Why Spain has avoided Europe's COVID surge

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BARCELONA, Spain — From Berlin to Budapest, Amsterdam to Athens, Europe is in a panic. With over 2.2 million new cases and more than 28,000 deaths over the past week and many countries hitting never-before-seen highs for infections, Europe is now COVID-19’s global epicenter, according to the World Health Organization.

National leaders are cracking down in a continental scramble to contain the coronavirus before the holidays.

On Monday, Austrian Chancellor Alexander Schallenberg effectively grounded the one-third of Austrians over age 12 who remain unvaccinated, imposing a lockdown solely on the unjabbed that bars them from leaving their homes except for work and grocery shopping. Denmark, which had dropped them in September, is again requiring COVID passports, the Netherlands is shuttering bars and restaurants at 8 p.m., and Germany, where outgoing Chancellor Angela Merkel is begging the 32 percent of Germans who aren’t immunized to get their shots, is bringing back mask mandates for schools, recently dropped in some parts, and is considering lockdowns as well as requiring a PCR test even to step on a bus.

Eastern European countries such as Bulgaria and Romania, with vaccination rates of 24 percent and 36 percent, respectively, are reeling, with hospitals and morgues overwhelmed. Vaccine-hesitant populations, particularly in the east, cooler temperatures, reopened schools, waning vaccine effectiveness and increased travel have helped create a perfect storm for this wave, which is Europe’s fourth, fifth or sixth, depending on how you count. “It’s a rocky road ahead for all of us,” Dr. Richard Pebody, who leads the high-threat pathogen team at WHO/Europe, told Yahoo News. “We can’t afford to let our guard down.”

As most of Europe suffers a COVID-anxiety attack, however, la buena vida continues in Spain. Crowds revel at terrace bars, drinking sangria and eating tapas into the night, the clubs have reopened, crowds frolic at beach parties and wine festivals, and unlike in many Western European countries, a vaccine passport is still not required. According to Statista, the COVID rate in Spain over the past seven days is 46 per 100,000 population, compared to Austria at 851, the Netherlands at 539 and Slovenia at 1,058.

Health workers wearing masks, face shields and gloves attend to a man with COVID-19 as he lies on a hospital bed in Huesca, Spain.
Health workers attend to a man with COVID-19 at San Jorge Hospital in Huesca, Spain, in November 2020. (Alvaro Calvo/Getty Images)

The reason for the relatively carefree mood across Spain, said Dr. Daniel Lopez-Acuña, former director of Health Action in Crisis at WHO, is the country’s very high vaccination rate, nearing 90 percent of those 12 and older, and its continued protection measures, like indoor mask mandates, which, unlike most places, Spain never dropped.

Those precautions are paying off. “Spain is doing particularly well compared to other European countries,” Lopez-Acuña told Yahoo News, crediting health agencies, stringent class-size reductions and mask wearing in schools, and a science-accepting public, as well as long-enduring COVID restrictions.

After being shut down for over a year, nightclubs didn’t reopen until October. The national government required pedestrians to wear masks even outside until this past June. Most Spaniards, Lopez-Acuña said, “have developed a consciousness” about COVID prevention measures, accepting social distancing and face covering indoors.

“Even in the streets, large parts of the population still wear the masks,” he said.

“We’re trying to learn from the success stories like Spain,” said Pebody. He noted that Spain and neighboring Portugal, where 87 percent of the population has had two shots, are “in a good position at the moment.”

People stand in line outdoors as they wait to receive a dose of the Johnson & Johnson COVID-19 vaccine in Barcelona.
People wait to receive the Johnson & Johnson COVID-19 vaccine at the Triumphal Arch in Barcelona on July 7. (Lluis Gene/AFP via Getty Images)

The spikes in cases and deaths across Europe are a preview of coming holiday attractions in the United States, Dr. Peter Hotez, immunologist and dean of the National School of Tropical Medicine at Baylor College of Medicine, told Yahoo News. What is currently happening in Europe, he said, “is almost certainly what we’ll see in the United States as we head into Thanksgiving and Christmas” — in the same way that the Beta and Delta variants of the coronavirus swept across Europe just weeks before slamming into the U.S.

Hotez said that to halt COVID-19 transmission, at least 85 percent of the entire population will need to be fully vaccinated — and “fully vaccinated now means three doses of [Moderna or Pfizer shots] or two doses of the J&J vaccine.” Until that happens, he recommends indoor masking in public situations, which remains controversial in much of the U.S.

