'Spain’s Villages Wage a Lonely Fight Against the Coronavirus' diff viewer (12/13)

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Spain’s Villages Wage a Lonely Fight Against the Coronavirus	Spain’s Villages Wage a Lonely Fight Against the Coronavirus
2020-06-24 13:06:30 UTC	2020-06-24 13:38:30 UTC (32 minutes later)
VALDERROBRES, Spain — The deafening rumble rose from the depths of the countryside, a welcome yet unnerving sign of life in a corner of northeastern Spain, where villages perched on craggy hills overlook vineyards and fields of olive and almond trees.	VALDERROBRES, Spain — The deafening rumble rose from the depths of the countryside, a welcome yet unnerving sign of life in a corner of northeastern Spain, where villages perched on craggy hills overlook vineyards and fields of olive and almond trees.
At the wheel of his tractor, a farmer disinfected the narrow streets of the village of Valderrobres, with a spreader normally used to fertilize his fields. The breeze sent flowerpots and chairs flying, but it didn’t matter. There was a virus to kill.	At the wheel of his tractor, a farmer disinfected the narrow streets of the village of Valderrobres, with a spreader normally used to fertilize his fields. The breeze sent flowerpots and chairs flying, but it didn’t matter. There was a virus to kill.
“Everything here arrives later,” said the farmer, Miguel Angel Caldu, about the initial lack of testing kits and protective equipment in the area. Half of the health workers at the local nursing home tested positive for the coronavirus, and so did nearly 50 of the 60 residents, 12 of whom have died.	“Everything here arrives later,” said the farmer, Miguel Angel Caldu, about the initial lack of testing kits and protective equipment in the area. Half of the health workers at the local nursing home tested positive for the coronavirus, and so did nearly 50 of the 60 residents, 12 of whom have died.
So every evening, locals like Mr. Caldu have been cleaning places like Valderrobres, a tourist town of about 2,400 people that is known for its 14th-century gothic castle and stone bridge.	So every evening, locals like Mr. Caldu have been cleaning places like Valderrobres, a tourist town of about 2,400 people that is known for its 14th-century gothic castle and stone bridge.
“If we don’t take care of ourselves, nobody will,” he said.	“If we don’t take care of ourselves, nobody will,” he said.
In terms of deaths, the coronavirus pandemic has hit Spain harder than every European country but Italy and has ravaged large cities such as Barcelona and Madrid. Less noticed has been the plight of villages.	In terms of deaths, the coronavirus pandemic has hit Spain harder than every European country but Italy and has ravaged large cities such as Barcelona and Madrid. Less noticed has been the plight of villages.
Like small communities around the world, Spain’s villages are finding that their isolation is a mixed blessing. It may offer some protection against contagion, but once the coronavirus strikes, it can reveal the particular vulnerabilities that smaller communities face.	Like small communities around the world, Spain’s villages are finding that their isolation is a mixed blessing. It may offer some protection against contagion, but once the coronavirus strikes, it can reveal the particular vulnerabilities that smaller communities face.
In Spain, despite a robust health care system and one of the highest life expectancy levels in Europe, rural areas have suffered from aging health care infrastructure and a lack of doctors, after decades of urbanization and a lack of public investment.	In Spain, despite a robust health care system and one of the highest life expectancy levels in Europe, rural areas have suffered from aging health care infrastructure and a lack of doctors, after decades of urbanization and a lack of public investment.
Rural areas also have an abundance of older adults. In Teruel, the province in a remote corner of Aragon that contains Valderrobres, they make up a quarter of the population. Villages in the region, many with centuries-old ramparts overlooking the countryside, now have the appearance of boarded-up fortresses trying to keep their aged populations safe.	Rural areas also have an abundance of older adults. In Teruel, the province in a remote corner of Aragon that contains Valderrobres, they make up a quarter of the population. Villages in the region, many with centuries-old ramparts overlooking the countryside, now have the appearance of boarded-up fortresses trying to keep their aged populations safe.
In other rural areas, such as the province of Soria, in the neighboring region of Castile and León, outbreaks overwhelmed for weeks the only hospital with intensive care units. Such rural stretches of Spain have among the lowest population density levels in Europe, and many there have long complained about being neglected and cut off by the national authorities.	In other rural areas, such as the province of Soria, in the neighboring region of Castile and León, outbreaks overwhelmed for weeks the only hospital with intensive care units. Such rural stretches of Spain have among the lowest population density levels in Europe, and many there have long complained about being neglected and cut off by the national authorities.
In one village in Teruel, the only doctor in the area interrupted his weekly visits after he had to go into isolation; in another, the only grocery store closed for days after the shopkeeper left.	In one village in Teruel, the only doctor in the area interrupted his weekly visits after he had to go into isolation; in another, the only grocery store closed for days after the shopkeeper left.
In Valderrobres, where the closest hospital with intensive care in the region is two hours away, the health authorities initially refused to test those at the nursing home who didn’t have symptoms, said the mayor, Carlos Boné, even as it became the epicenter of a local outbreak.	In Valderrobres, where the closest hospital with intensive care in the region is two hours away, the health authorities initially refused to test those at the nursing home who didn’t have symptoms, said the mayor, Carlos Boné, even as it became the epicenter of a local outbreak.
When Mr. Boné bought tests and discovered that two-thirds of the staff and residents had the virus, the regional authorities rejected the results because they came from a private lab, and then conducted their own tests a week later.	When Mr. Boné bought tests and discovered that two-thirds of the staff and residents had the virus, the regional authorities rejected the results because they came from a private lab, and then conducted their own tests a week later.
