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Talk:Putting resources into action

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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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[[File:Logo MonografíaSpain_Evolution-in-the-number-of-ICU-beds-during-the-first-wave-of-the-pandemic_2020_map_18511_eng.jpg|left|thumb|300px|Map: Evolution in the number of ICU beds during the first wave of the pandemic. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Evolution-in-the-number-of-ICU-beds-during-the-first-wave-of-the-pandemic_2020_map_18511_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_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-in-medicalised-hotels-during-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-in-medicalised-hotels-during-the-first-wave-of-the-pandemic_2020_map_18514_eng.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=s18514.s18514&s=2020-06-30&t=A02&view=map10 Interactive version].]]
[[File:Logo Monografía.jpg|left|thumb|300px|Map: Beds in medicalised hotels during the first wave of the pandemic. 2020. Spain.]]
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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.
The resources put into action to fight against [[File:Spain_Messages-on-twitter-in-solidarity-with-the COVID-19 pandemic are hard to be quantified because of the many different stakeholders involved, the heterogeneity of provisional-Hospital-at-Madrid-Trade-Fair_2020_statisticalgraph_18518_eng.jpg|left|thumb|300px|Statistical graph: Messages on twitter in solidarity with the provisional Hospital at Madrid Trade Fair. 2020. Spain.]] Some other actions were also taken and their sometimes intangible nature; proof of in order to increase the latter was capacity to accommodate the significant solidarity movement that took place during the hardest times growing number of the first wave of the pandemic (see chapter on Solidarity Actions)infected people requiring hospital admission, e.g. This chapter focuses, however, field hospitals were built and hotel beds were medicalised as presented 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 map on the effort made ''[[:File:Spain_Beds-in -medicalised-hotels-during-the health field as well as -first-wave-of-the experience at Lozano Blesa University Hospital in Saragossa (Zaragoza)-pandemic_2020_map_18514_eng. Second, the text delves into how the Armed Forces participated jpg|Beds in this deployment, what took place under Operation Balmis. There is no reliable record of which new resources were put into action medicalised hotels during the first wave of the pandemic aimed at fighting the coronavirus and reducing its impact. Some decisive links in ]]'' pandemic that shows the process results of building an effective response were for instance the financial efforts this action, with a large amount of the public administration, the initiatives that came from within society both individually and beds being made available in groups, the dedication of the non-medical staff and the donations from companiescentres.A first indicator depicting Regional authorities strove to multiply the changes that took place in hospitals was capacity to care for patients requiring hospital admission. For example, the increased availability Region of Intensive Care Unit (ICU) beds, which is shown by regions on Madrid set up the map Evolution facilities at Madrid Trade Fair as a provisional field hospital. The particular impact of ICU beds during the first wave of the pandemicon this territory shall be taken into account. There Nearly 5,000 patients were 150% more ICU beds (excluding newborns) towards the beginning of April 2020 than in January admitted and over 1,200 healthcare professionals worked from 23 March to 1 May 2020 in the public Halls 5 and private healthcare systems –including both beds with and without ventilators–7 at Madrid Trade Fair provisional field hospital. After the peak of the first wave of the pandemic, a decrease  There was registered in early Junealso an intense solidarity movement based on social initiatives. Social networks served to connect demands and offers; even so, there were 78% more ICU beds occupied at details on the end flow of the first semester of 2020 than messages on Twitter referring to solidarity deployed in this provisional hospital at Madrid Trade Fair are shown on the beginning of the yeargraph.
[[Archivo:Espana_Mensajes-en-Twitter-solidarios-con-el-hospital-de-IFEMA_2020_graficoestadistico_18518_spa.jpg|left|thumb|300px|Gráfico estadístico: Mensajes en Twitter solidarios con el hospital de IFEMA. 2020. España.]]
Some other actions were also taken in order to increase the capacity to accommodate the growing number of infected people requiring hospital admission, e.g. hotel beds were medicalised and field hospitals were built as presented on the map on Beds in medicalised hotels during the first wave of the pandemic that shows the result of this action, with a large number of beds being made available in non-medical centres.
Regional authorities strove to multiply the capacity to care for patients requiring hospital admission. For example, the Region of Madrid set up the facilities at Madrid Trade Fair as a field hospital. The particular impact of the first wave of the pandemic on this territory shall be taken into account. Nearly 5,000 patients were admitted and more than 1,200 healthcare professionals worked from 23 March to 1 May 2020 in Halls 5 and 7 at Madrid Trade Fair.
There was also an intense solidarity movement based on social initiatives. Social networks served to connect demands and offers; details on the flow of messages on Twitter referring to solidarity deployed in this field hospital at Madrid Trade Fair are shown on the graph.
