Tuesday, May 17

X-ray of the macro outbreak of Mallorca: how many are they, where are they and what effects can it have

The media attention of these weeks has been directed towards a single coronavirus outbreak. An end-of-year trip to Mallorca, which brought together students from all the autonomous communities and was held between June 12 and 18, has caused at least 1,167 cases of COVID-19, 12 hospitalized and 4,796 travelers in quarantine. Of all the young people affected, 26% have tested positive, according to data from the Balearic Health Council. The national scope of the transmission has forced the Center for the Coordination of Health Alerts and Emergencies (CCAES) to centralize management.

The macro outbreak due to a final study trip to Mallorca keeps thousands of young people in quarantine throughout the country

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In Salou, Lloret de Mar, Tenerife and Menorca There have been other outbreaks related to study trips totaling 900 infections in Spain. Public Health teams from all regions are working on screening and monitoring these outbreaks, especially the one that has spread throughout almost the entire peninsula: Mallorca.

“What has happened in the Balearic Islands is the anecdote, because the normal thing and what we Spaniards are doing is to comply with the sanitary measures and, therefore, Spain is a safe destination”, has insisted the Minister of Tourism, Reyes Maroto. “The perfect situation has been generated for a great transmission of the virus at a specific point,” said Fernando Simón, director of the CCAES. “It is not the first time that has happened, but it is the most mediatic,” he tried to reassure, although that of Mallorca is the largest coronavirus outbreak detected in Spain during the pandemic.

The priority for the communities now is to fine-tune the follow-up of intra-family contacts and those infected, most of whom – including those hospitalized – are mild or asymptomatic. Some have also pledged to tighten vigilance on macro events to prevent these outbreaks from replicating in the remainder of summer. The Alerts Report of the Ministry of Health asked last Thursday to suspend all end of study trips after this episode, in which there are already 11 affected autonomies.

The origin: boat parties, hotels and concerts

Hundreds of young people who finished the EBAU exams have organized their end-of-year trip to Mallorca. According to the authorities and local media that have tracked the outbreak, it began on the journeys to the Balearic Islands. The ferry leaving from Denia and Valencia lacked controls on the use of masks or safety distances during the seven-hour journey.

Upon arrival, tour operators had prepared several large-capacity events, including a reggaeton concert and boat parties. The first was held in two batches in the Palma bullring, on Tuesday June 15 and Sunday 19, and the images taken by the young people and the artists themselves show the general relaxation of safety regulations.

The Local Police broke in on Tuesday and canceled the concert, since the capacity was breached on the track and in the stands, where supposedly only 200 and 1,000 people could fit, respectively. Sunday’s appointment went ahead because the Palma City Council claimed that it could not cancel it preventively. Now, the Government has opened a file to the organizers of the festival for “very serious” infraction and for which they could be fined from 60,000 to 600,000 euros.

However, for epidemiologists, more problematic were the boat parties and the 20 hotel complexes where the boys were staying than the two open-air concerts. All these celebrations continued once they landed on the shore, with large bottles in the Arenal and Magaluf areas. The organizers, for their part, blame the Balearic Government for allowing crowds monitored by the Police with “about 4,000 kids” just after their scheduled activities.

“The focus is being placed on the kids, but the problem is that macro-trips are allowed with activities that carry inherent risk,” says Mario Fontán, Preventiva doctor and author of research on COVID-19. “Any type of measure that tries to control this alters the nature of the activity and makes it less attractive,” he understands. “We cannot blame only young people or a more transmissible variant, but those who allow this type of party”, shares Quique Bassat, pediatrician and epidemiologist at ISGlobal.

The Balearic Islands have announced that they are slowing down their tourist policy and de-escalation for a week. From now on, it will request a negative PCR from groups of more than 20 people entering the islands and, at the national level, the central government will also impose the green passport on British tourists. The United Kingdom was exempt until now due to its epidemiological trend, which has worsened after the emergence of the Delta variant. For their part, the councils of 11 communities closely follow the evolution of the kids returned from Mallorca, who already have a thousand infections and 5,000 quarantined contacts.

How many people are affected and where?

