Spain goes (partly) back to work with a message for U.S. coronavirus efforts: test, test, test | Trudy Rubin

Even as Americans debate who has the authority to restart the economy, Spain let nonessential workers return to work this week.

This is a bold — some say foolhardy — move by the Spanish government, given that Spain has the third-largest coronavirus death toll, a terrible figure of 18,000, lagging only behind the United States and Italy.

But, as President Donald Trump wrongly proclaims he has “total” authority to reopen the country, perhaps by May 1, and as several state governors contemplate how to do so, the Spanish experiment deserves our attention.

All the more so because Spain recognizes something Trump has not: a successful reopening depends on organized, scientific testing at a national level, to determine what is safe and what is not.

Like the U.S. government, Spain was slow to shut down, finally putting shelter-in-place requirements in place on March 14.

However, a “hibernation decree” for nonessential workers was put in place only two weeks before Easter. Now the government is letting hundreds of thousands return to work.

Spanish Prime Minister Pedro Sánchez insists Spain isn’t yet at the de-escalation phase. Schools, bars, restaurants, and cultural venues remain shuttered, and police are handing out masks at metro stations.

“Our reporting shows that there is a general sense of unease among a lot of people,” I was told by Simon Hunter, editor of the English edition of leading Spanish daily El País. “On public transport, it is very difficult to keep a safe distance, and they are concerned about their workplaces.”

Still, the economic pressures on Spain are forcing government officials to measure the risks of reopening against those of keeping the country shut down.

“The International Monetary Fund forecast is devastating for Spain, with 8% shrinkage of economy in 2020 and a 20% unemployment rate,” says Hunter. “So the government is seeking a balance between containing the crisis and seeing the economy tank.”

Yet, in order to truly return to normalcy, Spain confronts a problem similar to that faced by our country. There is a lack of widespread, coordinated testing for the virus, without which the government does not know how many people are infected, including those with no symptoms.

According to the Spanish Health Ministry, more than 90% of cases are going undetected. That raises red flags if stay-at-home orders are lifted.

“So now the Spanish government has to get up to speed to do mass testing,” says Hunter. The plan is for the Health Ministry to test around 62,000 people, according to a scientific plan that takes into account gender, location, and hardest-hit areas.

“Once the testing has been carried out, the government will decide which confinement measures can be lifted and how,” El País reports.

» READ MORE: Question for Trump: Where is the testing data we need to go back to work? | Trudy Rubin

We don’t know how well the Spanish Health Ministry’s testing efforts will turn out. But the point is that they do have a testing plan on which they hope to base any decisions about returning to normalcy.

Such a plan, at the national level, is exactly what the United States still lacks.

“We are operating in a fog because we never got the data,” says David Katz, founding director of the Yale-Griffin Prevention Research Center.

» READ MORE: How Germany got fatalities down and South Korea got masks | Trudy Rubin

Although the number of tests done in the United States has risen dramatically, the number of tests done per capita — the crucial figure — still lags dramatically behind many countries. And, astonishingly, the number of coronavirus tests analyzed each day by commercial labs in the U.S. reportedly plummeted by more than 30 percent over the past week.

Moreover, there has been no coordinated national testing strategy that would reveal the true infection rate, the percentage of asymptomatic cases, and the actual death rate. That would help determine who could go safely back to work.

And, contrary to President Trump’s claims, tests are not available to everyone who needs one. Far from it.

The backlog in New Jersey is getting worse, not better, according to the New York Times. Test scarcity may slow Pennsylvania’s reopening, according to an investigation by Spotlight PA.

New York is still desperately short, says Gov. Andrew Cuomo. He urged on Tuesday that the federal government work with states to get testing up to scale in a matter of weeks so that nonessential workers could go back to their offices and work sites.

But even before getting to mass testing, Katz would like to see the CDC organize a random, scientific sample testing of 5,000 to 10,000 people based on zip code, age, sex, health status, and populations of special interest. That would give a picture of the overall situation in the country.

“We’d be able to say who’s at risk, and who can safely go back to work. We could map the risk deferential and phase people back to normalcy.

“I’m appalled we don’t have the data in making life and death decisions,” Katz says. “I don’t know if Spain is doing it right or wrong, but we could know. We know how to do this. The United States of America should be capable of assembling data.

”Let’s get to the endgame in a rational, data-based, informed way.”