This February 24 marks one year since the quarantine for 14 days of almost a thousand people in a hotel in the South of Tenerife. The unprecedented decision was adopted after confirming the positive by COVID-19 of an Italian tourist, staying in a Costa Adeje hotel complex, the first case that was registered in Tenerife, just a few weeks after the first positive case declared in Spain of a tourist of German origin on the island of La Gomera.
Coordination, collaboration, interdisciplinary work, response capacity and means are the main keys with which the professionals of the Canary Islands Health Service (SCS) and from Canary Islands Emergency Service (SUC) who spearheaded the coordination of that health operation, which a year later could be seen as a “general rehearsal” of the measures and situations that were to become everyday just a few weeks later.
That vision is shared by Clara Gironés-Bredy, medical director of the Tenerife Primary Care Management and general coordinator of the sanitary operation; Marcela Posca-Maina, territorial director of the SUC of the province of Santa Cruz de Tenerife; Ramón Pinto-Plasencia, Director of Nursing of the aforementioned Management, and Verónica Suárez, Deputy Director of Nursing at the Hospital Universitario Nuestra Señora de Candelaria. They carried out coordination tasks in the health system, made up mainly of Primary Care health workers, SUC, of the two university hospitals on the island (HUNSC and HUC) and of the General Directorate of Public Health of the SCS.
All highlight the success of the device, but also how this previous experience allowed progress in lines of action, protocols and means of response to the pandemic in the following months, establishing a reference experience for the use of hotels as care and confinement resources mild patients. As examples they also cite measures such as the implementation from the first days of the SUC citizen information telephone on the COVID, line 900 112 061 still operating in the islands; the processing of samples in the laboratory of the Hospital Universitario Nuestra Señora de Candelaria or the performance of tests and screening, with more than 800 PCR tests in those 14 days.
This previous experience also facilitated the development of tracking teams, being one of the first territories to start them up, as Ramón Pinto-Plasencia, director of Nursing of the Primary Care Management of Tenerife, who states that the professionals who began to do the screenings in the hotel, continue in the Tenerife COVID trackers team. Months later, it would also be the pioneer territory in developing the first vehicle sampling operation, in the parking lot of the Faculty of Fine Arts in La Laguna, recalls Marcela Posca-Maina.
“We were very proactive and advanced in decision-making, we learned a lot from the interdisciplinary work model and the team leadership style that was implemented in that operation and that has marked the line and dynamics of work that has been followed in management later”, recognizes Clara Gironés, general coordinator of the operation, launched after the decision to close and confine the hotel raised by the Ministry of Health arranged on February 24.
In total, there was a work group of 71 professionals (13 doctors, 42 nurses, 4 administrative assistants and 10 logistics management technicians), reinforced with volunteers from the Group for Psychological Intervention in Emergencies and Catastrophes and with translators from the Spanish Confederation of Federations and Professional Associations of Tourist Guides. To which were added members of the National, Autonomous and Local Police and the hotel’s team of professionals, as well as the collaboration of other local and island administrations.
Unprecedented next, with the closest benchmarks in Hong Kong in the seven-day quarantines of the hotels, Metropole, during the SARS epidemic in 2003 and Metropark, for H1N1 in 2009, steps were taken to quarantine the hotel , in which 893 guests and 263 workers were staying. The clear objective was to prevent the spread of the virus, both within the complex and as on the rest of the island. “And it was achieved”, as Clara Gironés recalls, who emphasizes that this measure of control and limitation also prevented public alarm due to the possible dispersion and level of contagion.
The four of them health officials The data is referred to to highlight the success of the device: only seven positive cases, six of them close contacts of patient 0, and who remained isolated from the first moment, after the case was reported. There were no other guests, no workers, or members of the teams infected during the quarantine, or on the subsequent return to their homes.
The identification and isolation of close contacts, the prevention and protection measures adopted for the rest of the guests and workers -such as staying in the rooms, use of a mask or control of capacity and distance in common spaces-, and carrying out screenings “they were key” from the first moment in the protocol of sanitary action, highlights Verónica Suárez, deputy director of Nursing of the University Hospital Nuestra Señora de Candelaria.
We acted following the protocols and recommendations available at the time before the COVID-19 and since December there had been some preliminary work on response hypotheses to the declaration of a positive case in the islands, due to their status as a tourist destination, recalls Clara Gironés. It started from a health and organizational logistics based on disaster medicine but adapted to an urban environment, in which numerous logistical challenges had to be faced, both for the health response, as well as legal, organizational and security.
From the provision of resources abroad to create a sanitary device (tents, bathrooms, offices, furniture, technical means or rest areas), passing the airport procedures and with consulates and embassies to organize the return of guests of 24 nationalities, to guarantee adequate health care for those guests who had other health problems, such as monitoring of pregnancies, provision of medication or monitoring of more serious ailments.
Among those challenges was also the emotional and communicative. Transmit calm, security, understanding and confidence in the face of a very intense situation for the hotel workers and for hundreds of tourists who came to Tenerife to enjoy a few days of rest and who saw their freedom of movement restricted, in a context of uncertainty before the first cases of COVID-19 and advance of contagions in Europe and in the middle of a great mediatic expectation.
At this point, they highlight the role played by the volunteers of the Group for Psychological Intervention in Emergencies and Catastrophes (GIPEC) and also by the translators of the Spanish Confederation of Federations and Professional Associations of Tourist Guides (CEFAPIT), keys to facilitate that management of emotions and communication in 13 different languages. Although they recognize that in the first moments there were some situations of misunderstanding and resistance, they highlight the collaborative attitude of both the guests and the hotel workers, as well as the involvement and work capacity of all those who were part of the device.
The first departures of foreign tourists began on the 28th, in more than 50 flights and after checking that they were negative by PCR test. After the quarantine ended, on March 10, the last group of 274 guests staying at the hotel saw the doors open. A moment on a personal level that the four health officials agree to point out as the most emotional of all those who lived in those “intense days”, which they recognize were a “small-scale dress rehearsal” of what was to come. On March 11, the declaration of a pandemic was produced by the World Health Organization (WHO) and a week later the state of alarm was decreed in Spain.