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Area of Science:

  • Public Health
  • Epidemiology
  • Health Policy

Background:

  • The COVID-19 epidemic led to a state of alarm and confinement measures in Spain starting March 14, 2020.
  • This study describes the methodology and outcomes of lifting these mitigation measures.

Purpose of the Study:

  • To detail the process of de-escalating COVID-19 confinement measures in Spain.
  • To evaluate the impact of the transition strategy on public health indicators and response capacities.

Main Methods:

  • A four-phase plan, "Plan for the Transition to a New Normality," guided the progressive increase in activities.
  • A bilateral decision mechanism between the Spanish Government and autonomous communities (AC) utilized epidemiological indicators and core capacity assessments.
  • Territorial units for monitoring were established ad-hoc, ranging from Basic Health Zones to entire AC.

Main Results:

  • The de-escalation process occurred from May 4 to June 21, 2020.
  • Key indicators improved: 7-day incidence decreased from 7.4 to 2.5 per 100,000, PCR positivity dropped from 3.5% to 1.8%, and contact tracing reached 100% of cases.
  • Significant reinforcement of core public health capacities was observed nationwide.

Conclusions:

  • Systematic data management and interterritorial collaboration were vital for controlling the de-escalation process.
  • The transition successfully improved the epidemiological situation and substantially strengthened national public health response capabilities.
  • Sustained reinforcement of these capacities is essential for managing future epidemic waves.