Booster shots are slowly becoming available in Western European countries, where public health professionals are debating whether wealthy nations should require them before much of the world is vaccinated at all, and if entire populations need them or just older individuals and the immunocompromised. In response to rising case numbers in France, where a vaccine passport or proof of a negative PCR test is required to enter most facilities — including terrace bars, trains, museums and malls — President Emmanuel Macron is requiring that anyone 70 years old and up get a third jab to maintain their vaccine passport status. While the European Medicines Agency, the FDA of Europe, recommends all countries ultimately provide adults with a booster, in Spain and elsewhere they are currently being offered only to the immunocompromised and the 70-and-up population.

Hotez believes that until Spain’s population receives that third shot, it might squander its current coveted status as one of the few places in Europe not being forced to reimpose curfews and lockdowns. Author of “Modern Epidemics,” cellular biologist Dr. Salvador Macip, a native Spaniard teaching at the University of Leicester in England, told Yahoo News he is pessimistic that Spain can hold onto its current status for long. He believes that the vaccinations, prevention measures and the Mediterranean weather that favors outdoor socializing have simply delayed any surge on the Iberian Peninsula, and he’s particularly concerned that tourists, including unvaccinated ones from other parts of Europe, “can come into Spain without a PCR test.”

Indeed, Spain is becoming a desired destination for the unjabbed from France, for example, who can’t go to restaurants in their country without a vaccine passport or a negative test. Macip said that the governments of Spain and other southern countries don’t want to require entry testing from residents of other European countries because of the deleterious effects on the already struggling tourism industry. “It’s always a balance between economy and health, and this is a risk Spain may be able to take now because the number of cases is low,” Macip said. “But it’s not the safest thing to do.” He believes, as does Lopez-Acuña, that Spain may ultimately have to resort to the vaccine passport used in other countries.

A man in a T-shirt, wearing a face mask, sits as he receives a third dose of the Pfizer COVID-19 vaccine in Ibiza, Spain.
Richar Masias, who has a transplant, receives a third dose of the Pfizer COVID-19 vaccine on Sept. 15 in Ibiza, Spain. (Zowy Voeten/Getty Images)

But even if Macip raises an eyebrow at Spain’s “open doors” policy, he and others in public health are most chagrined by the actions of U.K. Prime Minister Boris Johnson’s government, which, having gotten half of its population vaccinated by midsummer, proclaimed July 19 as Freedom Day and dropped all masking requirements for England, though they remain in effect in Scotland, Northern Ireland and Wales. In England, Macip said, “they’re acting like there’s no pandemic anymore, so everybody’s just oblivious to the fact the virus is circulating at a very high level, actually.” U.K. cases jumped to nearly 50,000 a day earlier this fall. Though case numbers have dropped somewhat, the death rate is now rising.

Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, is likewise concerned about the United Kingdom. “We are also seeing the effect of waning immunity in older people, not helped by the slow delivery of boosters” and a delayed rollout of vaccines for young people in Scotland. And public health officials across Europe were shocked when Johnson recently toured a hospital and despite being asked repeatedly to don a mask, refused to do so.

Whether from the actions of populist politicians or the mouths of right-wing newscasters, the idea that COVID is already behind us deeply concerns those who are tracking its continuing travels.

United Kingdom Prime Minister Boris Johnson walks along a corridor at Hexham General Hospital in Hexham, England.
U.K. Prime Minister Boris Johnson at Hexham General Hospital in Hexham, England, on Nov. 8. (Peter Summers - WPA Pool/Getty Images)

Depending on rates of vaccination, preventative measures and the time of year, COVID is “going to go up and down,” Macip said. “So if we can go back to restaurants and go back to clubs in Spain, that’s great. But that doesn’t mean it will be the same next month.”

Nevertheless, added Pebody, “we’re in a much more positive position” than in early 2020, when COVID announced its problematic arrival. Huge swaths of the world are vaccinated, he pointed out, and in highly vaccinated countries, “we’re seeing reductions in hospitalizations and deaths. We have a much better idea now on which measures help to reduce transmissions and how we can keep ourselves safe. We’re increasingly learning how to manage and live with the virus.” And that’s a good thing, because it may be lurking for years to come. “I think it’s unlikely now that this virus is going to disappear — ever,” he said.

In the meantime, the parties continue and the Rioja is flowing in Spain. This week, at least.

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