COVID in Spain: 'It felt like a war'

2020 has been a hard year. Quite how hard is something Dr. Carmen Gijon is probably realizing only now. She has a few days off before she has to go back to work in the intensive care unit. It's been several months since her hospital in the north of Madrid was hit by the first wave of the coronavirus pandemic, back in March, but it's going to take a lot longer for her to process that experience. She and her colleagues were fighting around the clock for their patients' survival; they felt desperate, frustrated and powerless.

Carmen Gijon was present on countless occasions when a patient's life was lost to COVID-19. She saw people she had been treating moments earlier transferred into body bags. Some of them were elderly; others had only just become parents. Some had looked as if they were going to make it. Many died in the ICU with only doctors at their side. It was only rarely possible, under very strict conditions, to allow a relative to attend a deathbed.

'I cried every day on the way home'

The 38-year-old intensive care doctor fights back tears as she recalls these moments. Right into the summer, she and her colleagues were working shifts of eight days in a row without a break, followed by just one day off to recover; not thinking of themselves, giving 200%. They would cry every day on the way home, she says, as a way of letting it all out. After that they would fall into an exhausted, uneasy sleep.

"Sometimes I don't know how we survived it all. The first wave was literally like a battle," she says. Many of her colleagues have needed psychological support and, in some cases, medication, to find some peace of mind. Even the "very strong" are traumatized. There was a brief pause in the summer when the infection rate went down, but by September ICU beds were filling up again. Carmen Gijon is physically and mentally exhausted.

Doctors anticipate many more deaths after the holidays

It's a slap in the face after everything they went through in the spring, says ICU doctor Laura Sanz. She comments that not only were measures relaxed too far, individual people's behavior led to the virus getting out of control again. She thinks it's highly likely that there will be another wave.

Other doctors are also anticipating many more deaths from COVID-19, especially after the Christmas holidays. Between six and 10 people are allowed to get together in Spain, depending on the region. It remains to be seen whether everyone sticks to the rules, including taking care to maintain distance, wear masks and ventilate rooms. "Everyone knows by now what they need to do. It's a question of responsibility," says Laura Sanz. Right now, an increasing number of families are coming to her hospital in Madrid to get themselves tested before the holidays. Sanz sees this as a good sign.

She herself contracted COVID-19 at the start of the pandemic. The 37-year-old doctor believes she was probably infected at a point when no one was taking the danger seriously. She spent two weeks in the hospital struggling to breathe. Every day she was afraid her colleagues would have to transfer her to the ICU. She watched from her bed as the world around her changed. But she was lucky to have got a room: Not long afterwards, COVID patients were squeezing into every corner of the hospital.

'The sick were lying in the corridors'

"It felt like a war. There were even sick people lying in the corridors," she remembers. Some patients died so fast they didn't even have time to call for help. Without her roommate, 78-year-old Joaquina, Sanz says she wouldn't have made it. "In the 10 days we spent together, she was like a grandmother to me," she says. Joaquina didn't survive. The senior consultant who headed Sanz's department also died of COVID-19.

After her illness, Sanz wanted to go back to work as quickly as possible, not least to support her colleagues — but she still can't do long shifts. She's suffering long-term consequences of COVID-19: She has problems with her digestion. These consequences are being documented as part of her research: Sanz is working with other doctors to investigate the possible links between bacteria in the gut and coronavirus infection.

She describes bacteria as being like "the king of the jungle": Good ones defend their territory against attackers like the coronavirus. This could have an effect on the severity of the infection. It might also be possible to combat the long-term effects of the illness with bacterial flora. A glimmer of hope … However, by January at the latest she assumes she will be spending long days and weeks in the ICU. She hopes that she and her colleagues will have the energy they need for it. 2020 has been hard.