Spanish region bans smoking in outdoor public places in attempt to fight coronavirus

A region in Spain has introduced a ban on smoking in outdoor public places when social distancing cannot be guaranteed.  

The ban came into effect Thursday in Spain’s northwestern region of Galicia, with other areas mulling similar restrictions to curb the spread of the coronavirus.

Under a law approved by the regional government of Galicia late on Wednesday which came into force at midnight, removing a face mask to smoke in public is not allowed if it is not possible to maintain a distance of two meters (6.7 feet) between people.

The move is supported by research from Spain’s health ministry, who last month found that smoking can spread the virus because people project droplets when they exhale smoke. 

In addition, the virus could be spread when a person removes their face mask to smoke a cigarette, and by touching their cigarette before bringing it to their mouth.  

A region in Spain has introduced a ban on smoking in outdoor public places when social distancing cannot be guaranteed. Above, a woman smokes a ta bar terrace despite the ban on the first day the new law came into force in Galicia 

The ban came into effect Thursday in Spain's northwestern region of Galicia. Above, a man smokes a cigarette in a bar's terrace in Valencia on August 13

The ban came into effect Thursday in Spain’s northwestern region of Galicia. Above, a man smokes a cigarette in a bar’s terrace in Valencia on August 13

It is mandatory in all of Spain, except in the Canary Islands, to wear a face mask in all outdoor and indoor public spaces.

The Spanish Society of Epidemiology in July called for smoking to be banned in outdoor spaces, arguing there is a risk that smokers infected with COVID-19 but who are asymptomatic ‘could release droplets’ containing the virus ‘which put at risk the rest of the population’.

The smoking ban is the first of its kind in Spain and is part of a series of new measures imposed by Galicia, best-known as the destination for pilgrims hiking along the Camino de Santiago, to curb the spread of COVID-19.

It has already ordered the closure of bars and nightclubs and restricted the number of people who can enter shops at the same time.

Officials in other regions such as Madrid and the southern region of Andalusia, along with those in the central regions of Castilla y Leon and Castilla La Mancha, said they were considering similar smoking restrictions.

Spain’s highly decentralised system of government makes regions responsible for healthcare, leading to a patchwork of different measures to curb the virus across the country of 47 million people.

The World Health Organization has said tobacco users are likely to be more vulnerable to being infected by the virus and could increase the possibility of transmission of the disease since it involves contact of fingers with the lips.

While the smoking ban was applauded by many medical experts, some questioned its effectiveness.

‘There is not yet enough solid scientific information to show that in open spaces, tobacco smoke can transmit the disease,’ Fernando Garcia, an epidemiologist at the Carlos III institute for health, told AFP.

The Spanish Society of Epidemiology in July called for smoking to be banned in outdoor spaces. Above, a man smokes a cigarette in a street of Valencia on August 13, 2020

The Spanish Society of Epidemiology in July called for smoking to be banned in outdoor spaces. Above, a man smokes a cigarette in a street of Valencia on August 13, 2020

Does smoking increase the risk of catching coronavirus?  

 Smoking does increase the risk of getting coronavirus, according to a major British study that disputes growing evidence that the habit is protective.

A team at Imperial College London, King’s College London and Zoe – the developer of a symptom-tracking app – looked at 2.4million Britons, of which 11 per cent reported smoking.

The main finding was that current smoking was linked with a ‘substantially increased risk of developing symptoms suggestive of COVID-19’.  

Among ‘standard users’ – those who never actually had a test – current smokers were 14 per cent more likely to develop the classic triad of symptoms of COVID-19 than non-smokers.

These were a fever, persistent cough and shortness of breath.

They were also 29 per cent more likely to have more than five symptoms, and 50 per cent more likely to have more than 10 symptoms.

In addition, current smokers who tested positive were more than twice as likely to need to attend hospital due to COVID-19. 

The findings are in stark contrast to smaller and less accurate papers so far, citing a lower risk of hospitalisation in smokers. 

‘To take such an extreme measure when there is not anough evidence, I think is a bit disproportionate.’

