BARCELONA – The elderly of Barcelona’s working-class Poble Sec neighborhood, the generation who survived widespread hunger after the Spanish Civil War, started out vulnerable.
Drawn to Spain’s industrial heartland a generation ago, they relied in retirement on free lunches from neighborhood social centers. Many received medical care from the local clinic, where doctors and nurses made house calls. Social workers brought them groceries.
But the coronavirus pandemic has heightened their fragility, stripping away the safety nets that kept them fed and healthy and exposing them to a daily threat of infection that they know could kill them.
For two weeks, an Associated Press photographer accompanied Barcelona’s visiting health care workers and emergency medical personnel as they tended to Spain’s home-bound elderly.
“All the misery is coming to light,” said visiting nurse Laura Valdes after a day of house calls up and down the narrow stairwells of Poble Sec’s apartment blocks.
The autonomous region of Catalonia, of which Barcelona is the capital, ranks only second to Madrid in Spain’s official count of virus infections and deaths, with nearly 30,000 cases and more than 3,000 dead.
As in similarly hard-hit Italy, Spain’s elderly aren’t usually being tested for COVID-19. They also aren’t being admitted to hospital intensive care units, where coveted beds and breathing machines are prioritized for younger, healthier patients with a better chance of survival. Nationwide, only 3.4% of Spain's ICU patients are over 80.
As a result, Barcelona’s elderly are suffering at home, alone and more isolated than ever. Few know for sure if they have the virus, but the threat that they might catch it — even from the visiting medical teams they need — has only heightened their anxiety.
“If I get the virus, who will take care of my wife?” asked Jose Marcos, 89, as Valdes and other nurses checked on 86-year-old Josefa Ribas, who suffers from dementia and has been bedridden for two years.
Before the virus struck, Ribas’ nurses would be accompanied by social workers during their weekly visits to treat her bedsores. But those workers have stopped coming, either because they got sick, are observing stay-at-home orders or are themselves caring for loved ones.
Marcos’ son drops off groceries at the gate, but Marcos doesn’t dare go outside on his own for fear of infection. He tells a visitor that he survived the mass hunger that marked Spain’s post-war period, but wonders if he’ll survive this pandemic.
The home care workers themselves feel similarly exposed.
Alba Rodriguez is a pediatric nurse by profession but shifted gears to care for Barcelona’s elderly who are confined to their homes. She has had to get creative to protect herself, fashioning hazmat suits out of giant yellow garbage bags that she and her fellow nurses wear over their scrubs.
“We’re like onions,” Rodriguez said of the layers she wears. “Nothing is sufficient to protect you from the virus.”
The nurses know well there is a chance they might infect their patients during their visits, and they take all the precautions they can. Sometimes the elderly refuse medical care until it’s too late, because they fear visiting medics might bring the virus into their homes.
Maria Perez Gomez, 70, reluctantly called emergency medical services when she started having trouble breathing and developed a cough and fever. When the medics arrived, she begged them to tell her she wasn’t positive, though she suspected she was.
“Please leave me here at home, don’t take me to the hospital,” she pleaded. “Tell me doctor that I don’t have the virus.”
Gonzalo Garcia, 61, does have the virus and was hospitalized for it. He was discharged after he improved, and immediately went back home — to his waiting 91-year-old mother, Gloria. After a few days, he took a turn for the worse and had to call emergency services again.
“I’m drowning. I’m drowning. I can’t breathe,” he told the medic who arrived to check his lungs as he heaved on the living room sofa. All Garcia could manage was a raspy whisper.
The ambulance took him away. His mother was left alone.
Nicole Winfield contributed from Rome.