“Spain acted decently when the pandemic broke out”

The former Minister of Health, Salvador Illa, recalls in EL PERIÓDICO how were the beginnings of a pandemic full of uncertainties and that two years later it still has not ended

Salvador Illa (La Roca del Vallès, Barcelona, ​​1966) does not forget any detail of that decisive week in which Spain declared a state of alarm. It was March 2020 and the now first secretary of the PSC and leader of the opposition in Catalonia then held the position of Minister of Health. From his office in the Parliament, Illa assures that the covid-19 pandemic was the “most intense and exceptional” moment of his political career. This month marks two years since the appearance of the virus.

Do you remember that first meeting in which it was decided to apply the state of alarm?

I remember it well. The week that begins on Monday, March 9 and ends on Saturday, March 14, with the extraordinary Council of Ministers that agrees on the decree of a state of alarm, was very intense. It began with a phone call from the Basque Country Councilor Nekane Murga: there they already had a complicated situation in the Victoria area that led them to approve the suspension of school activities and the restriction of capacity. On Monday there was a face-to-face meeting with the counselor of the Madrid community at the Ministry to agree on the same. On Tuesday the minister’s council addressed the situation. On Wednesday, the WHO decreed the global pandemic. On Thursday, the European Center for Disease Prevention and Control (ECDC) decreed in Europe a public health crisis situation that affected the health system. On Friday the 13th, first thing in the morning, I had a call from the president, who asked my opinion.

And what did he say?

He asked me three questions. One, if we should approve the state of alarm: my answer was yes. The second was why: my answer, because the agility with which we had to make decisions was incompatible with a system like the one we have now, which forces us to call and agree on the measures with 17 autonomies. And the third question was if the Ministry of Health could direct all health in Spain, and I said no. He could lead the public health crisis, but not all health. Then he announced to me that we would shortly hold a meeting by videoconference with members of the Government team. There, the opinion of all was unanimous to convene a Council of Ministers and adopt a state of alarm. The president made the required calls to the head of state and the opposition, and announced it that same Friday in the early afternoon. And we already spent all of Friday afternoon and Saturday morning working on the text of the state of alarm, which came into effect on March 15.

He remembers the details of all those days.

I have had to tell it several times and they are difficult things to forget.

Did you expect that we would be confined for two and a half months?

No one knew how long we would be confined.

Were you concerned about how to convey this message to the public?

It was always clear to me that things must be explained to the public as they are, with transparency. You have to say what you know and what you don’t. We were fully aware that we were asking for very relevant sacrifices and, therefore, the minimum was to tell him the reasons that led us to make these decisions. On the other hand, everyone saw that this was happening everywhere, where similar decisions were made. There were four criteria that we had very clear from the beginning: science, joint work with the autonomous communities, coordination with all multilateral organizations at the European and international levels, and transparency. We worked from the beginning on two lines of communication: a more technical one that basically fell on Fernando Simón, and a more political one that fell largely on me.

“We work on two lines of communication: a more technical one that fell to Fernando Simón, and a more political one that fell to me”

What was the worst moment of the pandemic for you?

There was no worse moment, there were several especially tough moments. There were days – towards the end of March, the beginning of April – with a very high death toll. We reached 900 deceased some days. This does not leave you indifferent. There were also other moments on a more personal level that were difficult for me, for example when the Secretary General of the department at that time [Faustino Blanco] he had a heart attack and had to go to a hospital.

It was scandalous and painful to see how some nursing homes let their elderly die. Why did Spain allow that?

No, no, it was not allowed. Look, all over the world nursing homes had a very bad time, not only in Spain. Throughout the world we saw that there were some more vulnerable groups, specifically the centers for the elderly. From the beginning we made some protocols and I believe that all the communities, in the course of the first wave, made the right decision in my opinion to put the residences under the control of the health authorities – in many autonomies they were in the field of services social-. It seems to me that this has to lead us to conclusions and lessons to improve our model of care for the elderly.

There were communities that gave express orders not to transfer the seriously elderly to hospitals.

Look, on this I have always maintained a line of great prudence. With the people I worked with, who were the councilors of all the autonomous communities, everything that could be done and a little more was done at all times to attend to all areas. I’m not going to get into the political ‘pim pam pum’. Others have. I think what needs to be done is, when the time is right, calmly, draw conclusions about how things have gone, how we have responded to this, what aspect we can and should improve for eventual and future pandemics. I believe that Spain has acted with decency, and I believe that in view of how things are going – which are not over yet – our country has not done much better or much worse than the others. It has operated with license, thanks to a very resilient, very powerful national health system, which must be endowed with the necessary resources. And of course there are aspects that could be improved, of course there are.

How was your relationship with the autonomous communities?

Very complicity. We were all very aware from the first moment of what was potentially coming our way, and I have to tell you that it was a very complicity relationship not without some moments of discrepancy or tension; normal, on the other hand, when you handle situations of this kind. I want to value the very good work that all the autonomous communities have done in general.

“The councilors of all the communities always did everything they could and a little more. I am not going to enter into the political ‘pim pam pum’. Others have done it”

But they were sound -I’m talking about the second wave- the dialectical confrontations with communities like Madrid.

I have not had dialectical confrontations with the Community of Madrid. What I defended at all times was to put aside the confrontational policy. An attempt was made to enter into a confrontational dynamic and it seems to me that what citizens are demanding in those moments is that we act together. And, finally, I think that at least I tried, to avoid getting into sterile confrontations that were useless.

Did the Community of Madrid seem unfair to you at some point?

I’m not going into this. I made the decisions that I believed I had to adopt based on science, the recommendations of experts, international and multilateral organizations, coordination with the communities and transparency to citizens. Many of the measures were not easy to adopt and we did, and we always try to do so with the maximum complicity of the autonomies. In those moments what you cannot do is doubt what to do. If you have to do something, you have to have the courage to do it and explain it.

And was there a good relationship with Catalonia?

I had a good relationship with all the autonomous communities, also with Catalonia. Pandemics do not understand ideologies or borders. I have very different political positions from those of the head of Salut de Catalunya, but we work together. There were times when we disagreed, but the work was correct. And I think the co-governance scheme that we designed to de-escalate and manage subsequent waves has worked reasonably well. I am quite happy with this.

Where is Fernando Simón?

Fernando Simón acted as in my opinion a public servant should act in situations of this type. He was – and is – the head of the Center for the Coordination of Health Alerts and Emergencies (CCAES). We had the biggest health emergency in 100 years. From his position, he acted very professionally, with a sense of duty and a very exceptional vocation, and also demonstrated much-needed communication skills that were not required of him for his position. From here on, I should not and cannot pronounce myself on the role that he is doing now. We are in a different phase, at the beginning we had to communicate daily and Fernando did it very well.

“Fernando Simón acted as a public servant should act and also demonstrated much-needed communication skills”

How was your relationship?

Very complicity. We did not know each other and practically from the first day I set foot in Health, the covid-19 appeared. I tuned in very well with him, I always tried to respect his sphere of decision and I felt that he respected mine as a minister. He knows a lot about public health and epidemiology, and has a great vocation for service. A friendship relationship was born. There is a lot of mutual frankness.

Do you miss your position?

I am very excited about the work I do now. I really like politics understood as public service. I didn’t expect to deal with a pandemic, I did the best I could. And now I have a new responsibility in Catalonia that also fills me and that I face with great enthusiasm. I don’t miss what I did, but I do miss the ministry team.

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