Antoni Trilla
Senior Consultant at the Department of Preventive Medicine and Epidemiology at Hospital Clínic in Barcelona, Professor of Public Health and Dean of the Faculty of Medicine and Health Sciences at the University of Barcelona
The social and health situation in Ceuta is complex. Measures must be taken based on best practice and health evidence, setting aside any political debate.
In Spain, anyone posing a risk of a communicable disease – as is the case here – which is of public health concern to everyone (citizens, residents, migrants), even if they are not registered on the local council’s register, do not have a health card or are in an irregular administrative situation, can (and must) receive healthcare, whether preventative (vaccinations) or therapeutic (treatment).
Vaccination against certain diseases – a measure now also being considered in Ceuta – must always be voluntary (except in very exceptional cases) and must be properly recorded in an official document or register.
The basic rule is to ‘detect, isolate and treat’ cases and identify potential contacts. Each disease has its own specific protocol in this regard, depending on how it is transmitted (a case of active tuberculosis is not the same as a case of scabies, for example).
Contact tracing, should it be necessary, will not be easy. From what we know of the situation in Ceuta, there are many factors that mean it will need to be carried out in a highly personalised manner and to the greatest extent possible.
The most commonly used preventive measures in public health are isolation (of cases), wherever indicated, and quarantine (of contacts, who are by definition not ill but have been exposed to a case).
The term ‘lockdown’ usually refers to a set of public health measures that may be considered in a situation such as the current one to limit the transmission of an infectious disease amongst specific individuals or population groups.
Measures must always be proportionate to the identified health risk and based on the available scientific evidence.
The residents of Ceuta should, if I may offer some advice, remain calm and follow the recommendations of their healthcare professionals and public health authorities in each case, which may include reminding them of the importance of being properly vaccinated against certain diseases.
Finally, the implementation of all these measures requires sufficient healthcare staff, both for preventive care and for the management of potential cases.