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Los expertos creen que la "irresponsabilidad social" ha situado a España como líder de contagios en la Unión Europea

España se ha convertido esta semana en el país europeo con mayor tasa de contagios de coronavirus en los últimos 14 días: alrededor de 130 por cada 100.000 habitantes. Con unos indicadores considerablemente inferiores figuran Italia, Francia o Reino Unido, territorios que también sufriendo fuertes oleadas del virus.

El récord de positivos en España (alrededor de 325.000 desde que se declaró la pandemia) contrasta con el hecho de que nuestro país sea uno de los que más y mayores limitaciones ha establecido para tratar de contener al virus: desde el uso de mascarilla obligatoria hasta el cierre del ocio nocturno en el conjunto del Estado pasando por la prohibición de fumar en espacios públicos, entre muchas otras.

Con este marco tan restrictivo, ¿cómo es posible que la curva de contagios no se consiga doblegar y cada vez haya más rebrotes y positivos? La respuesta a esta pregunta no es fácil, ni única ni explicable tan solo desde el plano de conocimiento de la salud pública y la medicina.

El aspecto social, la forma de entender la vida del común de los españoles, también tiene mucho que ver en una pandemia como esta, en la que la responsabilidad de los ciudadanos resulta vital.

“No es fácil saber por qué España tiene la tasa de contagio por coronavirus más alta de Europa, pero probablemente se debe, en primer lugar, a un bajo cumplimientos de las medidas de autoprotección por algunos sectores de la población y, en menor medida, a limitaciones en las actividades de rastreo”, opina Fernando Rodríguez Artalejo, médico epidemiólogo y catedrático de Medicina Preventiva y Salud Pública en la Universidad Autónoma de Madrid (UAM).

“Sabemos que las medidas de autoprotección (mascarilla, distancia física...) son eficaces, por lo que la primera hipótesis es que no se han seguido bien, en algunos casos por actitudes irresponsables en actividades de carácter social”, agrega el profesor Rodríguez Artalejo, y cita reuniones familiares, funerales y espacios de ocio nocturno como algunos de los lugares en los que se relajado la observancia de medidas.

En este sentido, este experto en Salud Pública apunta que es posible que “la disciplina social” sea “menor” en los ciudadanos de los países mediterráneos que en los del centro y norte de Europa.

"No tenemos suficiente información epidemiológica comparada para interpretar de forma solvente cuales son las causas (del número de contagios en España a pesar de las restricciones)", indica Ildefonso Hernández Aguado, catedrático de Medicina Preventiva y Salud Pública y director del departamento de Salud Pública, Historia de la Ciencia y Ginecología de la Universidad Miguel Hernández, que añade que se ha de tener en cuenta, entre otras variables, "el incremento de la frecuencia de práctica de pruebas diagnósticas en España, que ha resultado en un incremento del porcentaje de asintomáticos."

Por ello, incide este experto, "se observa ahora una menor frecuencia de hospitalización y una menor letalidad, en comparación a los meses de marzo y abril". Más allá de este factor, agrega este catedrático, "es posible que la mayor intensidad de interacción social en la población más joven haya contribuido a aumentar la incidencia de infección en estos grupos". En este sentido, destacada que quizás "el cumplimiento de las medidas de protección no sea tan acentuado en jóvenes, lo que indica la necesidad de acciones de comunicación en salud pública adaptadas a las particularidades de este colectivo".

"El virus no desapareció con la llegada del verano, la gente pensó que sí, se confió y relajó las medidas de seguridad", aseguraba hace unos días en una conversación con 20minutos el catedrático de Patología Animal y director del Centro de Encefalopatías y Enfermedades Transmisibles Emergentes de la Universidad de Zaragoza, Juan José Badiola.

Este experto señala que en el origen de muchos rebrotes estaría esa carencia de responsabilidad social y también el hecho de que se llegó al verano con un "gran reservorio" del virus: las personas asintomáticas. En este sentido, Badiola se pregunta si España tiene más o menos casos de este tipo que en otros países de Europa...

Y señala: "Me cuesta trabajo pensar que España tenga más asintomáticos que Suecia, por ejemplo... ¿Cuál es la diferencia? Que ellos no tienen las costumbres sociales nuestras: no se abrazan, no se besan, si les dice la autoridad 'oiga, usted no se reúna con más de diez personas', pues allí no se reúnen con más de diez personas..."

La semana pasada, el ministro de Sanidad, Salvador Illa, hizo especial hincapié en la responsabilidad ciudadana para frenar los contagios, que llevan varias semanas al alza. La sociedad, señaló después de anunciar las nuevas restricciones que están entrando ya en vigor en las diferentes CC AA, no puede "tolerar que un comportamiento incívico de un ciudadano ponga en peligro" todo lo que se está consiguiendo en la lucha contra el virus.

El ministro se dirigió en especial a los jóvenes, a quienes instó a mantener la "disciplina" durante los meses que faltan hasta que "haya un tratamiento eficaz o una vacuna" contra el coronavirus.

Pero está claro que la ligereza de algunas personas a la hora de seguir las normas establecidas en materia de salud pública no son la causa exclusiva de los rebrotes. El catedrático Fernando Rodríguez Artalejo señala que los efectos de esa “menor” disciplina social se ven acentuados por los riesgos que conlleva la alta movilidad en nuestras áreas metropolitanas.

También asegura que influye que al principio había “cierta pasividad de las autoridades” en la exigencia del cumplimiento de las medidas de autoprotección y que en su momento no se prestó suficiente atención a ciertos grupos de especial vulnerabilidad (como son los trabajadores temporeros hortofrutícolas, las empresas cárnicas y personas que vienen en barrios de bajo nivel socioeconómico) que acabaron provocando brotes en algunas comunidades, como Aragón y Cataluña.

“Las medidas restrictivas han venido a posteriori, para controlar la transmisión comunitaria, y tendrán cierto efecto”, asegura el catedrático de la Autónoma, que añade que en Cataluña, “ya se ha estabilizado el gran crecimiento en el número de casos, aunque sigue siendo muy alto”.

Otras de las piezas a tener en cuenta para completar este complejo puzle, a juicio de Rodríguez Artalejo, son las “insuficientes” labores de rastreo. El profesor explica que este trabajo constituye “una segunda barrera a la transmisión” porque si los ciudadanos no siguen las medidas de protección y hay cierta transmisión comunitaria, “se verá desbordado”, como ya está sucediendo en algunos territorios. De ahí, abunda, que hayan sido necesarias medidas extra de control social, como el cierre del ocio nocturno, la limitación de horarios en hostelería o la prohibición de fumar si no hay distancia física, para tratar de frenar los contagios.

Lo previsible es que la incidencia de estas medidas sobre la curva de contagios, hoy por ascendente, se note en unos días. Lo esperable es que sea un impacto reductor, que consiga doblegar la curva.


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