Reflecting on the Canary Islands’ Pioneering Role During Spain’s Initial COVID-19 Lockdown

PCRS, Traceful, close contacts, isolation, epis, masks… all of the terminology that gained prominence following the declaration of the state of emergency on March 14, 2020 was utilized for around a month and a half in La Gomera, the Canarian island with merely 20,000 residents that confirmed the first case of COVID-19 in Spanish territory.

This Friday marks five years since the Canary Islands became the pilot scenario of the pandemic in Spain, not solely due to the first case of a German tourist but because just three weeks later, the first mass confinement was enforced in Tenerife after an Italian tourist tested positive while residing in the H10 Costa Adeje Hotel housing around 1,000 people.

An anecdote

Reflecting on these events, many of the key figures involved stress the lack of awareness and unconsciousness about the implications of a virus that was at the time referred to simply as “the Wuhan virus”, named after the Chinese city where everything began.

“We perceived the first case as a mere anecdote, an experience that might even serve us positively, with some humour about the peculiar circumstance of it occurring in La Gomera,” recounts Blanca Méndez, the then Director of the Canarian Health Service (SCS), to EFE.

“We felt no pressure beyond the initial jitters regarding the adequate treatment of the affected individual in a third-level hospital. We were concerned about the lack of ventilators or specialists, but we anticipated the transfer of resources from Tenerife if the situation escalated,” recalls Méndez, who also mentions the initial challenges faced in the sample transfer, which could be analysed only at the Carlos III Public Health Institute in Madrid and adds that “there was fear” among healthcare professionals tasked with relocating the swabs.

Despite acknowledging that there was “anecdotal reluctance,” the head of the laboratory in La Gomera, Jesús Grande, notes that the samples were enclosed within a triple container, which was further secured in a biological waste bin, rendering “any chance” of infection impossible.

Ultimately, it was the Minister of Health of the Canarian government at that time, Teresa Cruz, who personally transported the samples from four tourists at the hospital to La Gomera Airport, where they were then flown by helicopter to Tenerife and subsequently via military plane to Madrid.

Additionally, tracking down the tourists proved challenging, as it involved reviewing security footage from both the South Tenerife Airport and the Port of Los Cristianos with little certainty regarding their movements. Moreover, there was a necessity to trace their nearby contacts, whom they also had to quarantine in the rural dwelling they occupied on the island.

A policeman for each close contact

In fact, the Canarian police dispatched four officers to La Gomera to ensure 24-hour surveillance of the four tourists, with the particularity that all of them spoke German. “We were keen to communicate with them without intermediaries and to understand their feelings, how they were faring,” explains Gustavo Armas, the former general director of Security and Emergencies, to EFE.

According to Aaron Plasencia, a SCS nurse and team coordinator for the contact tracing efforts, the approach employed with the German tourist later helped to establish the protocols for the contact tracers, nearly 100 of whom were active at the peak of the pandemic.

“There was absolutely no groundwork for these protocols or making specific decisions, but epidemiology experts provided recommendations that evolved as we learned more about the virus’s behaviour,” adds Plasencia, recognising the logistical challenges involved in managing close to 1,000 individuals confined in a hotel “under secure conditions”, amidst such a high level of uncertainty.

A “remove and put” of epis

From a care perspective, Elena Yanes, the Supervisor of the Hospitalisation Area of the Gomera Hospital, recalls the challenges associated with reconfiguring an entire hospital floor to create “dirty areas” designed for patients suffering from COVID-19.

Initially, they only possessed Individual Protection Equipment (EPIs) that were past their expiry date, gathered during the Ebola crisis in 2014. Worse still was the recollection of not just the work itself but the “remove and put” of the EPIs and the exhaustion that ensued.

“The world felt somewhat smaller because, prior to that, everything appeared distant and was met with ignorance. Once we adapted the floor to accommodate them, it was a bit surreal, as we had isolated everything significantly, and then they entered simply walking in wearing masks. It resembled a scene from a film,” she recounts.

The H10 confinement

Three weeks later, with anxiety and an industry on edge, the tourism sector faced another test: a positive case of a 61-year-old Italian tourist at the H10 Costa Adeje Hotel.

To ensure that no one left the hotel, they established three security perimeters:

• The first managed by the Canarian police.
• The second by the National Police.
• The third by the Local Police of Adeje.

In addition to outdoor monitoring, internal surveillance was conducted with plainclothes officers dressed in EPIs to supervise the interactions of the guests, including around 200 children.

“Overall, the guests behaved admirably during the 14 days of confinement,” states Gustavo Armas, although he concedes that there were attempts to escape that were unsuccessful.

The then head of Epidemiology in the Canary Islands, Amós García, confesses that the decision to shutter the hotel was “extremely difficult to make” in a community that relies on tourism. However, from a health standpoint, “it was the best course of action to prevent the outbreak from spreading beyond there,” he asserts.

At that moment, “We believed that COVID-19 was akin to the flu,” not to downplay its severity but because the information from China suggested “that kind of severity,” he notes.

For Gustavo Armas, this decision led to him receiving threatening messages, including death threats, on his personal phone. Meanwhile, Blanca Méndez, the then director of the Canarian health service, recalls that there were voices within the Governing Council accusing her and the council members of “endangering tourism.”

“But ultimately, time demonstrated we were correct,” she concludes.