Madrid breaks the bridges with Health after being left behind by the delay in detection



05/16/2020 05:00Updated: 05/16/2020 06:26

The The confrontation between the Community of Madrid and the Ministry of Health seems insurmountable. After receiving another refusal to advance in the de-escalation, the region will remain in phase 0 —Although with some relief for the economic recovery, so it can be spoken of a stage 0.5— at least, another week. And all this despite the insistence shown by the autonomous administration, which not only claims to be “ready” to move to the next level, but also branded as “political attack“the decision of the central government.

The environment of Isabel Díaz Ayuso frames him in the “campaign” that his Executive is suffering in recent days, while the regional vice president, Ignacio Aguado, speaks openly of “political decision without technical criteria”. Bridges are broken to the point that the Community will formally request a written report with the objective criteria to deny them the pass, and does not rule out legal actions against the Government “in case of not receiving it” or of verifying that “citizens have been deliberately harmed” of that autonomy. In the central executive, although they admit that Ayuso seeks the “frontal shock”, they believe that not all channels of dialogue have been flown, since the regional councilor, Enrique Ruiz Escudero, “interested” to maintain the dialogue with Health.

Although Minister Salvador Illa refused to explain the evident clash between administrations, the head of the Coordination Center for Alerts and Health Emergencies (CCAES), Fernando Simón, did openly acknowledge that there had been a strong debate, “an important discussion “ between authorities. The fire is widening, and Madrid is not a minor region: Ayuso is the main institutional benchmark for Pablo Casado, who bet on it and launched it, and his government is used as a battering ram against Pedro Sánchez.

Beyond the Interterritorial Council of the National Health System that Health celebrates every Friday with the Autonomous Communities, Illa spoke by telephone with the counselor Ruiz Escudero throughout the afternoon. There was no bilateral meeting as Ayuso had mentioned the day before, but a call “of just three minutes“It did not sit well in the Community either. That was the culmination of an intense day, with more exchange of documents and conversations between the technicians, as confirmed by health sources.

In fact, since Thursday it was a fact that Madrid would not advance in level. The regional president already advanced it after the first meeting with the ministry. “He does not seem willing to go to phase 1,” Ayuso complained on the eve of San Isidro, without the decision having yet been made in Moncloa. But on Friday it was confirmed and addressed at the meeting of the de-escalation committee, chaired by Sánchez himself. Despite the “impressive progress”, in the words of Simon, the Community I still wouldn’t be ready to make the jump.

Madrid breaks the bridges with Health after being left behind by the delay in detection

The arguments of the central executive emphasize that in the de-escalation process the key factor is the early detection, to isolate and track contacts across the primary care, the most important medical unit in this period. According to Health sources, it is only “two days” ago that the Madrid region began to reinforce the activity of health centers, so they understand that it is necessary to “consolidate” the detection system so that its real capacity to diagnosis. Without that guarantee, “and not just promises “, the ministry prefers to remain prudent. Moncloa continues to remember that primary care was precisely the level of care “that most cuts suffered during the crisis. “

The Executive notes that just two days ago the region began to reinforce primary care, the great victim of past “cuts”

In addition, the central government also insists that it is the autonomous community with the highest level of transmission and the highest incidence in the pandemic. Not only has it registered the highest number of affected people (66,005, almost a third of the total, 230,183), but it also accumulates the highest figures for hospital admissions, in ICUs and deaths. That it is the autonomous community with the highest population density in the entire country – especially the capital itself – also favors a high rate of contact between people, thereby increasing the probability of transmission of covid-19. In addition, the Government argues, Madrid is a central node of mobility throughout the country, so the risk of the disease spreading increases, which requires caution. Are the “particular circumstances“to which Simon was aiming, despite the effort and progress made.

Juanma Romero

32 million Spaniards are already in the midst of declining confinement, but 30% remain in stage 0, although with improvements. Premises of more than 400 m2 may open at 1

Madrid does not see it: “It is an arbitrary decision”

In addition, the director of the CCAES pointed out that there have been in Madrid “a very important number of undetected cases” that could still be spreading the disease. He added that it is not a “low number given the volume of infections that have been detected” in the region. In short, the treatment of Madrid or Barcelona, which will also continue in that phase 0.5, cannot be the same as in other cities, because in both points the evolution of the pandemic has been “explosive”. “If Madrid has an outbreak,” warned Simón, “will probably affect all of SpainAs a summary from the ministry: a virus in Madrid is like operating a fan.

