In this case it was not the denunciation of a specific political party, or a sector interested in certain economic changes within the country, that has raised the alarm about social conditions in Spain. In this case it was the NGO Amnesty International which, after a study and a subsequent report entitled "The other pandemic", has denounced that Spain has violated the right to physical and mental health during the COVID-19 crisis. Almost nothing.

Many will praise the Spanish health system on World Health Day, to be celebrated on 7 April, but the authors of this study will disagree. The study, carried out in Madrid, Catalonia and Castilla-La Mancha, points to a health system dismantled by cutbacks, a collapsed primary care system and opaque administrations as the conditions causing this violation of rights. And the elderly, the chronically ill and immigrants as the main neglected.

Of course, as is usually the case, those who have suffered most from this setback in our healthcare capacity have been the least privileged, and among them, undocumented migrants.

In an administration that has erected significant barriers to access to healthcare, especially for those most dependent on the system, people without regularised immigration procedures have suffered doubly. On the one hand, due to a habitual lack of resources that prevents them from turning to the private sector. On the other hand, the difficulty of benefiting from a public health system that is already deteriorated per se.

Thus, in addition to their usual lack of security, there are aspects such as the loss of their jobs for those who are in the process of extending their residency, difficulties in renewing their papers, living with many other people, greater difficulty in accessing telematic health formats due to a lack of technological resources, and a long etcetera of problems.

Along with irregular immigrants, other sociological groups such as women - who represent 75% of carers in the domestic sphere and who have suffered the impact of the overload of care in the face of the saturation of primary care -, the elderly - who have had more obstacles in adapting to the telephone model or the online appointment system -, chronic patients, those suffering from mental health illnesses and victims of gender violence, - even though, between January and April 2020, calls to 016 increased by more than 1. 000 %, and online consultations soared by 67.3%.

The data on this violation

The Other Pandemic report thus echoes the overmortality reflected in the Daily Mortality Monitoring System (MoMo), which puts the number of unexpected deaths between March 2020 and February 2021 at 81,608, while the Ministry of Health's official figure for coronavirus deaths is around 68,000.

The debacle of the health system that has left so many on the sidelines is also reflected in the closure of centres. In Catalonia 39 centres and 362 local clinics were closed, in Madrid 21 (7 in the afternoon only) and 87, respectively. The government of Castilla-La Mancha claims not to have officially closed any, but Amnesty International claims to have information about the closure of at least two local clinics.

Of course, this situation has also been reflected in the high price paid by health professionals. The high number of infections among their workers, the lack of adequate reinforcements to cover their sick leave and the high percentage of professionals over 60 years of age (27.5% of the staff) who could not attend to patients because they were at risk, dealt a huge blow to health services.

And what can we say about the lack of personal protective equipment (PPE) - more than 123,603 health professionals have been infected with the coronavirus and 89 have died to date, a negative record in Europe - or the overload of care provided by these professionals, who in some centres have accumulated up to a hundred patients a day.

Conclusions

Faced with this situation, the NGO, while acknowledging that no state "could have been prepared for a pandemic of such magnitude", says that Spain faced the crisis with a health system "very weakened" by the austerity policies of previous years and aggravated by the lack of human and material reinforcements. This has plunged large sectors of the population into a situation "between abandonment and dismantling".

In doing so, "Spain has violated the right of every person to the enjoyment of the highest attainable standard of physical and mental health". And there, in the boat of those who suffered most from this pandemic, along with the professionals who tried to put a stop to it, along with the elderly, women, and patients with mental illnesses, are irregular immigrants. This also showed that this pandemic is not being the same for everyone.

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