With 30 cases per 100,000 inhabitants, Galicia has one of the lowest prevalence rates of the virus in Spain, which has nearly 330,000 infections, the highest number in Western Europe.

The ban on smoking comes as the country grapples with the worst infection rate in western Europe. Spain now has 376,864 confirmed total cases, and 28,579 deaths. 

Spain confirmed 44,400 new cases over the past 14 days alone, compared with just 4,700 new cases registered by Italy, with 60 million inhabitants, which was the first European country to be rocked by the virus.

Spain is still in good shape compared with many countries in the Americas, where the spread seems unchecked in the United States, Mexico and several South American countries.

But hospitalizations with COVID-19 have quintupled in Spain since early July, when cases were down to a trickle after a severe lockdown stopped a first wave of the virus that had pushed the health care system to breaking point.

On Tuesday, Spain’s ministry reported 805 people nationwide hospitalized over the past seven days. Half of the 64 people who died over the previous week were from Aragon, the region surrounding Zaragoza. 

Spain’s former King Juan Carlos is with lover of 40 years in Abu Dhabi hotel, royal expert claims 

Spain‘s scandal-hit former king has fled to Abu Dhabi with his long-time lover, a royal expert has claimed.   

The controversial Juan Carlos, 82, is believed to be with his ‘most faithful friend for the past 40 years’ in a £10,000-a-night presidential suite in Abu Dhabi. 

Royal expert and author Pilar Eyre says the ex-king and his wife Sofia have not shared a bedroom since she caught him with another woman on a 1976 hunting trip.

The lothario’s female companion has given up a summer cruise to join him in his Middle East hideaway following his shock decision to quit Spain earlier this month, Eyre claimed. 

She wrote in glossy Spanish magazine Lecturas: ‘The king is not alone.

‘His faithful friend for the past 40 years is with him, the person who forgives everything, never fails him, accompanies him, comforts him.’

The former Spanish king has allegedly had an astonishing 5,000 lovers in his lifetime according to Spanish historian Amadeo Martinez Ingles. He is pictured above with his wife Sofia in 2007

She added: ‘They have experienced a wonderful love affair and face their future together hand in hand.

‘Juan Carlos, who has been so courageous on other occasions, should show himself publicly with her. He owes it to her, and also to us.’

The mistress of the former king, who according to Spanish historian Amadeo Martinez Ingles has had an astonishing 5,000 lovers in his lifetime, was not named.

Royal expert and author Pilar Eyre says the ex-king and his wife Sofia have not shared a bedroom since she caught him with another woman on a 1976 hunting trip

Royal expert and author Pilar Eyre says the ex-king and his wife Sofia have not shared a bedroom since she caught him with another woman on a 1976 hunting trip

Pilar Eyre also claimed in her article that Juan Carlos had left Spain with just two suitcases containing only the ‘essentials.’ 

But one Spanish news website today said she ‘could be’ Marta Gaya, a Majorcan-born interior designer who has been dubbed the ‘love of his life’ in the past in their homeland.

Pilar Eyre’s lover claims will add to the controversy surrounding the former king’s departure from Spain amid an ongoing corruption scandal.

On Sunday protestors in Madrid called for an end to the Spanish monarchy, the same day a poll by SigmaDos found more than 63 per cent of those questioned felt it was a bad idea for Juan Carlos to have left the country.

His whereabouts following his August 3 exit, announced in a letter to his son Felipe VI made public after he left, sparked a guessing game which placed him in Portugal and the Dominican Republic before it emerged he was in Abu Dhabi.

The runaway former king, who abdicated in favour of Felipe VI in 2014, was pictured getting off a private jet before bunkering down in a £10,000 suite at the seven-star Emirates Palace.

Right-wing Spanish newspaper ABC had previously claimed Juan Carlos took a private plane from Vigo near Spain’s north-west border with Portugal on Monday with at least five other passengers including four bodyguards.

And in a detailed summary of the seven hour 13 minute flight covering the 3,751 miles between the Galician coastal city and Abu Dhabi, ABC identified the jet as a £45million Global 6500, registration number 9H-VBIG, hired from the Maltese branch of airline TAG Aviation. 

