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{{ANEEtiqueta|palabrasclave=covid-19, pandemiapandemic, covid19, camas en UCIIntensive Care Units beds, hoteles medicalizadosmedicalised hotels, fuerzas armadas en la pandemiaArmed Forces in the pandemic, Twitter|descripcion=Estudio cartográfico de los recursos movilizadosCartographic study of putting resources into action|url=valor}}{{ANEObra|Serie=Monographs from the National Atlas of Spain|Logo=[[File:Logo Monografía.jpg|left|50x50px|link=]]|Título=The COVID-19 pandemic in Spain|Subtítulo=First wave: from the first cases to the end of June 2020|Año=2021|Contenido=New content}}
{{ANENavegacionCapitulo (monografía COVID-19)|estructura=Estructura temática|seccion=[[The COVID-19 pandemic in Spain|The COVID-19 pandemic in Spain]]|capitulo=Putting resources into action}}
{{ANENavegacionHermanos|anterior=[[First COVID-19 cases]]|siguiente=[[Rising phase of the pandemic]]}}
The resources put into action to fight against the COVID-19 pandemic are hard to be quantified because of the many different stakeholders involved, the heterogeneity of the actions taken and their sometimes intangible nature; proof of the latter was the significant solidarity movement that took place during the hardest times of the first wave of the pandemic (see chapter on ''[[Solidarity initiatives | Solidarity initiatives]]''). This chapter focuses, however, on two aspects that may help understand the swift response of the public administrations to the extraordinary situation from March 2020. It first shows some indicators on the effort made in the health field as well as the experience at ''Lozano Blesa University Hospital'' in Saragossa (Zaragoza). Second, the text delves into how the Armed Forces participated in this deployment, what took place under Operation Balmis.
There is no reliable record of which new resources were put into action during the first wave of the pandemic aimed at fighting coronavirus and reducing its impact. Some decisive links in the process of building an effective response were for instance the financial efforts of the public administration, the initiatives that came from within society both individually and in groups, the dedication of the medical staff and the donations from companies.
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[[ArchivoFile:Espana_EvolucionSpain_Evolution-dein-lathe-dotacionnumber-deof-camasICU-debeds-UCIduring-durantethe-lafirst-primerawave-olaof-dethe-la-pandemia_2020_mapa_18511_spapandemic_2020_map_18511_eng.jpg|left|thumb|300px|MapaMap: Evolución de la dotación de camas de UCI durante la primera ola de la pandemiaEvolution in the number of ICU beds during the first wave of the pandemic. 2020. EspañaSpain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_EvolucionSpain_Evolution-dein-lathe-dotacionnumber-deof-camasICU-debeds-UCIduring-durantethe-lafirst-primerawave-olaof-dethe-la-pandemia_2020_mapa_18511_spapandemic_2020_map_18511_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_EvolucionSpain_Evolution-in-the-number-of-ICU-beds-during-the-first-wave-of-the-pandemic_2020_map_18511_eng.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=s18511.s18511&s=2020-06-30&t=A02&view=map10 Interactive version].]] [[File:Spain_Beds-in-medicalised-hotels-during-the-first-wave-of-the-pandemic_2020_map_18514_eng.jpg|right|thumb|300px|Map: Beds in medicalised hotels during the first wave of the pandemic. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Beds-dein-lamedicalised-dotacionhotels-deduring-the-first-wave-of-the-pandemic_2020_map_18514_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Beds-camasin-demedicalised-UCIhotels-duranteduring-lathe-primerafirst-olawave-deof-lathe-pandemia_2020_mapa_18511_spapandemic_2020_map_18514_eng.zip DatosData]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=s18514.s18514&s=2020-06-30&t=A02&view=map10 Interactive version].]]
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A first indicator depicting the changes that took place in hospitals was the increased availability of beds allotted to Intensive Care Units (ICUs), which is shown by regions on the map ''[[:File:Spain_Evolution-in-the-number-of-ICU-beds-during-the-first-wave-of-the-pandemic_2020_map_18511_eng.jpg|Evolution in the number of ICU beds during the first wave of the pandemic]]''. There were 150% more ICU beds (excluding newborns) towards the beginning of April 2020 than in January 2020 in the public and private healthcare systems –including both beds with and without respirators–. After the peak of the first wave of the pandemic, a decrease was registered in early June; even so, there were 78% more ICU beds occupied at the end of the first semester of 2020 than at the beginning of the year.
