COVID-19 and the structural vulnerabilities in the Spanish health and long-term care systems

The article analyses the impact of COVID-19 on health and long-term care systems, as well as institutional resilience by applying indicators of preparedness, agility and robustness. The study shows how the weakness of intergovernmental and cross-sectorial coordination instruments, and the particularities of the Spanish health and long-term care sectors, hindered the initial response to the challenges presented by the pandemic. However, after the first tragic wave of the disease, the intensification of cooperation mechanisms between health and social services authorities, as well as the free initiative of long-term care facility managers, corrected these initial errors and reversed the long-term care facilities’ extremely fragile situation.