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HEALTH

Coronavirus death casts dark shadow over Spanish town

After burying five elderly people in one morning, the local priest can finally remove his gloves, a job all too familiar in this central Spanish town blighted by death.

Coronavirus death casts dark shadow over Spanish town
Photo: PIERRE-PHILIPPE MARCOU / AFP

These days, they no longer publish death notices in Tomelloso, a town of 36,000 located in the arid plains of La Mancha, about two hours south of Madrid.

Before the epidemic took hold, it was a peaceful town visited by tourists following in the footsteps of Don Quixote, the delusional would-be knight in Miguel de Cervantes' 1605 novel.

Known for its vineyards, Tomelloso would normally be gearing up for its end-of-April festival celebrating the Virgin of the Vines featuring floats, fanfares and carts pulled by mules in vibrantly colourful regalia.

But things this year have been very different, with Mayor Inmaculada Jimenez saying the virus killed at least 104 of the town's residents in March alone.

“I'm speaking to you through the pain… that we all feel over the savage way this virus has brutalised our town,” said the 38-year-old in a video from home at the end of March, not long after giving birth. 

Buried without family or flowers 

“It was only five burials today, but we've had as many as 10 or 12,” said one of the graveyard workers. Today it was 80-year-old Jesus who was being buried — alone, without family or flowers.

Only three graveyard staff were there, standing around his coffin as the priest gave a brief blessing.

At the burial of former bus driver Aquilino, 88, who died at an old people's home, three of his relatives were present — the maximum number allowed as Spain's death toll climbed towards 16,000.

Ana Alcolea, one of his four children, told AFP only she could be present.

“The other three are in Barcelona — two have coronavirus and the other works in a hospital,” she said.

It's not easy “to get used to the situation”, said Alcolea, 51, who was unable to see her dad during the last month of his life, except for during rare video calls with the help of the nurses.

Death notices are no longer put up here, says Alcolea, who believes the number of dead is higher than that given by the town hall.

Regional figures show there are 99 coronavirus patients in the town's hospital and many more are sick at home.

'We need heroes'

Worst-hit has been the Elder retirement home where Aquilino lived.

Taped to its front door is a sign seeking help which reads: “We need heroes.”

“We put it up because we're having a problem finding staff,” explains one of the nurses in this 170-bed private residence, wearing a full protective suit.

In mid-March, regional health authorities said 15 people had died at the home, although a local official said by now the toll was likely to be closer to “around 50”.

Appearing on Spanish television, the home's manager seemed completely overwhelmed, describing it as “a horror film”.

And when the authorities finally moved in, they said the residency no longer had a doctor “because he left”. Within the Castilla-La Mancha region, at least 177 of its 400 old people's homes have been affected by the virus, officials say. 

'All the doctors are sick'

Leaving a health centre after finishing her shift, 52-year-old nurse Belen Penaranda said the effect of the virus had been devastating.

“It's been appalling. It's hard to see people dying when you can't save them,” says Penaranda who normally works in paediatrics but is helping out wherever she can.

She says her former workplace had to be closed down as “all the doctors and more than half of the nurses were sick” because they were not able to protect themselves properly.

She herself has one green surgical mask. Instead of a gown she wears “a painting overall given to me by a friend”.

“Planes (of medical equipment) keep arriving from China but I don't even have a FFP2 mask,” she says of the white facemask which offers the best protection.

Near the town's shuttered bullring, three police cars sound their sirens as they drive past a building until an elderly lady comes to the window.

When they see her, they get out and begin clapping. “She's sick so we applaud her every day,” says one of them, clearly moved.

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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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