{{ANEAutoria|Autores= José Sancho Comíns}}
{{ANETextoDestacado|titulo=HOSPITAL CLÍNICO UNIVERSITARIO «LOZANO BLESA»UNIVERSITY HOSPITAL IN SARAGOSSA (ZARAGOZA)|contenido=La experiencia vivida en el hospital Clínico Universitario This note is a brief summary of the experience at Lozano Blesa de University Hospital in Saragossa (Zaragoza no es fácil de sintetizar) which may be understood as an example of the situation in many hospitals in Spain during the first wave of the pandemic. El This hospital abarca una amplia área sanitaria con población muy castigada por la covers a large healthcare area including a population heavily affected by COVID-19 y con numerosas residencias de ancianos en su ámbito de referenciaas well as a large number of nursing homes. El primer caso se identificó en el hospital el 3 de marzo de The ‘COVID-19 Group’ was created in January 2020. En enero, ya se había constituido en el at this hospital el Grupo COVID formado por profesionales de los servicios de Medicina Preventivaand included professionals from Preventive Medicine, Prevención de Riesgos LaboresOccupational Risk Prevention, UrgenciasEmergency, MicrobiologíaMicrobiology, Medicina InternaInternal Medicine, Enfermedades Infecciosas y Cuidados IntensivosInfectious Diseases and Intensive Care departments, junto con representantes de la dirección médica y de enfermería del centrotogether with representatives from the hospital medical and nursing management teams. Este grupo elaboró un This COVID-19 Group drew up a Contingency Plan de Contingencia cuyas previsiones quedaron superadasfor the hospital, whose forecasts were soon largely exceeded. The first COVID-19 case was detected on 3 March 2020. Se cuidó especialmente que la movilización desencadenada tuviera su apoyo en un doble componenteSpecial care was taken to ensure that the actions triggered were supported from both a human and a technical perspective. With regard to the former, humano y técnico. En relación al primerothe high level of professionalism of all health and non-health workers at hospital shall be highlighted: doctors, hay que destacar la profesionalidad de todos los trabajadoresnurses, sanitarios y no sanitarios. Médicoslaboratory technicians, enfermeroscleaning staff, técnicos de laboratorio y otros muchos profesionales trabajaron hasta la extenuación en turnos doblestechnicians who control ventilation circuits and many other professionals worked double shifts, horas extraordinariasovertime, etc. No es fácil olvidar la cara de los profesionales con las marcas de presión de los equipos de protecciónProtective measures were increased at hospital. All possible scenarios as well as the protective equipment to be worn were defined. Su trabajo no hubiese sido posible sin otros muchos profesionalesSpecial attention was paid to staff protection training. The so-called Extended Universal Precautions were extended to the entire hospital in order to protect other patients and hospital employees. The workflow was modified and professionals who had never worked together before started to form multidisciplinary teams: neurologists, como los servicios técnicos que controlan los circuitos de ventilación o el personal de limpiezaallergists, cuyo esfuerzo ha sido encomiablehaematologists, entre otrosanaesthesiologists, etc. started to work side by side with internists and intensivists. Desde el punto de vista técnico se tomaron las decisiones más oportunasFrom a technical point of view, decisions were made based on new data received. The health system was not prepared for a la vez que se vivía un inestimable aprendizaje. El sistema sanitario no estaba preparado para un fenómeno de tal magnitud, ni tan mantenido en el tiempophenomenon of such magnitude and so long-lasting. No obstanteNevertheless, se multiplicó el esfuerzo para adaptar el efforts were multiplied to adapt the hospital desde el punto de vista estructuralstructure, de equipamiento y organizativoequipment and organisation. A new intensive care unit was built in record time. En un tiempo récord se creó una nueva área de cuidados intensivos, se adaptó el Bloque Quirúrgico para acoger a pacientes The surgical block was adapted to accommodate COVID y a pacientes operados no -19 patients and non-COVID. La zona de hospitalización se reorganizó con áreas exclusivas para pacientes -19 patients, the inpatient area was reorganised with exclusive areas for COVID; en urgencias se estableció un circuito independiente para los posibles pacientes infectados. En relación a los recursos humanos, se intensificaron las medidas de protección-19 patients, definiendo los escenarios posibles en el centro y los equipos de protección a portar; junto a todo lo anteriorseparate circuit was set up in the emergency department for possible infected patients, se cuidó muy específicamente la formación del personal en protección. Se extendieron a todo el hospital las denominadas Precauciones Universales Ampliadas, con el fin de proteger a otros pacientes y a los profesionales del propio hospital. Las dinámicas de trabajo se modificaron y profesionales que nunca habían trabajado juntos formaron equipos multidisciplinares; fue realmente gratificante ver cómo neurólogos, alergólogos, hematólogos, anestesistas… trabajaban codo con codo con los internistas e intensivistasetc.}}
{{ANEAutoria|Autores= María José Amorín Calzada}}
{{ANESubirArriba}}{{ANETextoEpigrafe|epigrafe=Operación BalmisOperation BALMIS}}
[[ArchivoFile:Espana_DatosSpain_GENERAL-generalesDETAILS-deOF-laTHE-OperacionBALMIS-BALMIS_2020_ilustracion_18554_spaOPERATION_2020_illustration_18554_eng.jpg|right|thumb|300px|IlustraciónIllustration: Datos generales de la Operación GENERAL DETAILS OF THE BALMISOPERATION. 2020. EspañaSpain.]]
