New story in Health from Time: Spain Is Facing a Second Wave of Coronavirus Outbreaks. Here’s What to Know

Authorities in Spain prohibited anyone from entering or leaving the town of Totana in the southeastern part of the country yesterday, after 55 people who went to a local bar tested positive for COVID-19. The town, home to 32,000 people, is one of many in Spain to go back into lockdown, as the country struggles to contact trace and get a handle on new outbreaks popping up across the nation.

Spain was home to one of Europe’s worst COVID-19 outbreaks, experiencing 270,166 cases and 28,429 deaths since January. The country also had the world’s highest reported rate of COVID-19 infection for doctors and nurses. But after four months in one of the strictest lockdowns on the continent, Spain lifted its state of emergency on June 21 amid lower case numbers and fatality rates, reinstating people’s freedom of movement and opening borders to some countries.

A month later, Spain is facing another surge in cases. Widespread neglect of social distancing rules and limited contact tracing have driven spikes in new daily infection rates that has forced the government to place parts of the country under temporary lockdown again.

Although other European countries like Germany and Portugal have also seen the number of new daily cases tick up, they have not been on the same scale as Spain. On Wednesday, 730 new infections were reported in Spain, the highest increase in new daily cases since May 8. Spanish health officials reported on July 20 that the infection rate has tripled in just over two weeks from 8.7 per 100,000 people infected on July 3, to 27.4 per 100,000 this week. Salvador Illa, Spain’s health minister, said on Wednesday that there are 224 local outbreaks throughout the country and warned that if they cannot be kept under control, he will be forced to call another state of emergency.

Here is what to know:

How did Spain handle its reopening?

When Spain began slowly lifting its lockdown in early June, social distancing protocols were put in place.

People were required to stay 1.5 meters (4.9 ft) apart in public and face masks were compulsory for anyone over the age of six if maintaining social distancing was not possible. Bars and restaurants opened with limited capacity as did cinemas, theatres and exhibitions.

By June 21, Spain began lifting some border controls, and reopened its border with Portugal on July 1.

But experts say that the rush to reopen the country to tourism may have led to a rise in new infection rates. “We faced a lot of pressure from the tourist industry because it’s one of the main economic sectors of Spain,” says Dr Jacobo Mendioroz, the director and coordinator of the committee responding to coronavirus in Catalonia. “We may have rushed into opening all the big stores, just to have tourists coming into our country.”

Where have the outbreaks occurred?

The first outbreaks were in care homes and slaughterhouses in Lleida, a city west of Catalonia. Two other northern regions, Galicia and Aragón, also experienced outbreaks.

By July, thousands of seasonal workers from Morocco and sub-Saharan Africa working as fruit pickers in northeastern Spain also tested positive for the virus. The migrant workers live in overcrowded homes, making social distancing difficult, exacerbating the spread of the virus.

But the infection rate appears to be rising particularly among teenagers. The number of people between the ages of 10 and 19 who tested positive with COVID-19 have increased sevenfold over the past month. While young people are less likely to require hospitalization if infected with COVID-19 than older patients, the spike in infections rates among this demographic remains concerning given young people’s potential to spread the virus to vulnerable populations. Getting younger people to socially distance, however, is challenging. “It’s hard to tell young people not to have gatherings together,” Mendioroz says.

Why is Spain struggling to get a handle on new outbreaks?

Many experts attribute these local outbreaks to a lack of contact tracing. People who have tested positive for the virus in Spain have reported that they were not asked to provide a list of people or establishments they came into contact with in the two weeks leading up to their diagnosis. Sonia Ramírez, a 21 year-old Spaniard from the northeast region of Catalonia, told the Associated Press that after testing positive for the virus, she independently had to warn family and friends of possible exposure. “They didn’t ask me who I had been with,” Ramírez told the AP. “They didn’t even ask if I had been to work recently, which of course I had.”

The virus is also spreading quickly as a result of people and establishments failing to follow social distancing protocols. A club in Barcelona, for instance, has been accused by regional officials for allowing more people into their establishment than permitted, resulting in 91 people testing positive with the virus (club officials insist they followed the guidelines).

Whether large cities like Barcelona will have to lockdown remains a question. Ada Colau, the left-wing mayor of Barcelona, has cautioned that the government is considering bringing in some restrictions for inhabitants of the city but says it will not return to a full lockdown as it did in March.

The uptick in new cases has neighbouring countries worried. Jean Castez, the new French Prime Minister, has warned that France may be forced to close its borders with Spain if numbers continue to rise. “This is an issue we are following closely,” Castez said while visiting Prades, a French city on the border of Spain.

What can other countries learn?

Although other countries can learn from Spain’s mistakes with contact tracing and opening border too quickly, Mendioroz says that the key to curbing the spread of the virus is clear communication with the public about the pandemic.

“We didn’t manage to communicate well that this pandemic will last a long time and that the protective measures should be implemented at all times,” he says. “I think the more we can communicate that the pandemic can be maintained through collective responses instead of through authoritarian measures, the more people will be joining this kind of safe behaviour.”