Spain's former king Juan Carlos was banished from the country by his son

Reigning King Felipe VI banished his father amid the latter's corruption scandal, sources claim

Spain’s former king Juan Carlos (left) was banished from the country by his son (right) – the reigning King Felipe VI – amid the latter’s corruption scandal, sources claim

It also claimed the flight path was ‘altered’ as part of a ‘legal’ practice adopted by footballers and other celebrities and wealthy businessmen to disguise the identity of the person on the plane, saying it marked Paris-Abu Dhabi but overnighted in Vigo on Sunday before leaving for the Middle East.

Naming the airport it touched down at as Al Bateen Executive Airport, the first dedicated private jet airport in the Middle East and North Africa regions, it said Juan Carlos made the final part of his long journey to the government-owned Emirates Palace Hotel by helicopter.

Juan Carlos, in his letter to Spain’s current king announcing his decision to leave his homeland, wrote ‘Guided by my conviction I can offer the best service to Spaniards, its institutions and to you as King, I am communicating my decision to move away from Spain.

‘It’s a decision I am taking with deep feeling but with great serenity.

‘I have been King of Spain for almost 40 years and during that whole time, I’ve always wanted the best for Spain and for the Crown.’

He signed off the letter: ‘With affection as always, your father.’

It later emerged he had already left Spain by the time the letter was released by the Royal Household.

Juan Carlos is stayiing in a £10,000-a-night presidential suite in the Emirates Palace Hotel (air view pictured) in Abu Dhabi, Spanish daily ABC reported

Juan Carlos is stayiing in a £10,000-a-night presidential suite in the Emirates Palace Hotel (air view pictured) in Abu Dhabi, Spanish daily ABC reported

Pictured left to right: Then-Princess Letizia , Prince Felipe, Queen Sofia and King Juan Carlos pose for a photo in 2009

Pictured left to right: Then-Princess Letizia , Prince Felipe, Queen Sofia and King Juan Carlos pose for a photo in 2009

His departure sparked mixed reactions, with monarchists and right-wing politicians accusing the government of forcing him into exile.

Critics of the former king accused him of an amateur attempt to protect himself and his son from the corruption scandals threatening the future of Spain’s dwindling royal family.

Pablo Iglesias, the left-wing leader of Sanchez’s government coalition partner Podemos, has branded the former king’s ‘flight abroad’ as ‘unworthy of a former head of state’ and claimed it left the country’s Royal Family in a ‘very compromised position.’

Juan Carlos’s lawyers insist he remains ‘at the disposition’ of Spain’s judicial system.

His departure from Spain comes after Swiss prosecutors opened an investigation into bank accounts allegedly held by Juan Carlos in tax havens.

Spain has launched its own investigation based in part on information shared by Switzerland about cash the former king allegedly received as part of his involvement in a high-speed Saudi Arabia rail contract.

The Spanish Royal Household has so far declined to comment on Juan Carlos’s whereabouts.

The £3bn seven-star Emirates Palace Hotel opened its doors for the first time in November 2005.

It is set in 1,000 hectares of landscaped parkland with 100 water fountains and 8.000 trees. It has a near-mile-long private beach, a four mile jogging track, two swimming pools and underground parking for 2,500 cars.

The hotel has a total floor space of 850,000 square metres, putting Buckingham Palace’s 77,000 square metres in the shade.

Tony Blair and Bill Clinton have been among the heads of state to grace it along with musicians and film stars such as Sir Elton John, Will Smith and Justin Timberlake.

The hotel has 302 grand rooms and 92 suites. ABC appears to be claiming Juan Carlos is staying on the highest floor of the hotel, in one of the six suites said to be out of bounds to all expect members of UAE royal families.

It said Sheikh Mohammed bin Zayed al Nahyan, Crown Prince of the Emirate of Abu Dhabi, had made the hotel ‘paparazzi-proof’ with more private security following Juan Carlos’s arrival.

Eyre’s article also claimed he was due to have a minor operation at a hospital in Abu Dhabi to correct an operation in Spain which had not had ‘the desired effects.’

