MADRID (AP) - When the coronavirus pandemic was first declared, the Spaniards were ordered to stay at home for more than three months. For weeks they were not allowed outside even for training. Children were banned from playgrounds, and the economy largely stopped.
But officials credited the draconian measures to prevent a complete collapse of the health care system. Lives were saved, they argued.
Now, almost two years later, Spain is preparing to adopt another COVID-19 handbook. With one of Europe's highest vaccination rates and its most pandemic-hit economies, the government is laying the groundwork to treat the next rise in infection not as an emergency, but as a disease that has come to stay. Similar steps are under consideration in neighboring Portugal and in the United Kingdom.
The idea is to go from crisis mode to control mode and approach the virus in much the same way that countries deal with flu or measles. This means accepting that infections will occur and providing extra care to vulnerable people and patients with complications.
Spain's center-left prime minister, Pedro Sánchez, wants the EU to consider similar changes now that the rise in the omicron variant has shown the disease to be less fatal.
"What we are saying is that in the next few months and years we will have to think without hesitation and according to what science tells us how to deal with the pandemic with different parameters," he said on Monday.
Sánchez said the changes should not happen until the omicron rise is over, but officials need to start shaping the post-pandemic world now: "We are doing our homework and anticipating scenarios."
The World Health Organization has said it is too early to consider an immediate change. The organization does not have clearly defined criteria for declaring COVID-19 an endemic disease, but its experts have previously said it will happen when the virus is more predictable and there is no persistent outbreak.
"It's a bit of a subjective assessment because it's not just about the number of cases. It's about difficulty, and it's about impact, ”said Dr. Michael Ryan, WHO's emergency manager.
Dr. Anthony Fauci, the top physician for infectious diseases in the United States, speaking at a panel at the World Economic Forum on Monday, said COVID-19 could not be considered endemic until it drops to "a level so it does not disturb society."
The European Center for Disease Prevention and Control has advised countries to move to more routine management of COVID-19 after the acute phase of the pandemic. The agency said in a statement that several EU states beyond Spain would want to adopt "a more long-term, sustainable monitoring approach."
Just over 80% of Spain's population has received a double dose of vaccine, and the authorities are focused on strengthening the immunity of third-dose adults.
Vaccine-acquired immunity, combined with widespread infection, allows for the concentration of prevention efforts, testing and disease-tracking resources on moderate to high-risk groups, said Dr. Salvador Trenche, head of the Spanish Society for Family and Community Medicine, who has led the call for a new endemic response.
COVID-19 "should be treated like the rest of diseases," Trenche told The Associated Press, adding that "normalized attention" from healthcare professionals would help reduce delays in treating non-coronavirus-related problems.
The public also needs to come to terms with the idea that some deaths from COVID-19 "will be inevitable," Tranche said.
"We can not do on the sixth wave what we did on the first: the model must change if we want to achieve different results," he said.
The Spanish Ministry of Health said it was too early to share any drawings prepared by its experts and advisers, but the agency confirmed that one proposal is to follow an existing model of "on-call monitoring" currently used in the EU to monitor flu.
The strategy has been nicknamed "influenza-icing" by COVID-19 by Spanish media, although officials say influenza systems need to be significantly adapted to coronavirus.
For now, the discussion of going for an endemic approach is limited to affluent nations that can afford to talk about the worst of the pandemic of that time. Their access to vaccines and robust public health systems is the envy of developing countries.
It is also not clear how an endemic strategy would coexist with the "zero-covid" approach adopted by China and other Asian countries and how it would affect international travel.
Many countries overwhelmed by the record number of omicron cases are already giving up on massive tests and cutting quarantine times, especially for workers who show no more than cold-like symptoms. Since the beginning of the year, teaching in Spanish schools only stops if major outbreaks occur, not with the first reported case as they used to.
In Portugal, with one of the world's highest vaccination rates, President Marcelo Rebelo de Sousa declared in a New Year's speech that the country was "moving into an endemic phase." But the debate over specific measures disappeared as the spread quickly accelerated to record levels - nearly 44,000 new cases in 24 hours reported Tuesday.
However, hospitalizations and deaths in the vaccinated world are relatively much lower than in previous increases.
In the United Kingdom, wearing masks in public places and COVID-19 passports will be dropped on January 26, Prime Minister Boris Johnson announced on Wednesday said the latest wave had "peaked nationally".
The requirement that infected people be isolated for five full days remains in place, but Johnson said he will seek to scrap it in the coming weeks if virus data continues to improve. Official statistics estimate at 95% the proportion of the UK population that has developed antibodies to COVID-19 either from infection or vaccination.
"As COVID becomes endemic, we will need to replace legal requirements with advice and guidance and encourage people with the virus to be careful and considerate of others," Johnson said.
For some other European governments, the idea of normalizing COVID-19 is at odds with their efforts to increase vaccination among reluctant groups.
In Germany, where less than 73% of the population has received two doses, and the infection rate breaks new records almost daily, comparisons with Spain or any other country are rejected.
"We still have too many unvaccinated people, especially among our senior citizens," Health Department spokesman Andreas Deffner said Monday.
Italy extends its vaccination mandate to all citizens aged 50 or over and imposes fines of up to € 1,500 on unvaccinated people who show up for work. Italians must also be fully vaccinated to access public transport, planes, gyms, hotels and trade fairs.
Associated Press writers Maria Cheng, Danica Kirka and Sylvia Hui in London, Raf Casert in Brussels, Colleen Barry in Milan, Italy and Geir Moulson in Berlin, contributed to this report.
Follow AP's pandemic coverage at https://apnews.com/hub/coronavirus-pandemic