Several factors were key to the success of Operation Balmis. The unit of command was adapted, the chain of command was simplified and procedures were streamlined from requests for assistance to their fulfillment. All available assets worked under the Operations Command, organised into five Component Commands: Land, Sea, Air, Emergency and Military Health. Even the operation logistics were centralised.[[File:Spain_Interventions-under-Operation-Balmis-by-location_2020_statisticalgraph_18378_eng.jpg|right|thumb|200px|Statistical graph: Interventions under Operation Balmis by location . 2020. Spain.]][[ArchivoFile:Espana_IntervencionesSpain_Evolution-dein-the-number-of-interventions-under-Operation-Balmis_2020_statisticalgraph_18516_eng.jpg|left|thumb|300px|Statistical graph: Evolution in the number of interventions under Operation Balmis. 2020. Spain.]][[File:Spain_Interventions-launder-OperacionOperation-Balmis-segunby-lugar_2020_graficoestadistico_18378_spatype_2020_statisticalgraph_18379_eng.jpg|right|thumb|200px|Gráfico estadísticoStatistical graph: Intervenciones de la Operación Interventions under Operation Balmis según lugarby type. 2020. Spain.]][[File:Spain_Evolution-in-the-number-of-disinfections-at-nursing-homes_2020_statisticalgraph_18517_eng.jpg|left|thumb|300px|Statistical graph: Evolution in the number of disinfections at nursing homes. 2020. EspañaSpain.]]
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[[ArchivoFile:Espana_IntervencionesSpain_Interventions-deunder-laOperation-Operacion-Balmis_2020_mapa_18461_spaBalmis_2020_map_18461_eng.jpg|left|thumb|300px|MapaMap: Intervenciones de la Operación Interventions under Operation Balmis. 2020. EspañaSpain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_IntervencionesSpain_Interventions-deunder-laOperation-Operacion-Balmis_2020_mapa_18461_spaBalmis_2020_map_18461_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_Intervenciones-deSpain_Interventions-launder-OperacionOperation-Balmis_2020_mapa_18461_spaBalmis_2020_map_18461_eng.zip DatosData]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=s18461.s18461&i2=c13023.c13023&t=A02&t2=A02&view=map9 Versión interactivaInteractive version].]]
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[[ArchivoFile:Espana_HuellaSpain_Geographical-geograficafootprint-deof-lasthe-FuerzasArmed-ArmadasForces-enunder-laOperation-operacion-Balmis_2020_mapa_18380_spaBalmis_2020_map_18380_eng.jpg|left|thumb|300px|MapaMap: Huella geográfica de las Fuerzas Armadas en la operación Geographical footprint of the Armed Forces under Operation Balmis. 2020. EspañaSpain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_HuellaSpain_Geographical-geograficafootprint-deof-lasthe-FuerzasArmed-ArmadasForces-enunder-laOperation-operacion-Balmis_2020_mapa_18380_spaBalmis_2020_map_18380_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_Huella-geograficaSpain_Geographical-defootprint-lasof-Fuerzasthe-ArmadasArmed-enForces-launder-operacionOperation-Balmis_2020_mapa_18380_spaBalmis_2020_map_18380_eng.zip DatosData].]]
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{{ANEAutoria|Autores= Miguel Ángel Villaroya Vilalta}}
{{ANESubirArriba}}
{{ANENavegacionHermanos|anterior=[[First COVID-19 cases]]|siguiente=[[Rising phase of the pandemic]]}}
{{ANEPaginaDescargas (monografía COVID-19)}}