Who is Spain’s former king, Juan Carlos I?

Juan Carlos I reigned as king of Spain from November 1975 until his abdication in June 2014

Juan Carlos I reigned as king of Spain from November 1975 until his abdication in June 2014

Juan Carlos I reigned as king of Spain from November 1975 until his abdication in June 2014. 

He was a popular monarch for most of his four-decade reign who played a critical role in the country’s transition to democracy. 

He is the grandson of Alfonso XIII, the last king of Spain before the abolition of the monarchy in 1931 and the subsequent declaration of the Second Spanish Republic. 

Juan Carlos was born in Rome, Italy, on January 5, 1938, during his family’s exile. He came to Spain in 1947 to continue his studies and entered the Zaragoza military academy. 

He completed his tertiary education at the University of Madrid and went on to marry Princess Sofia of Greece and Denmark in Athens in 1962. 

They went on to have two daughters and a son together: Elena, Cristina, and Felipe.  

Juan Carlos first began periodically acting as Spain’s head of state in the summer of 1974. Fascist dictator Francisco Franco died in November the following year and Juan Carlos became king on 22 November 1975, two days after Franco’s death.

Juan Carlos was hailed for his role in Spain’s transition to democracy and reforms to dismantle the Francoist regime. 

However the King and the monarchy’s reputation began to suffer after controversies surrounding his family arose. 

In April 2012, Juan Carlos faced criticism for an elephant-hunting trip in Botswana during a time of financial crisis in Spain. 

The public found out about the trip only after the King injured himself and a special aircraft was sent to bring him home.

Spanish officials stated that the expenses of the trip were not paid by taxpayers or by the palace, but by businessman Mohamed Eyad Kayali.

Corruption scandals circling the royal family closed in when his daughter, Princess Cristina, was accused of tax fraud in 2014 and became the first Spanish royal to stand trial. She was later acquitted, but her husband was sentenced. 

He abdicated in favour of his son, Prince Felipe, in 2014, and last year, Juan Carlos announced his decision to withdraw from public life, ending his remaining institutional functions and appearances from June 2019. Last August, he successfully underwent heart surgery in Madrid.  

In June 2020, Spain’s supreme court prosecutor opened an investigation into Juan Carlos’ involvement in a high-speed rail contract in Saudi Arabia that was granted to a group of Spanish companies in 2011.

King Felipe renounced his own inheritance and stripped his father of his palace allowance in March after reports the latter received $100 million from the late Saudi king and gave millions to a businesswoman.  

Coronavirus Spain: Girl, 11, dies from Kawasaki-like syndrome

An eleven-year-old girl has died from organ failure in Spain after suffering from a Kawasaki-like disease linked to the coronavirus, according to local media.

The child, who had no known underlying health conditions, passed away at the Joan XXIII University Hospital of Tarragona in Catalonia yesterday after testing positive for Covid-19. 

Catalonia’s public health secretary claimed it was too early to say Covid-19 was definitely the cause of death, adding that it was ‘a very sad case’.

But the girl’s case had all of the hallmarks of the Covid-linked disease, which has been dubbed Paediatric Inflammatory Multisystem Syndrome Temporally (PIMS-TS).  

The condition appears to strike children around the age of 10, on average, typically causing stomach pains, vomiting, diarrhoea, fevers, rashes, red eyes and swollen feet. 

Fatal complications of the illness appear to be related to the strain it puts on the heart – but the exact details of how the condition kills remain unclear.

Doctors are almost certain the illness is being caused by the coronavirus but they haven’t yet been able to prove it yet.

At least two British children have died from the condition and hundreds have been hospitalised. 

