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HEALTH

‘Stay at home’: How to self-isolate in Spain and what to do if you have symptoms

Spain has seen the number of infections spiral since the start of the week,becoming one of the worst-hit countries in Europe, overtaking France with the highest number of cases.

‘Stay at home’: How to self-isolate in Spain and what to do if you have symptoms
Avoid socializing and stay at home is the advice from health officials in Spain. Photo: AFP

The speed of contagion appears to have surpassed that of Italy a week ago.

But apart from four towns in Catalonia authorities have so far ruled out an official lockdown even in Madrid which counts around half of the cases across Spain.

However, Madrid authorities have taken new steps to limit contagion and are urging residents to stay at home and “self-isolate” and if they show symptoms of the coronavirus then to put themselves in quarantine.

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Ignacio Aguado, vice president of the Community of Madrid said: “We need people to stay at home, and if they don't do it voluntarily, we will have to bring in forcible measures to see that they do.”

In an interview with TVE on Friday he warned: “This is a silent hurricane. We need people to be aware. We are going to have two or three very difficult weeks.”

He insisted that the hospitals were now at breaking point. “The health system is at its limit. People need to people stay at home, not just in Madrid but throughout Spain.

“The virus is incubating. The real problem is that as the infected population grows, critical cases grow and will lead to the collapse of the health system.

“It is important that the elderly stay at home but also the young, because they can infect others in whom it can be lethal. All of society must be aware of the seriousness of the problem.”

His warnings came as Madrid mulled measures to force the closure of restaurants and bars.

Authorities have already shut down schools, universities and elderly day care centres and closed sports facilities and cultural centres.

Madrid has borne the brunt of the crisis, clocking up more than 2,000 infections and 40 deaths by Friday morning.

Residents have been told not to travel to other parts in Spain but without official controls, many have already done so, including students who have returned to their home towns after university classes were suspended.

Reports that families were decamping to second homes or renting ‘casa rurals’ to escape the city have also caused fears that the virus will be spread further rather than contained.

“To beat the virus as quickly as possible, responsibility and socialdiscipline is essential. This requires big changes in our habits,” said Prime Minister Pedro Sanchez in a televised address on Thursday evening. He will conduct all future meetings by video conference.

The hospitals are so overwhelmed with new cases of coronavirus that many have reported being unable to speak to medical professionals, even if they are showing symptoms of having the covid-19.

The current advice for those who display mild symptoms including a cough, fever or shortness of breath is to quarantine at home.

Isolation:

  • Isolate a suspected coronavirus patient in their own room with exclusive access to a bathroom If that is not possible then maintain at least two metres from the patient at all times
  • The room should be well-ventilated with an open window to the outside, but avoid air currents to the rest of the house.
  • Keep the door shut on them to avoid contagion with those living in the rest of the house.
  • Make a flip top bin available for them (lined with a bag) so they can dispose of their own waste tissues.

Communication:

  • Make sure they have a phone line to communicate directly with medical staff in case the symptoms worsen.
  • To minimise contact with the rest of the household, use a monitor (such as in use for young children) or communicate by mobile phone.

Confinement

  • If possible limit the patient’s movement in the rest of the house to avoid contagion with others living there.
  • If that isn’t possible then make sure they use a face mask and wash their hands frequently
  • Pay special attention to clean everything handled by the patient and disinfect it after they have touched it
  • Avoid other people coming to the house

Keep clean

  • Wash hands properly after every interaction with the patient.
  • Everyone in the household should wash hands after coughing, sneezing, using a tissue, and before eating and after wiping down surfaces.
  • Keep a set of utensils, cup, glass, plates etc, only for use by the contagious person
  • If you have to share a bathroom with a contagious person make sure it is cleaned with bleach and wiped down thoroughly after they have used it and keep their own towels etc in a separate place from your own.
  • Clothes worn by contagious people should be kept in a sealed bag after use and then washed separately at a temperature of between 60-90C

People have reported difficulties in contacting medical authorities to report their symptoms and request coronavirus testing and it now seems likely that only those with more than mild symptoms will be advised to do so.

Those with severe symptoms should attempt to seek medical treatment by calling the regional coronavirus hotline (listed by region in the tweet below) or if emergency treatment is sought then the 112 emergency number.

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HEALTH

When can doctors in Denmark refuse to continue treating patients?

General Practitioners in Denmark have the right to break off a patient-doctor relationship in specific circumstances.

When can doctors in Denmark refuse to continue treating patients?

Although doctors in Denmark have the right to decide not to continue treating a patient – requiring them to find a new GP – the circumstances in which this can happen are limited, and must be approved by health authorities.

The frequency in which the circumstances arise is also low. A doctor decided to no longer receive a patient on 375 occasions in 2016, according to the medical professionals’ journal Ugeskrift for Læger. The following year, newspaper Jyllands-Posten reported the figure at 458.

There are two main categories of circumstances in which a doctor can choose to take this step. The first is in instances of violent or threatening behaviour from the patient towards the doctor. 

The second (and most common) is when the doctor considers the relationship to have deteriorated to the extent that confidence has broken down, according to Ugeskrift for Læger.

It should be noted that patients are not bound by any restrictions in this regard, and can decide to change their GP without having to give any justification.

A patient also has the right to appeal against a doctor’s decision to ask them to find a new GP. This is done by appealing to the local health authority, called a Region in the Danish health system.

In such cases, a board at the regional health authority will assess the claim and if it finds in favour of the patient may order the doctor to attempt to repair the relationship.

Doctors cannot end a relationship with a patient purely because a patient has made a complaint about them to health authorities. This is because patients should have the option of making complaints without fear of consequences for their future treatment. 

However, if this is accompanied by the conclusion on the doctor’s part that there is no longer confidence in them on the part of the patient, they can remove the patient from their list.

The right to no longer see patients in the circumstances detailed above is provided by doctors’ collective bargaining agreements, the working conditions agreed on between trade unions and employer confederations under the Danish labour market system.

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