{{ANEAutoria|Autores= José Sancho Comíns}}
{{ANETextoDestacado|titulo=«LOZANO BLESA» UNIVERSITY HOSPITAL IN SARAGOSSA (ZARAGOZA)|contenido=This note is a brief summary of the experience at Lozano Blesa University Hospital in Saragossa (Zaragoza) which may be understood as an example of the situation in many hospitals in Spain during the first wave of the pandemic. This hospital covers a large healthcare area including a population heavily affected by COVID-19 as well as a large number of nursing homes. The COVID‘COVID-19 Group Group’ was created in January 2020 at this hospital and included professionals from Preventive Medicine, Occupational Risk Prevention, Emergency, Microbiology, Internal Medicine, Infectious Diseases and Intensive Care departments, together with representatives from the hospital medical and nursing management teams. This COVID-19 group Group drew up a Contingency Plan for the hospital, whose forecasts were soon largely exceeded. The first COVID-19 case was detected on 3 March 2020.
Special care was taken to ensure that the actions triggered were supported from both a human and a technical perspective. With regard to the former, the high level of professionalism of all health and non-health workers at hospital shall be highlighted: doctors, nurses, laboratory technicians, cleaning staff, technicians who control ventilation circuits and many other professionals worked double shifts, overtime, etc. Protective measures were increased at hospital. All possible scenarios as well as the protective equipment to be worn were defined. Special 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, allergists, haematologists, anaesthesiologists, etc. started to work side by side with internists and intensivists.
From a technical point of view, decisions were made based on new data received. The health system was not prepared for a phenomenon of such magnitude and so long-lasting. Nevertheless, efforts were multiplied to adapt the hospital structure, equipment and organisation. A new intensive care unit was built in record time. The Surgical Block surgical block was adapted to accommodate COVID-19 patients and non-COVID-19 patients, the inpatient area was reorganised with exclusive areas for COVID-19 patients, a separate circuit was set up in the emergency department for possible infected patients, etc..}}
{{ANEAutoria|Autores= María José Amorín Calzada}}
{{ANESubirArriba}}
{{ANETextoEpigrafe|epigrafe=Operation 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.]] The intervention of the Armed Forces in the fight against the COVID-19 pandemic under Operation Balmis was an example of the so-called ‘new missions’ of the Navy, the Army and the Air Force, as a key tool for solving all kinds of crisis. The missions allotted to the Armed Forces were set forth in Spanish Organic Law 5/2005 on National Defence, which states: “The Armed Forces, together with the National Institutions and the Public Administrations, must preserve the security and well-being of citizens in case of serious risk, catastrophe, calamity and other public needs, in accordance with current legislation.” However, the first time that the Armed Forces took on this task was under Operation Balmis, as part of the effort to defeat COVID-19 (except for interventions of the Military Emergency Unit and 43 Air Force Group as well as minor interventions by some other units in recent years). Operation Balmis, which involved over188,000 military professionals, was the largest peacetime effort in the history of the Spanish Armed Forces.
The intervention of the Armed Forces in the fight against the COVID-19 pandemic under Operation Balmis was an example of the so-called new missions of the Navy, the Army and the Air Force, as a key tool for solving all kinds of crisis. The missions allotted to the Armed Forces were set forth in Spanish Organic Law 5/2005 on National Defence, which states: “The Armed Forces, together with the National Institutions and the Public Administrations, must preserve the security and well-being of citizens in case of serious risk, catastrophe, calamity and other public needs, in accordance with current legislation.” However, the first time that the Armed Forces took on this task was with Operation Balmis, as part of the effort to defeat COVID-19 (except for interventions of the Military Emergency Unit and 43 Air Force Group as well as minor interventions by some other units in recent years). Operation Balmis, which involved over 188,000 military professionals, was the largest peacetime effort in the history of the Spanish Armed Forces.Spanish Royal Decree 463/2020 from 14 March 2020, on the state of alarm, was the legal framework for involving the Armed Forces in the fight against the pandemic. As soon as the political directives were received, it was decided to launch a military operation conducted by the Armed Forces. The Operations Command and the Joint Chiefs of Staff began planning and, almost simultaneously, executing Operation Balmis. It was named after the Spanish military doctor who had the insight to effectively bring take the smallpox vaccine from Europe to the Americas in the 19th century.
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.]]
[[Archivo:Espana_Evolucion-de-las-intervenciones-de-la-Operacion-Balmis_2020_graficoestadistico_18516_spaRequests for support were forwarded directly to the Operations Command through the Government Delegates (the highest representatives of the national government in the different regions), who then forwarded them to the different ministries to manage the crisis. This support was validated, assigned and ordered in a systematic and simple process that allowed the requests to be fulfilled quickly.jpg|left|thumb|300px|Gráfico estadísticoBasically, four main areas of support were considered: Evolución de las intervenciones de la Operación Balmis. 2020logistics, health, security and infrastructures. EspañaThe most common tasks were disinfection, transfer of the sick, building field hospitals, transport of medical equipment by air and land, and presence to contribute to public security.]]