The child, who had no underlying health conditions, passed away at the Joan XXIII University Hospital of Tarragona in Catalonia (pictured) yesterday after testing positive for Covid-19

In the largest study of its kind yet, paediatricians detailed the course of the mystery inflammatory illness in 78 hospitalised youngsters. The most common symptoms were fever, shock, abdominal pain, vomiting and diarrhoea. Other reported symptoms by other doctors are a rash (see bottom right, in different skin colours), red eyes, a headache, swollen hands and feet and confusion

In the largest study of its kind yet, paediatricians detailed the course of the mystery inflammatory illness in 78 hospitalised youngsters. The most common symptoms were fever, shock, abdominal pain, vomiting and diarrhoea. Other reported symptoms by other doctors are a rash (see bottom right, in different skin colours), red eyes, a headache, swollen hands and feet and confusion

The Spanish girl was initially admitted to the Verge de la Cinta Hospital in Tortosa over the weekend, according to regional newspaper Diario de Tarragona.

It’s unclear what her initial symptoms were, but her condition is said to have deteriorated rapidly.

The child was then transferred 50 miles to the Joan XXIII early on Monday morning when her organs started to fail.

Secretary General of Public Health, Mr Argimon,said the girl had been diagnosed with Covid-19, but , for the moment, it was not possible to know if the virus was the cause of the death. ‘You have to differentiate the two things well,’ said Argimon. ‘It it is a very sad case.’

WHAT DO WE KNOW ABOUT THE NEW ILLNESS?

WHAT IS IT CALLED?

The illness has been likened to Kawasaki disease, which mainly affects children under the age of five.

But it has been named Paediatric Inflammatory Multisystem Syndrome Temporally (PIMS-TS) because it is new and distinct from Kawasaki.

WHAT SYMPTOMS DOES IT CAUSE?  

The majority of the children being hospitalised with the condition have suffered from a high fever for a number of days, severe abdominal pain and diarrhoea.

Some develop a rash and red eyes or red lips, while a very small group go into shock, in which the heart is affected and they may get cold hands and feet and have rapid breathing. 

The symptoms are similar to those caused by Kawasaki disease, a rare but treatable condition that affects around eight in every 100,000 children each year in the UK. 

WHO DOES IT AFFECT?

PIMS-TS appears to be more likely to affect older children than Kawasaki disease (average nine years old versus four years old respectively), British researchers recently wrote in the Journal of the American Medical Association. 

Up to 80 per cent of affected children in a study of 78 children by the Royal College of Paediatrics and Child Health were from black, Asian and minority ethnic backgrounds (BAME). 

Similarly, more than half (57 per cent) of 21 youngsters diagnosed in a Paris hospital were of African heritage, compared to 29 per cent of European descent.

Dr Sara Hanna, medical director at Evelina London Children’s Hospital, said 70 to 80 per cent of children seen in London hospitals have been BAME.

WHEN DID OFFICIALS FIRST START TO SEE CASES?

The NHS sent an alert to doctors on April 27, warning them to look out for signs of the syndrome. 

At the time they said cases had been appearing in tiny numbers in London for about three weeks. Since then they have spread further across the country.

There have been less than 200 cases of PIMS-TS reported in England so far, according to researchers at the Imperial College Academic Health Science Centre. Figures for the UK are not clear.

IS IT CAUSED BY SARS-COV-2, THE CORONAVIRUS?

Doctors are almost certain the illness is being caused by the coronavirus but they haven’t yet been able to prove it. 

Cases began appearing as the UK’s coronavirus outbreak hit its peak and similar conditions have been reported in China and Italy during the pandemic.

However, not all children with the Kawasaki-like syndrome test positive for the virus. Swab testing has suggested some of the children have not been infected with COVID-19 at the time they were ill.

But all patients have tested positive for antibodies, doctors said, meaning they have had the coronavirus in the past.

They said this suggests it is a ‘post-infectious phenomenon’ which is caused by a delayed overreaction of the immune system, which may happen weeks or even up to a month after the child was infected with Covid-19. 

IS IT TREATABLE? 

Yes. But there have been some reported deaths – at least two, according to the RCPCH.

The only child known to have died with it, a 14-year-old boy, died of a stroke that was triggered by the life support machine he was on.

Doctors are currently treating the condition by using medications to calm down the immune system and dampen the overreaction.

Dr Liz Whittaker, a paediatrician at Imperial College Healthcare in London, said the sickest children are usually very ill for four to five days and begin to recover a couple of days after starting treatment.

