Although the incidence and hospitalizations have been above the national average, the capital has not experienced the announced catastrophe.

The Isabel Zendal hospital, specific for Covid-19 cases.

On September 18, 2020, after knowing the worst figures in number of infected since April, President Isabel Díaz-Ayuso, Vice President Ignacio Aguado and the Minister of Health, Enrique Ruiz-Escudero summoned the media to a televised press conference. The state of nervousness was total and unflattering.

Despite being a prepared intervention, citizens had to listen to the same speech three times and only at the end, when asked questions from the media, were we able to find out exactly what measures the community government had prepared to stop what was a second wave ahead of the rest of Europe.

All this nervousness, all this feeling of being overcome by events, collided with the work that the Community technicians had been carrying out for weeks before. A work based on the speeding up of the results through the massive application of “rapid tests” of antigens and mass screening in basic health areas with high incidence, something that, in principle, was contraindicated for this type of diagnostic test … but it worked.

In that press conference, these measures and the following two weeks of the evolution of the pandemic in Madrid, the autonomous management is summarized: a community that had to always anticipating, and often blindly, that it broke with established agreements on how to combat the virus and that it lived in constant confrontation with the central government and its technicians.

The pandemic in Madrid got off to a very bad start. All the aforementioned constants can already be observed in the week prior to the announcement of the state of alarm on March 13: Madrid did not have the first outbreaks (those were in Haro, Vitoria and Igualada) but had the most serious and also focused on residences and hospitals, a gruesome combination.

Madrid was the first to have serious hospital problems and the first to be singled out: throughout that week, the closing rumor did not include the whole country but only Madrid, just as in Italy it had happened with Lombardy. When Fernando Simón affirmed that it was absurd to close the schools, Madrid followed the decision made by the Vitoria city council and closed its own without any consensus, giving a clear alarm signal of what was coming.

Covid data in Spain.

Covid data in Spain.

The collective imagination remembers Madrid as the place where there were the most deaths during the first wave. The harsh images of the Ice Palace, a recreational place for children in the Hortaleza neighborhood, turned into a morgue. Actually, following the official data, There were more deaths in Castilla La Mancha, especially in Cuenca and Albacete.

Until May 11, according to Health, 8,683 Madrilenians died out of a population of 6.5 million. In Castilla-La Mancha, with 2 million inhabitants, had registered 2,786 deaths by then, percentage higher numbers.

However, Health did not include in its figures all the Madrilenians who died without having passed a test. And they were many. Those who died in hospitals admitted by default to Covid plants without time for a test that did not arrive, those who died in residences, those who died at home without time to join a collapsed emergency room.

The data of the Community of Madrid for that same day, which is where all the divergence is concentrated, speak of 13,704 deceased, of them 4,438 in nursing homes, an outrage that no one has just touched at all because both the regional and national governments have little to gain from the dispute.

Madrid was one of the first to ask to get out of the control of the sole command and one of the last to do so. It did not enter phase 1 until May 25. That meant being able to open bars, restaurants, cinemas, theaters and shops with limited capacity, that is, basically what we have now.

The decision was quite controversial and in principle endorsed by a “committee of experts” that it is not at all clear that it existed beyond the minister Illa himself, the director of CCAES and the director of Public Health. The excuse for delaying the phase passage of Madrid was the high number of occupied ICU beds. At that time, there were 236. The latest update published on Wednesday March 10, 2021 indicates 471 patients in critical condition.

Evolution of hospitalized cases in Madrid.

Evolution of hospitalized cases in Madrid.

Strictly speaking, Ayuso only had a quiet month at the head of the pandemic: June. It was the month in which it was threatened to settle accounts and it was warned of what could enter through Barajas. Again, discrepancies with the government. The summer was a small nonsense: while the members of the autonomous government, especially those of Ciudadanos, invited tourists to return to the center to consume, the incidence of infections rose every week without anyone doing anything about it.

September 18 did not arrive from one day to the next. During nine weeks in a row, the number of infections rose, first slowly and then with a certain noise, and the number of hospitalized patients went up as well, although nothing comparable to that of March and April, of course.

The peak of daily infections of the second wave was 7,226. The peak of hospitalized patients came ten days later and stood at 3,326. Nor do we know to what extent the first data is accurate since the information given in the regional report was badly dated. Those were the days when It could take a week for them to do a PCR test and another week to know their result.

A whole quarantine in uncertainty. The antigen tests changed everything, as did the screening, as probably helped by the fact that the regional measures were added to those imposed by the central government: a state of alarm that lasted from October 9 to 24 when the situation seemed to begin to be controlled.

Since then, already in that strange co-governance regime in which the national executive limits itself to providing a legal framework within which communities can act more or less as they please, Madrid has openly opted for a way of reconciliation between health and economy.

While the other communities closed and confined to the minimum alert, Madrid has since August 14 of last year without falling below 190 cases per 100,000 inhabitants in 14 days, and since January 13 of this year, without lowering the 450 hospitalized in ICU, which would mark 35% of Covid occupancy on the total of expandable beds that was established as an indicator of sanitary collapse at the meeting of the Interterritorial Council of Early October Health.

Situation of assistance capacity.

Situation of assistance capacity.

In turn, the relatively low mortality (since August 6,408 deaths have been reported, that is, one in a thousand Madrilenians has died in this period alone) has transferred an image of success that is undoubtedly nuanced but has a point of truth: other regions and other countries, with much more restrictive measures for their economies and their social life, have obtained worse results.

Of course, they have not subjected their healthcare system to such constant pressure for so long. The economic results, on the contrary, have been quite encouraging and at the forefront of everything, the figure of the Deputy Minister of Public Health, Antonio Zapatero, has stood out as a man who at least knew what he was doing and cared to explain it.

In summary, Madrid has not experienced the apocalypse that has been predicted so many times, but it is still in very high numbers compared to the national average. The data for Tuesday, March 9, 2021 speak of a 14-day incidence of 232.2 cases per 100,000 inhabitants, bordering on extreme risk.

If we look at the incidence at 7 days, Madrid is the second community with the worst numbers, only behind Melilla. Regarding hospitalized, the regional report speaks of 2,135 hospitalized, of which 471 would be occupying an ICU bed. The ministry raises those numbers to 2,235 and 496 respectively, the only community next to La Rioja to exceed the aforementioned 35% Covid occupancy.

Anticipation in the closure of schools, insistence on passing the phase after confinement, antigen tests, screening and perimeter closure by health areas and by municipalities, together with a policy of incentive for the hotel and trade industry. Those six have been the measures that have marked the actions of the Díaz-Ayuso executive during this pandemic.

Assessing them one by one would require a doctoral thesis, because no one is quite clear about why or to what extent they have worked or, rather, what the verb “to function” means. What is clear is that Madrid set a goal, went ahead of everyone to achieve it and risked everything necessary without causing a hecatomb. Many did not bet on it.