[[Archivo:Espana_Intervenciones-de-la-Operacion-Balmis-segun-tipo_2020_graficoestadistico_18379_spaThis last task was one of the first to be scaled down after the initial phase, as the population accepted the instructions for total mass lockdown.jpg|right|thumb|200px|Gráfico estadístico: Intervenciones de la Operación Balmis según tipoNevertheless, patrols were maintained to support the police in border controls and critical infrastructure security until the end of the Operation. 2020. España.]]
[[Archivo:Espana_Evolucion-de-las-desinfecciones-de-residencias-de-mayores_2020_graficoestadistico_18517_spaThe most delicate task for the soldiers was to transfer and guard the deceased in the temporary morgues set up during the period when the capacity of funeral services was overwhelmed.jpg|left|thumb|300px|Gráfico estadístico: Evolución de las desinfecciones de residencias de mayoresInitially, the Military Emergency Unit was in charge of this mission, which was later joined by other military professionals. 2020One of the most common and critical tasks were military interventions in nursing homes (5,301), given the vulnerability of this population and the great extent to which it was affected by the pandemic. EspañaInitially, major activities included disinfections (11,061), although civilian professionals were also trained during the final stages in this task and were able to take over from the military units.]]
Several factors were Transport was another key to requirement, especially in the success of Operation Balmis. The unit of command was adaptedearly stages, the chain of command when medical material was simplified, and procedures were streamlined brought from requests for assistance China to their fulfillmentSpain in military aircrafts. All available assets worked under the Operations Command, organised into five Component Commands: Land, Sea, Air, Emergency and Military Health. Even Also of major importance is the operation logistics were centralised.Requests for support were forwarded directly given to the Operations Command through the Government Delegates (the highest representatives of the national government in the different regions)food banks, who then forwarded them which used military means to the different ministries distribute food to manage the crisismost vulnerable layers of society. This support  Another key aspect was validated, assigned and ordered in a systematic and simple process that allowed the requests to be fulfilled quickly. Basically, four main areas of support were considered: logistics, health, security for the assembly and infrastructures. The most common tasks were disinfection, transfer operation of the sick, building provisional field hospitalsat Madrid and Barcelona Trade Fairs.  The entire permanent military hospital network, transport of medical equipment by air including military hospitals in Madrid and landSaragossa (Zaragoza), and presence was devoted to contribute the care of patients affected by coronavirus. Products to public security.This last task was one of combat the first to be scaled down after virus were produced at the initial phaseDefence Pharmacy Centre, especially masks, as once the population accepted machines purchased in China were received. Staff shortages in the instructions Military Health Corps did not allow for total mass lockdownmore significant support in this field. NeverthelessHowever, patrols were maintained it was possible to support the police make up for shortfalls in border controls and critical infrastructure security until the end some parts of the Operation.The most delicate task Spain; for the soldiers was example, through Galicia hospital ship belonging to transfer and guard the deceased Spanish Navy in Ceuta and Melilla, which enabled extending the temporary morgues set up during the period when the hospital capacity of funeral services was overwhelmedboth towns. Initially,  The interventions of the Military Emergency Unit was Armed Forces under Operation Balmis took place in charge of this mission, which all Spanish regions. This was later joined by other military professionals. One done without reducing the permanent missions of the most common and critical tasks were military interventions in nursing homes (5,301), given the vulnerability of this population Armed Forces and the great extent to which it was affected by the pandemicinternational missions abroad. InitiallyThe latter saw, major activities included disinfections (11however,061), although civilian professionals were also trained a temporary reduction in the final stages those involved as COVID-19 reduced activity in this task their places of deployment. Nevertheless, maritime surveillance as well as airspace surveillance and control in Spain were able to take over from the military unitsnot affected.Transport was another key requirementThe Armed Forces carried out their work under Operation Balmis, especially in performed the early stagesrole for which they are trained and specially qualified, when medical material was brought from China to Spain in military aircrafts. Also and directly supported the well-being and security of major importance is the support given to food pantries, which used military means to distribute food to the most deprived peoplepopulation.
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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=[[Primeros casos]]|siguiente=[[Fase ascendente de la pandemia]]}}
 
{{ANETextoEpigrafe|epigrafe=Recursos relacionados}}
 
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{{ANENavegacionHermanos|anterior=[[Primeros casos]]|siguiente=[[Fase ascendente de la pandemiaCategory:Social facilities]]}} [[Categoríaes:Servicios y equipamientos socialesRecursos_movilizados]]
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