Alberto Pérez of Madrid, like many others, utilized a home test to determine that COVID-19 was causing him headache and cold-like symptoms.
He went to a hospital emergency department for confirmation after being unable to reach his local health center, where phones went unanswered and online appointments were full up for the following week. After a three-hour wait, health staff there agreed with his self-diagnosis but did not offer a PCR test to assure a more accurate result.
“The nurse who saw me stated I had the omicron form since I hadn’t lost my sense of taste or smell,” said Pérez, 39, who works as an online game developer in Madrid. “How could she know?” you might wonder.
During the present phase of the coronavirus epidemic, primary health care providers in Spain are overburdened with patients who want testing, require medicine, or need certifications to excuse their absence from work.
In Europe, family doctors are frequently the first port of call for medical attention. They, together with primary care nurses, are seen as critical in helping to prevent illness, relieve hospital pressure, and provide continuity of treatment.
The mounting workload in Spain has prompted doctors and nurses to cancel regular checkups for conditions other than COVID-19 and postpone visits to vulnerable people at home, in a country that only a few weeks ago thought itself relatively safe because more than 80% of the target population is fully vaccinated.
Because Pérez’s positive test was done at home, neither the hospital nor his local health center were willing to spend the money on a PCR test for him. The PCR samples may be sequenced to detect viral variations, something no one did with Pérez or the thousands of other positive home test cases in Spain.
“You get the impression that they don’t have any resources, that they don’t have any personnel, and that all they do is send people home to hide the truth,” Pérez added.
Primary health care in Europe has long been underfunded and understaffed, according to Caroline Berchet, a health economist at the Paris-based Organization for Cooperation and Economic Development. The epidemic has only revealed the system’s resulting flaws.
“Investment in primary health care is insufficient throughout Europe” and beyond, according to Berchet. In 2019, primary health care received just 13 percent of health spending in the 38 OECD member nations, including the United States, compared to 28 percent for in-patient care.
“In all (OECD) nations, primary health care requires improved finance and investment to provide more personnel, more training, better compensation and working conditions, and more flexible delivery of treatment,” she added.
Paloma Repila, a spokeswoman for SATSE, the largest Spanish nurses’ organization, claimed that the current spike has resulted in many patients with lesser symptoms having a “brutal impact” on local health facilities due to fewer hospitalizations.
“Because infection rates are so high, we’re moving the pandemic out of the health-care context and expecting people to care for themselves,” she added.
“While individual responsibility is admirable, requiring people to self-diagnose, manage their own medical leave, and be left without professional follow-up is quite concerning.”
Years of financing cutbacks to the public health system in France are being blamed for rural doctor shortages.
According to experts, a similar situation exists in Italy, where general practitioners are feeling the strain of the recent rise as well as the demands of more paperwork to certify people are safe to return to work and school.
According to Repila, a spokesman for the Spanish union, authorities should be concerned about the ramifications.
“What form of the virus do you have if you take the test at home?” “We’re not sure,” she said. “Everything is dependent on sequencing that isn’t happening, even the length of self-isolation times.”
Even the daily data that give headlines and influence expert and policymaker responses are out of sync once again, as they were at the start of the pandemic. That’s because home test results aren’t being reported to overburdened health facilities, either because phones aren’t answered, appointments aren’t available, or people just don’t care.
Last week, Health Minister Carolina Darias urged individuals to submit positive tests even if they have no symptoms or want to stay at home with minor ones.
Medical workers, according to unions and other professional groups, are overwhelmed by the volume of phone calls, video-assisted consultations, and demands for testing, advice, treatment, or granting certifications for persons who need to justify a leave of absence.
Contact tracking, which was originally thought to be crucial to ending the epidemic, has long been forgotten.
For most of the epidemic, primary care was largely ignored by the media and the general public, since most of the focus was on hospitals’ and critical care units’ ability to cope with the influx of patients.
However, labor unions and professional associations claim that the issues started much earlier, as a result of years of underfunding that resulted in a high number of temporary medical staff contracts and inferior health facilities.
Following the European debt crisis of 2008, Spain’s conservative government adopted tough austerity measures, including major cutbacks to the public health system’s budget. Similar cutbacks were made in other parts of Europe.
Last month, Spain’s center-left Socialist administration published a two-year plan to increase the quality and accessibility of basic health care. The move, according to critics, was long overdue.
Pérez, the online game creator, continued to test positive with home kits ten days after finishing his quarantine at his Madrid home, but he was still unable to schedule an appointment with his medical practitioner. His health center, which he finally contacted by phone, advised him to stay at home during the holidays and gave him a call the following week.
“We are left to cope with this on our own since there are no physicians or nurses,” Pérez remarked. “How is that unrelated?” says the narrator.
