A week after hitting the east and south of the peninsula, we are still far from calculating the impact of DANA on the number of deaths. But there is another indirect impact, which occurs on the health of those affected, those who have seen how the water has devastated their homes or who find themselves in the middle of the chaos and destruction of the largest natural disaster in the world. century.
Doctors and public health experts who spoke with this newspaper agree that much of that impact will be psychological, the anxiety and stress that grips people who have lost a loved one or seen their homes devastated.
“The collapse in the mental health of the population is terrible,” he explains. Juan Francisco Navarropresident of the Valencian Society of Preventive Medicine and Public Health, who also emphasizes that there will be an impact due to “the interruption of all health programs, both chronic and medical. In this case, the question would be: “Who will not be affected?” »
Perhaps we should first talk about significant situations which, in reality, do not pose much danger to the population. Among its recommendations for the population and volunteers of the Valencian Community, the Ministry of Health includes not touching corpses.
Given the doubts about the risk that this entails, the department headed by Mónica García clarified that “there is no scientific evidence that [los cadáveres] constitute a significant risk of epidemic diseases (cholera, typhus and others) after a natural disaster.
And remember that “if infections do occur, their origin is more likely to come from the survivors themselves.”
The most obvious risk for Eduardo Brionesmember of the Spanish Society of Epidemiology, are “gastrointestinal diseases, such as dysentery, hepatitis A and gastroenteritis in general, due to water contamination and poor hygienic conditions” .
The recommendation is clear: only drink water known to be safe to drink. In the case of tap water, “there is always a risk of contamination, but we assume that the supplier company provides information on potability.”
This risk, he warns, is “very variable from one municipality to another, even from one street to another”.
Proliferation of mosquitoes
Julia Maria Ruizcoordinator of the public health working group of the Spanish Society of General and Family Physicians (SEMG), recalls that in addition, flood waters should not be used “for washing dishes, brushing teeth or washing and prepare food.”
Only bottled, boiled or treated water should be used and “any food or bottled water that comes or could have come into contact with floodwaters” should be removed.
The water is also home to leptospira, a bacteria that can cause fever, headaches, myalgia or conjunctival infections, endemic to Valencia (in Albufera), but which benefits from effective antibiotic treatment.
Juan Francisco Navarro points out that in addition to bacteria, stagnant water is a breeding ground for mosquitoes. “They can be vectors for the transmission of tropical diseases like dengue and, although it is not easy to cause an epidemic of indigenous cases, we must take health measures.”
Waste also poses a risk. “It is not enough to separate them from houses and put them 15 meters away. Mosquito larvae will grow in the waste mud, there will be cockroaches and rats… And these animals are vectors for transmitting diseases. Transmission routes must be able to reach waste for kilometers, because mosquito flight zones are wide.”
The president of the Valencian Community, Carlos Mazón, warned this Monday of the risk of tetanus among affected citizens and injured volunteers, but experts consulted by EL ESPAÑOL do not believe this is one of the main risks.
“Obviously, around thousands of people may have been injured, both during the floods and during the reconstruction, but if we are very well vaccinated in the whole population, it is against tetanus and, in Spain, s “There are cases, they are absolutely exceptional.”
Other infections raise more concerns which, in the chaos of these days and those that follow, can have an impact on the health of the most vulnerable: chronic patients, the elderly or immunocompromised people.
The threat of the flu
“We are in the middle of the entry period for respiratory viruses and the crowds are terrible,” he says. Although reports of respiratory infections indicate that these remain under control, the chaos after DANA could affect the vaccination campaign against influenza and Covid (and RSV in newborns and infants), with consequences harmful in a few months.
“I hope there will not be a maximum peak before around Christmas. These are serious infections in the elderly and vulnerable: If we compare the risk of tetanus with that of the flu and Covid, I prefer the latter as a much greater risk“We must continue vaccination programs, even if it is with mobile teams to reach where we currently cannot.”
Among other things, experts recommend the use of personal protective equipment such as masks, gloves or rubber boots when cleaning streets and houses; and take extreme hygiene, if this cannot be done by washing your hands with soap and water, using hydroalcoholic solutions, and ventilate the rooms as much as possible.
However, the health risk situation may extend beyond this first phase of disaster management. “We will have to examine the epidemiological data, since the surveillance systems continue to work and will detect anomalies,” explains epidemiologist Eduardo Briones.
Normality will only be achieved “to the extent that sanitary conditions are restored. In a country like ours, We do not expect there to be major epidemics or health consequences beyond what we are experiencing.“.
Juan Francisco Navarro estimates that, “if everything goes well and if there is no further rain this week to worsen the situation”, the work of professionals and volunteers can “leave the areas cleared in two or three weeks. No risk at all because the houses will have to be rebuilt, but very appreciable work may have been carried out.
