ABSTRACT
INTRODUCTION: The state of alarm was declared in Spain due to the COVID-19 epidemic on March 14, 2020, and established population confinement measures. The objective is to describe the process of lifting these mitigation measures. METHODS: The Plan for the Transition to a New Normality, approved on April 28, contained four sequential phases with progressive increase in socio-economic activities and population mobility. In parallel, a new strategy for early diagnosis, surveillance and control was implemented. A bilateral decision mechanism was established between the Spanish Government and the autonomous communities (AC), guided by a set of qualitative and quantitative indicators capturing the epidemiological situation and core capacities. The territorial units were established ad-hoc and could be from Basic Health Zones to entire AC. RESULTS: The process run from May 4 to June 21, 2020. AC implemented plans for reinforcement of core capacities. Incidence decreased from a median (50% of territories) of 7.4 per 100,000 in 7 days at the beginning to 2.5 at the end. Median PCR testing increased from 53% to 89% of suspected cases and PCR total capacity from 4.5 to 9.8 per 1000 inhabitants weekly; positivity rate decreased from 3.5% to 1.8%. Median proportion of cases with traced contacts increased from 82% to 100%. CONCLUSION: Systematic data collection, analysis, and interterritorial dialogue allowed adequate process control. The epidemiological situation improved but, mostly, the process entailed a great reinforcement of core response capacities nation-wide, under common criteria. Maintaining and further reinforcing capacities remained crucial for responding to future waves.
ABSTRACT
BACKGROUND: In developed countries tobacco smoke is the preventable risk factor that causes more deaths. The objective of this study was to assess the impact of tobacco in the Galician adult (aged 35 and over) population from 2001 to 2006. METHODS: Attributable mortality was estimated by a prevalence-dependent method based on the population attributable fraction. Galician prevalence of tobacco consumption was estimated for the period 2001-2006 based on local population surveys and relative risks derived from the Cancer Prevention Study-II. Years of life expectancy lost related to tobacco consumption were calculated applying the method proposed by Arriaga. RESULTS: In Galicia, among 2001 and 2006, 21.588 deaths were attributed to tobacco consumption in the 35-year-old population and above, which supposes 12,5 % of the mortality happened across the period. The percentage of years of life expectancy lost as reason of the consumption of tobacco decreased from the first one to the second triennium in males (28,1 % vs 26,8 %) and it increased in females (9,9 % vs 10,9 %). CONCLUSIONS: At general population level tobacco attributable mortality shows a stable pattern. This is probably related to a slight increase of mortality in young females and a decrease in males' mortality.
