The pandemic was first confirmed to have spread to the region on 25 February 2020 with the positive result of a 24-year-old male who had been in Italy. By the time the pandemic started the region had 540 available ICUs and roughly 14,000 hospital beds. On 9 March 2020, the Government of the Community of Madrid approved extraordinary measures, including the cancellation of all in-person classes in the Autonomous community of Madrid at all educational levels for an initial period of 15 days, until 26 March, encouraging online lessons instead if possible. On 13 March 2020 the Government of the Community of Madrid decreed the shutting down of bars, restaurants and "non-alimentary" shops. On 14 March the country-wide state of alarm for an initial period of 15 days was declared in accordance with Article 116.2 of the Spanish constitution. On 12 March, the hiring of Antonio Burgueño as advisor was announced by the regional administration. Burgueño had previously served as Director-General for Hospitals under Manuel Lamela, Juan José Güemes and Javier Fernández-Lasquetty, and had left office after Justice blocked the latter's attempt to further privatize the health system. During the height of the crisis the regional administration conducted a triage, denying the transfer to the public hospital network of old people in dire conditions from the nursing homes, yet it allowed the transfer of ill-people in possession of a private health insurance, despite the regional health minister had assumed command over the private health care system on March 12. On 19 March the regional minister for Social Policies,, addressed a petition to the Government of Spain, asking for the intervention of the Military Emergencies Unit in the nursing homes. He was immediately disauthorized by Isabel Díaz Ayuso. Reyero was removed from the political management of the nursing homes on 26 March. Then, the regional government entrusted to Encarnación Burgueño—the daughter of Antonio Burgueño and owner of Cardio Líder —the managing of the nursing home's crisis, enforcing the so-called "Operación Bicho" from 26 March onwards, attempting to provide care to the nearly 50,000 old folks in the nursing homes. 12 days later, on 6 April, the Operación Bicho was abruptly aborted. More than 3,000 old people had died during that period. All was fine for Burgueño by 4 April, as she reportedly wrote to a close collaborator "we already have inspected 8,700 grandpas". Do you know what that means? The work you have performed? Just in a week?... No way! If we keep doing this, we are becoming kings and masters of the social-health management in Madrid autonomous community. You are going to realize my dream, working in the social-health sector. Having my own company." On 31 March 2020, two weeksafter the death of 19 elderly people in a care home Monte Hermoso became public, the regional administration decided to intervene 8 private retirement homes, overwhelmed by the deadly advance of the pandemic, sometimes hidden by the companies operating the old folks' homes. The regional legislature, the Assembly of Madrid, was kept closed for more than a month, until sessions were resumed on 14 April. The government coalition between PP and Ciudadanos showed discrepancies on the handling of the management of the retirement homes. From 8 March to 14 April, almost 5,000 older people died in nursing homes in the region. On 7 May 2020, the director-general of public health resigned, apparently in protest at the regional government's decision to request a loosening of the lockdown restrictions. On 1 June 2020, , regional minister responsible for nursing homes at the height of the health crisis, declared he had asked for three times the regional ministry of Health to allow the transfer of old people to hospitals, to no success.
