Discussion
This Spanish perspective is a very small contribution. Pandemics are, by definition, of worldwide dimensions and COVID-19 is one generating still unknown damage and damping social and economic development. Other specialties are now reporting diverse experiences from most of affected countries (1), aiming at describing the impact of the SARS-CoV-2 on organ failure.
However, the contributions of physicians and HCW from all over the world to understand, diagnose and treat the disease, COVID-19, are just a small part of a problem of extraordinary dimensions. Amidst the pandemic, it is time to start thinking of seeking for responsibilities at the highest level. Because of such a worldwide problem, many professionals around the world are voicing what could have been done in preventing the spread of the disease. It is clear that this pandemic hit countries and governments unprepared. However, the governmental actions widely differed contributing to diverse degrees of local spread despite the repeated warnings of the WHO (10).
The very recent contribution of Chaudhry et al (30), analysing data from the top 50 countries ranked by the number of cases, literally concluded that “the findings of this country level analysis on COVID-19 related health outcomes suggest that low levels of national preparedness, scale of testing, as well as population characteristics such as obesity, advanced age and higher per capita GDP are associated with increased national case load and mortality”. This is critical to understand the behavior by country and region. Low levels of national preparedness are only related to government actions, fundamental in the control of local extension of the disease. This includes, among other, the timing of implementation of measures. In the case of Spain is known through each and every media, that the Spanish government did not prepare for the epidemic. As it is also literally stated in the editorial by Carriazo et al (1), it failed to limit public mass gatherings and astonishingly and actively promoted a large demonstration in Madrid on 8 March that was led by Deputy Prime Ministers Carmen Calvo and Nadia Calviño and by Ministers Irene Montero, Fernando Grande Marlaska, Isabel Celaá, Arancha González Laya and Carolina Darias. A number of them and others like the wife of the Prime Minister, became infected (31). Some of the cabinet members as Deputy Prime Minister Pablo Iglesias did not follow the recommendations in terms of confinement (32). The attitude of the Public Health representative, Fernando Simón, without opposing the large demonstration or in other words, supporting its go-ahead, led to the country ranking highest in deaths per capita. In the case of Spain, more blatant is that nobody publicly said a word about the MOH 2007 measures addressing a flu pandemic, published after the SARS of 2002 (33). Remember, those responsible have names like this article’s authors.
The medical community, physicians and HCW, have done their duty and beyond. Many have stayed on the road. Cardiac surgery has also responded, as it is clear from this special issue of the Journal. As we have also recently said (34), it is time for those responsibly to honestly (sic) addressing the society. The time hopefully will come when we must discuss about accountability, legal responsibilities, and eventual criminal charges of those responsible for the disaster due to inappropriate handling of the crisis (1). Let us see what comes; however, as also stated by us (34), what we foresee is living with uncertainty, mortality and more state security protocols, with the pandemic being an excuse for absolute control of our lives. It also will be the need to guarantee the protection of citizens facing abuse from the State.