“In villages, it’s always ‘It will arrive soon,’ or ‘You will get this shortly,’” Mr. Boné said. “In the meantime, we’re risking lives, and here, 35 workers are 35 people you know.”	“In villages, it’s always ‘It will arrive soon,’ or ‘You will get this shortly,’” Mr. Boné said. “In the meantime, we’re risking lives, and here, 35 workers are 35 people you know.”
Mr. Boné, a former nurse, worked in the nursing home for two straight weeks because most of its nurses have had to isolate themselves at some point and he couldn’t find replacements.	Mr. Boné, a former nurse, worked in the nursing home for two straight weeks because most of its nurses have had to isolate themselves at some point and he couldn’t find replacements.
Like many other European countries, Spain has struggled to contain the spread of the coronavirus in many parts of its territory. Unions are taking the authorities to court after thousands of health care workers became infected. Soldiers have found residents abandoned or dead in nursing homes. But in remote areas, the crisis has accentuated a perception that the right to health care might differ depending on where a person lives.	Like many other European countries, Spain has struggled to contain the spread of the coronavirus in many parts of its territory. Unions are taking the authorities to court after thousands of health care workers became infected. Soldiers have found residents abandoned or dead in nursing homes. But in remote areas, the crisis has accentuated a perception that the right to health care might differ depending on where a person lives.
“In the areas that may have been neglected, the feeling of abandonment can be as much emotional as it is material,” said Sergio del Molino, a novel writer and journalist who has coined the expression “España vacía,” or “empty Spain,” to refer to the draining away of people and skilled workers, and the hollowing out of infrastructure, especially in rural areas.	“In the areas that may have been neglected, the feeling of abandonment can be as much emotional as it is material,” said Sergio del Molino, a novel writer and journalist who has coined the expression “España vacía,” or “empty Spain,” to refer to the draining away of people and skilled workers, and the hollowing out of infrastructure, especially in rural areas.
Confinement measures enforced throughout Europe have plunged other rural areas into similar situations. In a small village in the Lombardy region, the epicenter of Italy’s outbreak, a ban on leaving a town without a health or work reason has forced the national agency managing the crisis response to make multiple trips per day to the closest supermarket to bring food to locals there.	Confinement measures enforced throughout Europe have plunged other rural areas into similar situations. In a small village in the Lombardy region, the epicenter of Italy’s outbreak, a ban on leaving a town without a health or work reason has forced the national agency managing the crisis response to make multiple trips per day to the closest supermarket to bring food to locals there.
In France, which has long struggled against a shortage of doctors in some rural areas, an organization representing small towns has recommended that municipal employees deliver bread and groceries to aging populations.	In France, which has long struggled against a shortage of doctors in some rural areas, an organization representing small towns has recommended that municipal employees deliver bread and groceries to aging populations.
In Spain, Aragon has received roughly as many tests per inhabitant as the Madrid region, the epicenter of Spain’s outbreak, but half as many masks per inhabitant. And mayors of isolated villages in Teruel argue that the masks that have been sent have mostly gone to Aragon’s larger cities.	In Spain, Aragon has received roughly as many tests per inhabitant as the Madrid region, the epicenter of Spain’s outbreak, but half as many masks per inhabitant. And mayors of isolated villages in Teruel argue that the masks that have been sent have mostly gone to Aragon’s larger cities.
“There is an advantage in isolation, distance provides protection,” said Angel Paniagua, a researcher at the National Research Council of Spain, who has studied the country’s most isolated regions. “But when the virus hits, you’re left with your own problems.”
Updated June 22, 2020	Updated June 22, 2020
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.	A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.	The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.	The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.	So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.	If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
	“There is an advantage in isolation, distance provides protection,” said Angel Paniagua, a researcher at the National Research Council of Spain, who has studied the country’s most isolated regions. “But when the virus hits, you’re left with your own problems.”
Mr. del Molino, the author and journalist, said that resources had dwindled in many rural areas after health care was gradually decentralized to the regions in the 1980s and ’90s.	Mr. del Molino, the author and journalist, said that resources had dwindled in many rural areas after health care was gradually decentralized to the regions in the 1980s and ’90s.
In the province of Soria, about 120 miles north of Madrid, a death rate of more than one per 1,000 inhabitants has been more than double the national average. Local politicians have denounced the shortage of doctors after the hospital in the city of Soria had to almost triple intensive care capacity but without any extra staff. “We are not fighting this virus with the same weapons” as in the bigger cities, Soria’s mayor, Carlos Martínez, said in a telephone interview.	In the province of Soria, about 120 miles north of Madrid, a death rate of more than one per 1,000 inhabitants has been more than double the national average. Local politicians have denounced the shortage of doctors after the hospital in the city of Soria had to almost triple intensive care capacity but without any extra staff. “We are not fighting this virus with the same weapons” as in the bigger cities, Soria’s mayor, Carlos Martínez, said in a telephone interview.
Regional authorities reported 44 confirmed coronavirus deaths in Soria in March, but Mr. Martínez said that the toll was surely higher. Total deaths from all causes in the province that month was nearly 250, he noted, up from 83 over the same period in 2019. “The numbers don’t add up,” he said.	Regional authorities reported 44 confirmed coronavirus deaths in Soria in March, but Mr. Martínez said that the toll was surely higher. Total deaths from all causes in the province that month was nearly 250, he noted, up from 83 over the same period in 2019. “The numbers don’t add up,” he said.