Of the 1,167 total cases identified and the 4,796 travelers in quarantine, 249 remain isolated in Mallorca, at the hotel bridge Palma Bellver. 62 of them with positive PCR, 175 with negative and 12 pending the result. The other 12 who have been transferred to the Son Espases Hospital, as a precaution, had “fever, sore throat and general malaise, and some high fever, over 38.5 and mild symptoms,” reported the Balearic Ministry.

“The families and those affected themselves are collaborating a lot,” Simón acknowledged. However, there are those who do not follow that trend. Parents are assuming the costs of quarantine and some parents have criticized that their children remain in Palma without the security of having been in contact with a positive. In fact, They are already those who have denounced the Balearic Government for illegal detention. The executive, for his part, has justified the forced isolation due to the “seriousness” of the situation and the disease.

To prevent this from happening again, the Ministry of Health has asked to consider close contacts to any young person who has participated in a trip to Mallorca. All of them carry out a mandatory 10-day quarantine back home and undergo two diagnostic tests.

The 12 young people who have been transferred to the Son Espases Hospital, as a precaution, had “fever, sore throat and general malaise, and some high fever, over 38.5 and mild symptoms.”

Eleven autonomous communities have detected cases associated with the trip to Mallorca. The most affected are Madrid, with 410 positives; Euskadi, with 172; and Catalonia, with 132. Some of these, such as Madrid, suspect that in a few days there will be intra-family outbreaks. “His parents, between 50 and 59 years old, are right now the most vulnerable people, because some will not be vaccinated with the two doses,” Fernando Simón recalled. Of this cohort, 69.9% have received the complete guideline.

“Those who are not yet immunized have to be aware of it,” said the spokesman, referring to the younger population. “The outbreak is not having a huge impact on the incidence, but it already represents a notable percentage of the cases detected: 2.5% of the last 14 days and 5% of the last 7 days,” he has listed. “They are young people, but it is possible that one of them ends up hospitalized or that one of them dies,” Simón concluded.

What can it mean for the control of the pandemic?

Spain has definitively broken its downward trend in incidence and has once again exceeded 100 cases per 100,000 inhabitants after 92 last week. “More than the effect of macro shoot, I am concerned about the increases in infections throughout the country, “says epidemiologist Quique Bassat. The incidence has increased in Aragon, the Balearic Islands, the Canary Islands, Cantabria, Castilla y León, Catalonia, the Valencian Community, Extremadura, Galicia, Madrid, Murcia and Melilla Many of them, with no known relation to the Mallorca outbreak.

“The sanitary and epidemiological impact, in collective terms, may not be so important”, acknowledges Mario Fontán. The health worker warns that, although the vulnerable population is covered, the second doses of a stretch of 60-69 years are still lacking. “Vaccines are not infallible and can fail in the population that responds worse by age or by underlying pathologies. In macro numbers, it may not have a great impact, but in micro, that a young person infects a family member can cause suffering.” The key is, in his opinion, to find a middle ground between “the catastrophic discourse and the one that takes away all the importance of COVID-19.”

In macro numbers, it may not have a great impact, but in micro, a young person infecting a family member can cause suffering. The tension is between the catastrophic discourse and the one that diminishes the importance of COVID-19.

Mario Fontan
– Preventive doctor and researcher

Regarding whether the mobility and relaxation of the measures associated with summer can represent a peak like that of August 2020, experts prefer not to compare. “Last year the incidence was much lower, but there were not so many vulnerable people protected by the vaccine,” Fontán points out. It also recognizes that not only hospital indicators matter. “They are very relevant, of course, but the great error of the entire pandemic has been to measure saturation only in hospitals and not in Primary Care, which are the ones that from now on will manage the tests, screenings and tests. low, “he remembers.

“It was not difficult to anticipate: remove the mask, remove prevention measures, reopen nightlife and organize mass trips, and join it to a much more transmissible delta variant, was the recipe of the great outbreak “, Bassat enumerates.” This should serve as a lesson and to give thanks to the vaccine: if it had occurred among unvaccinated 60-year-olds, it would have been a carnage, “says the epidemiologist.

Both he and Fontán trust that this is not the usual trend of summer. First of all, because of the image it offers outside of Spain at a time when the “green” label is played to receive tourists. And finally, because “some measures are recoverable” if it is shown that this has had an unacceptable impact on the trend of the pandemic.