Ayuso stresses that Madrid meets the criteria and sees a “political attack”. “This decision has been made beyond the doors of the ministry,” he argues.

There is another element that the Government uses: the de-escalation process is “very complex” and requires that the management teams be “highly coordinated”. However, Madrid has just relieved the resigning director of Public Health, Yolanda Fuentes, so it is required that the new leadership dome “settle and assume the situation.” Lastly, Health uses the flexibility measures that are introduced as of Monday (and that are published this Saturday in the BOE), which allow us to talk informally about that stage 0.5, allow some relief “without increasing the risks of crowding or increased mobility. “That is why the green light is given to the opening of retail stores up to 400 square meters, libraries or museums under certain limitations, but neither terraces nor social contacts are authorized. The transition, reiterates the Executive, it is not a “competition” or an examination, but a process that requires the maximum “caution” and to land in the new normality “as soon as possible” it is key “not to take precipitous steps”.

Madrid breaks the bridges with Health after being left behind by the delay in detection

But all these explanations, insist from the Community, do not meet real health criteria. According to the Autonomous Administration, Madrid has had a positive evolution of all the required objective markers, where the number of hospitalized patients has also decreased by 86% and admissions to intensive care by 73%. In fact, Ayuso says that the region “has addressed and rectified” these days the issue raised last week by Health to deny the move to phase 1, in reference to conducting PCR tests. “We have expanded the capacity to more than 11,000 daily and we are ready to make even 15,000“they assure.

In the Community, in fact, they consider that the conduct of the central Government with Madrid is “arbitrary“and insist that in a health crisis” political criteria cannot in any way prevail. “It is clear that this decision has been made beyond the doors of the ministry. The same people who denied the severity of the epidemic on 8-M now deny the phase change to Madrid without technical criteria, “concludes Ayuso herself, who next week will demand the report with objective criteria and will request the level jump again. .

Fernando Garea

The vice president of the Community of Madrid openly disagrees with the Madrid president’s strategy of confronting the central government and about the protests

“They hit with a song in the teeth”

Illa was asked several times about this issue. He insisted that the government complies “strictly” with the obligations of “transparency”, but did not show any report, nor did it do so last week after complaints from various communities, the case of Valencia, governed by the socialist Ximo Puig. In the end, he ended up opening the door for those documents to transcend if they are claimed: “The administrative records will be submitted to the consideration of whoever considers it, always based on what the current legislation establishes. “

Illa avoids the reproaches and does not remove the reports. In the central executive they believe that the president seeks to “confront”, but the dialogue will survive

Executive sources emphasize that there are evaluation reports and a written resolution, in addition to an agreement (in the best case) with each autonomy, but “there is no precedent“of this situation nor a protocol of what should be the flow of documents. They also remember that the Community of Madrid has not published either the reports that it draws up or its own experts in the area of ​​Public Health, also officials, such as those of the ministry .

Madrid breaks the bridges with Health after being left behind by the delay in detection

“Ayuso makes a noise, but deep down they [el Gobierno regional] they give a song in the teeth with this 0.5 phase proposed by Barcelona and which Madrid is now accessing – pointed out sources from the Executive who are familiar with the negotiations. But the Community plays all or nothing, because look for confrontation and anger. Miguel Ángel Rodríguez [MAR, el jefe de Gabinete de la presidenta] He plays to make her very famous, and he takes every opportunity. Now he wants to project an affront to the Government, but the councilor is not interested in flying the bridges with Health, and neither are we. “

Illa, in each public appearance, responds almost with traced words every time she is asked about complaints from the communities about mismanagement or about supposedly arbitrary decisions: she will not enter “reproaches“Nor did it this Friday, when the president’s outrage was already being heard.” We have a very cordial and friendly relationship with all the CCs. AA., Also with Madrid, and we will continue to maintain it. We are not going to issue any kind of reproach with any community. We are going to do our job the best we know and act with criteria of prudence, caution and security, “replied the minister. The president has set that guideline and also applies it, although his party sometimes goes on the offensive, blaming the uncontrolled expansion of the covid to the management of the regional government and cuts in PP administrations, in regional power since 1995, 25 years ago.

There is still a lot of de-escalation, many weeks of exams. The Ayuso’s war against Sánchez it has only just begun.


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