of community transmission beyond the Chinese province of Hubei. In just two days, ECDC’s assessment of the impact of covid-19 on infected people varied completely, as as shown by the internal ‘e-mails’ between both institutions. Thanks to a request for access to documents, El Confidencial has obtained all the correspondence between this European body and the department under the Ministry of Health in recent months. These emails reveal how the different countries were pooling what they were discovering about the growing pandemic and, in this case, how our country underestimated the threat posed by the Asian coronavirus during the first days of the presence of the pathogen in Europe. in Spain a high impact if we have an imported case Between that Wednesday in February and Friday something happened, and in Europe they began to assess more seriously the possibility that the impact of the disease for the infected individual was really greater. In the risk assessment published on Friday, February 7, the potential impact of covid-19 on patients was already classified as high. This drastic change did not go unnoticed by the Spanish CCAES, which at 17:54 that Friday sent a new ‘e-mail’ to the European center: “We have seen today the risk assessment published on the ECDC website and we are a little surprised, because the sentence sent in the draft text that said ‘the impact of the infection on the population from the EU / EEA and the UK is considered low ‘has disappeared from the published document. Instead, the published version includes the impact for infected individuals and is considered high “.’ E-mail ‘sent by the CCAES to the ECDC on February 7.The sender of the CCAES considers that this last point is “debatable”, but “we can accept it as long as the phrase that appeared in the draft that was previously sent remains,” a phrase that according to the Spanish representative coincides with the e guides CDC. “We are not considering a high impact in Spain if we have an imported case,” the letter concluded. It is unknown whether it was Simón herself or a member of her team who forwarded these emails, given that Regulation 2018/1725 protects the reproduction of personal data of this type. A spokesperson for the Ministry of Health told El Confidencial that “both the 6 February like February 14 the ECDC considered the risk of coronavirus low. ” Indeed, the February 13 risk assessment, the oldest version kept in the repository cache, indicated the risk of infection in Europe “currently low.” However, the impact of the disease on an infected person is already considered “high”, in line with what was defended by the ECDC despite the protest sent by the CCAES. From Health, they have not answered specific questions about the classification of the impact of covid-19 on infected people in those days of February and the opposite positions between the ECDC and the CCAES. Risk assessment published on February 13 by the ECDC.The vision of the Spanish center fully coincides with the one that Fernando Simón sent to public opinion. That week, Spain had counted the second case in Spain, a tourist in the Balearic Islands who had joined the isolated German in La Gomera since January 31. “It does not imply any more risk for our country,” explained Simon about that new case imported on February 9. They ignored the Spanish recommendation “Thank you very much for your comments.” The following Monday, February 10, the ECDC politely responds to Spain. “The text of the risk assessment was changed, as you point out, after an internal discussion by the technical team and the advice of our chief scientist,” Swedish Mike Catchpole. “The text to which you refer is on the impact of infection, if acquired. Although we determined that the probability of infection for the EU / EEA population is very low, we have determined that the impact of infection, if acquired , it is high for the infected individual and also for public health and health systems. ” This mention of “public health and health systems” does not appear in the risk assessment of February 13, but it does appear in a larger document published the next day. ECDC’s response to CCAES on considering the impact of covid- 19 in patients, and finally added that the impact could vary between the different Member States depending on the preparation, capacity and health resources, as happened later. The text finally published on February 7 is no longer available on the internet (beyond the versions stored in repositories), since it has been updated several times in the last four months. At the same time that the Spanish and European centers exchanged emails Electronic on the classification of the impact of the coronavirus in infected patients, major technology such as LG or Ericsson announced their withdrawal from the Mobile World Congress, which was to be held in Barcelona from February 23. Finally, on Thursday, February 13, the MWC was canceled.Stigmatization of the testesThe cancellation of the MWC must have been a turning point for Spain on the potential impact of the coronavirus in our country, but the messages that Fernando Simón transmitted were still reassuring. The following week the 60th meeting of the ECDC Advisory Forum was held in Stockholm. The public record of that meeting includes seven interventions by Dr. Simón before his European counterparts. In one of them, Simón defended “testing only those travelers from Hubei, with the possibility of expanding to mainland China.” Furthermore, it was of the opinion to lower the risk of some territories that the ECDC had rated as “high” to “moderate”. A draft of the February 13 ECDC obtained by El Confidencial identified China, Singapore, Hong Kong, Malaysia, Vietnam and Japan as “territories with presumed community transmission.” Simon was of the opinion that the risk of some territories that the ECDC had rated “high” to “moderate” In this sense, the director of the CCAES considered that “it is irrelevant if there is community transmission, the time factor and the incidence is much more important”. Regarding Spain, Simón pointed out that more than 600 tests had been carried out up to that date, “but it is not just a matter of the number of tests. Each person should be isolated, health personnel are afraid of becoming infected and those who have been carried out a test they are being stigmatized “. However, the beginning of the act shows that Spain had tested 60 people, two of whom tested positive. On February 22, a key date, the ECDC advisory forum concluded with the commitment of the member states to hold extraordinary meetings based on the evolution of the coronavirus pandemic. The first of these meetings was immediate. Three days after this forum, an ECDC representative – presumably chief scientist Mike Catchpole – sent an ‘e-mail’ to the national centers to hold an urgent meeting on the situation in Italy. February ECDC to European countries. “These outbreaks raise concerns about the possibility that similar transmission events could occur anywhere in the EU and the impact of these transmissions, as well as highlighting the need to ensure that adequate preparedness exists in the EU / EEA health services, “said the ECDC member. That Saturday, 33 confirmed cases were registered in Lombardy and another nine in the rest of Italy. In addition, “259 contacts in the first cases (15%) tested positive.” “Although there is a history of contact with someone from China in the index case, it is not clear that this could explain the contagion for the temporary period,” he added. February 22, a day before the planned opening date for MWC , the ECDC gave the first serious alarm about the spread of the coronavirus in Europe.