There have been fewer than 200 cases of PIMS-TS reported in England so far, with a range of symptoms and severity. Most children have already recovered. 

Nearly 300 cases the life-threatening syndrome have been identified in the US, in two studies published in The New England Journal of Medicine.  

The illness has been likened to Kawasaki disease, which mainly affects under-fives and causes blood vessels throughout the body to swell. 

Children appear to fall sick with PIMS-TS several weeks after being infected by the coronavirus, called SARS-CoV-2. 

In April, clinicians in the UK were alerted to a cluster of children with unexplained inflammation requiring admission to intensive care units.

A major study was carried out over 40 days and 78 cases of PIMS-TS were reported by 21 of 23 intensive care units in the UK. Two of the chidren died.

The full findings were published in the medical journal, The Lancet, last month. 

The study said hospital admissions to paediatric intensive care between April 1 and May 10 was at least 11-fold higher than historical trends for similar inflammatory conditions.   

Dr Patrick Davies, consultant paediatric intensive care specialist at Nottingham Children’s Hospital, published the findings of 78 children across 21 of 23 UK paediatric intensive care units during that time period.

They each fulfilled the condition definition newly outlined by the Royal College of Paediatrics and Child Health to help both doctors and parents spot the signs. 

A fever was present in all cases studied, and children also suffered with shock, abdominal pain, diarrhoea and vomiting. 

They received a varied range of treatments, and one child was given the antiviral remdesivir – which became the first medication to get approval for use on the NHS to treat Covid-19 in May.

A third of patients were found to have coronary artery abnormalities. These included coronary aneurysms – the abnormal dilation of a artery supplying the heart. 

Four per cent of patients had significant blood clotting that was affecting the blood flow in vessels.

Doctors believe the survival rate is high because three per cent (two) of children in the study died. 

Dr Padmanabhan Ramnarayan, senior author of the research, told MailOnline: ‘While it is difficult to comment about the cause of death in individual cases, potential mechanisms for a poor outcome might include blood clots in the brain, excessive bleeding and severe heart failure. 

‘However, this study shows that the condition is rare and has affected few children overall, and that outcomes for those who have needed ICU care is generally very good.’

He added that PIMS-TS is an inflammatory condition and causes a similar phenomenon to the ‘cytokine storm’ described in adults with Covid-19.

A cytokine stormy, potentially fatal, is when the immune response goes into overdrive and immune cells start attacking healthy tissue as well.  

Dr Ramnarayan, a consultant in paediatric intensive care retrieval at Great Ormond Street Hospital, said: ‘[It] may lead to multiple organs being affected, mainly the heart, kidneys and blood vessels.’ 

Academics did not reveal who the children who died in the study cohort were. It is not clear they are two previously reported UK fatalities linked to Kawasaki and Covid – a 14-year-old boy and an eight month old baby.

The death of the unnamed 14-year-old boy, treated at Evelina London Children’s Hospital in May, was reported on May 13. He had been part of a cluster of cases of PIMTS at the hospital. 

The baby, Alexander Parsons, who had no underlying health conditions, passed away after being admitted to Plymouth’s Derriford Hospital on April 6.

He had been diagnosed with Kawasaki disease the day of his death and suffered a ruptured aneurysm, but it is not clear if his case was linked with Covid-19, his parents said.

Dr Ramnarayan said clinicians across the world have already made tremendous progress in understanding PIMS-TS, The Sun reports.  

‘However, many aspects of the condition remain unclear, such as why it only affects some children or what the long-term implications of having this condition are,’ he added.

Dr Barney Scholefield, senior author, said a wealth of information to help treat cases has been uncovered so far.

‘A large group of children’s intensive care clinicians from across the NHS have rapidly worked together to help understand this condition,’ the paediatric intensive care consultant at Birmingham Women’s and Children’s NHS Foundation Trust and researcher at the University of Birmingham said.

Lead researcher on the paper and consultant paediatric intensive care specialist at Nottingham Children’s Hospital, Dr Patrick Davies said the key to successful treatment is ‘close collaboration with many specialists’.