Candel et al. recently published preventive health strategies and policies implemented in the Community of Madrid to face the second wave of COVID-19 [1]. Although the measures enumerated are strongly advocated by the authors, some of them are controversial and have questionable effectiveness.
Selective perimeter confinements, by basic health area, were proposed as one of the local government's top measures. But unlike the authors’ claim, it hasn't been followed by observable differing trends in confined versus unconfined neighborhoods [2]. Therefore, the magnitude of its impact appears to be minor, as the article to which the authors make reference to points out. In addition, the authors associate this controversial strategy with an increased use of barrier measures, despite no scientific evidence whatsoever supporting this assertion.
Regarding the "limited diagnostic resources" the Community of Madrid had to face, the authors responded with pioneering measures, including antigen testing and contact surveillance. Regardless of the controversial role of antigen testing in asymptomatic contact settings, the cornerstone of the epidemiological surveillance is the invaluable work of contact tracers. However, at the peak of the second wave, Madrid was well below the international recommended ratio of 30 professionals per 100,000 inhabitants as local authorities from Madrid admitted [3]. Moreover, in September, the Community of Madrid stopped PCR testing of close contacts unless they were cohabitants or people at risk [4]. The lack of detection may have led to a decrease in the number of reported positive cases, giving a spurious sense of control of the pandemic. Notably, despite the measures praised by the authors, the desired figure of 25 cases per 100.000 inhabitants was not reached at any time during the second wave (the lower figure of cumulative incidence was 190 as of December 9) [5], chaining the second to the third devastating wave we are currently dealing with.
Though we understand a “commentary” to be a kind of article where opinions as well as scientific data can be discussed, we feel that in this particular case the authors have used a scientific platform to praise the local government's policies without objective data.
Author contribution
Both authors contributed equally
Declaration of competing interests
None
References
- 1.Candela, F.J., San-Román J., Barreiro P., et al. Integral management of COVID-19 in Madrid: turning things around during the second wave. Lancet Region. Health – Europe [ahead of print]. [DOI] [PMC free article] [PubMed]
- 2.Comunidad de Madrid. Datos sobre coronavirus, covid 19 -TIA zonas básicas de salud. Last accesed on Febrery 2021. Available at: https://datos.comunidad.madrid/catalogo/dataset/covid19_tia_zonas_basicas_salud
- 3.https://elpais.com/sociedad/2020-10-26/espana-tiene-el-doble-de-rastreadores-que-en-julio-pero-llegan-tarde.html
- 4.Comunidad de Madrid. Protocolo de actuación ante la aparición de casos de COVID-19 en centros educativos de la comunidad de madrid. Last accesed on Febrery 2021. Available at: https://www.comunidad.madrid/sites/default/files/doc/sanidad/epid/protocolo_actuacion_casos_covid-19_en_centros_educativos_cm.pdf
- 5.Ministerio de Sanidad. Actualización nº 268. enfermedad por el coronavirus (COVID-19). Last accesed on Febrery 2021. Available at:https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov/documentos/Actualizacion_268_COVID-19.pdf