As the head of the Emergency Department at the Clínico Virgen de la Victoria hospital in Malaga, Eduardo Rosell has seen the cruelest side of a new illness that can affect anybody. Now that Malaga is in Phase One of the easing of lockdown and the restrictions of the last two months are not as strict, Dr Rosell says people still need to be cautious in order to prevent further infections. "We need to be cautious and not go out happily into the street as if nothing had happened, thinking this is over," he warns in this interview.
-Do you think people here are behaving well after more than two months of this health crisis, or is there a certain relaxation now?
-Overall, people in general have been very aware of the fact that the number of infections has been dropping because of the confinement. Lockdown is a tool that shows us that people have done as they were told, stayed home and behaved themselves. They have also followed the hygiene advice. Having said that, there are always some who don't comply with rules.
-There is a risk that the coronavirus will flare up again. What do you think needs to be done to reduce the chances of that?
-In Malaga 4.4 per cent of people have had the illness and in Spain as a whole the average is five per cent. Those figures show that the percentage of the population with antibodies that offer immunity from coronavirus is very low. This means the way to prevent contagion is to follow the safety and hygiene measures, which are simple, and anyone can do that.
-Everybody should know what those measures are, but it is always good to make sure. Could you remind us?
-It is essential to keep washing your hands, use protective gloves, maintain social distancing and use masks when you go out. It's right that masks are being made obligatory, because they are one way of preventing infection. The mask protects the person who is wearing it and also those nearby. They mean you can isolate yourself more from what is around you, and it is also necessary to keep two metres away from other people. This protection 'obliges' you to be more careful in your personal relations. There are many other basic measures that help to prevent contagion, including intensifying the cleaning of your homes, using a lot of bleach and detergent in kitchens and bathrooms, and also communal areas, and frequently cleaning the handles of doors and windows.
-So you agree with the measure to make masks obligatory, not just on public transport but everywhere.
-I believe people should wear a mask whenever they go out into the street. In the hospital, we are used to wearing a mask all day anyway, from the moment we arrive to the moment we leave. Also, when you go into your home you should wash your hands, and have a cloth with bleach by the front door to disinfect the soles of your shoes and avoid physical contact with the rest of the family. In our case, when we leave the hospital we are always a bit afraid of carrying the virus into our homes. That's why it is important to avoid direct contact. It is preferable to be as least affectionate as possible with your loved ones.
-We are allowed to go to the terraces of bars now. What do you think we should do if we choose to do that?
-Be very, very careful and cautious about touching the table and the chair you are sitting on, and of course don't cough on anybody or over the beer or whatever they are having. There are numerous risk factors when you go outside. I'm not saying don't go to bars, just be cautious and use common sense to prevent possible contagion.
-In other words, use your head when you go out and don't put yourself or anybody else at risk, is that right?
-Exactly. We have to go out sometimes, but it is essential to be really cautious and not act as if nothing has happened, when there have been so many deaths and so many people have been very seriously ill in the intensive care units.
-The key, then, is that we should not drop our guard or feel overly confident because the number of infections of SARS-CoV-2 has dropped.
-That's it exactly. Above all, we must not lose our fear of this virus, because it will be with us until we have sufficient immunisation to deal with it, as we do with flu, for example. This is a new virus. There is still a great deal that we don't know about it, and an awful lot that we can't explain. We don't know what its morphology is, nor how it behaves in humans. Several research studies are being carried out, but there is still so much we don't know about how coronavirus behaves. For example, we don't know why it affects some people more than others. There is still so much we need to find out. That's why it is best to treat it with great caution and not trust it for a single moment.
-So precaution is essential if we are to prevent a second wave which could end up with the intensive care units being full again...
-Of course. I repeat: we really have to be on our guard with this virus, because we still don't have a specific treatment for it. We have to do everything we possibly can so that patients don't end up in the ICU. The patients who come out of intensive care are still suffering serious respiratory problems, which can affect other organs and cause loss of musculature. They are people who have overcome the most critical phase of the illness, but once they leave intensive care they still have to go through a process of rehabilitation and adaptation.
-The population needs to be very aware that Covid-19 is an illness which is extremely serious if there are complications, and can mean a patient needs intensive care and may die.
-Yes, that's correct. I'll say it yet again: we have to treat this virus with great caution, adopt all possible preventive measures and not go out happily into the street as if nothing had happened and thinking it's all over, because it did happen and it is far from over.