Excess deaths in second wave: 11,000 victims since July

The number of unexpected fatalities calculated by the National Statistics Institute in Spain is double the official coronavirus death toll. The total is nearly 59,000 since March

A woman leaves flowers at the Poblenou cemetery in Barcelona.
A woman leaves flowers at the Poblenou cemetery in Barcelona.Albert Garcia

Statistics in Spain show 11,000 excess deaths during the second wave of the coronavirus, compared with the same period last year.

Since these are deaths from all causes, the difference between the observed and the expected death count since July, using data from the National Statistics Institute (INE) based on civil registry records, could be partly explained by the summer heat.

But the Carlos III public health institute, which runs a mortality monitoring system called MoMo, has only categorized 1,959 deaths as caused by heat this year, the same number as last year.

The 11,000 figure is twice the official coronavirus death toll notified by the Spanish Health Ministry, which has registered 5,400 Covid-19-related deaths since July. The graph shows the evolution of both figures.

There are different factors that could explain the difference. On the one hand, the ministry only counts victims who tested positive for coronavirus. But at this point in time, there should be few people dying without a test, in contrast with the situation in March, when only individuals with clear symptoms were getting checked for the virus.

It is also possible that the information released by the ministry is incomplete or not up to date. It is a known fact that the SiViES system used by regional authorities to send data to the Health Ministry shows half as many Covid-19 hospitalizations as the count made by the actual hospitals. A similar problem could explain the difference between the 5,400 deaths relayed by SiViES and the 11,000 excess deaths observed by civil registries across Spain compared with the same period last year. If the average of the last five years is used, the difference is 10,800 excess deaths.

A third possibility is that the excess death count includes deaths from other causes. This could be individuals whose illnesses went undiagnosed during the crisis months, or who received poorer medical treatment. Such cases would not be part of the official Covid-19 death tally, yet could be attributed to the overall health crisis caused by the virus.

Evolution since March

The graph shows the daily evolution of official coronavirus deaths according to the ministry’s count, and the excess deaths observed at civil registries compared with last year, based on INE data:

The most salient aspect of the graph is the first wave, which produced 47,000 excess deaths in the spring. There, too, it is clear that official figures were lagging behind. Civil registries counted thousands of deaths in March that were only later added to the official death toll. The INE’s data, published every two weeks since June, show that in May and June the ministry was still adding deaths that had occurred earlier according to registry death records.

The graph shows another peak in early August. This probably reflects an unspecified number of coronavirus deaths in combination with a heatwave, which is a typical cause of excess deaths. According to the Carlos III Institute, high temperatures may have caused up to 2,000 deaths during the course of two to three weeks around early August. That is the same figure as last year, although the 2019 peaks occurred in July.

Since early August, death records have continued to show more fatalities than in previous years, for a total of 11,000 more than last year. Together with excess deaths since March, the total comes out to nearly 59,000. The INE figures, therefore, suggest that the real death toll from coronavirus is close to 59,000, although the official death toll is around 33,000.

Regional differences

The impact of the second wave can also be broken down by regions. Aragón, Extremadura, Castilla y León, La Rioja, Andalusia, the Balearic Islands, Castilla-La Mancha and Murcia have all recorded excess deaths above 14% since July. The graph shows the excess deaths observed by civil registries compared with last year (expressed as absolute numbers, as percentages and per 100,000 inhabitants). It also includes the ministry’s official death toll.

Aragón has been showing the greatest excess deaths since the summer. An outbreak there was contained in July, but the fatalities have been accumulating. There are also significant excess deaths in other parts of Spain hard hit by the virus, such as Castilla y León and La Rioja – more so than in regions with a high incidence of the virus such as Madrid or Navarre.

Andalusia and the Valencia region show excess deaths of 15% and 13% during the summer months, even though their official death counts represent less than a quarter of the total. Part of that difference could be explained by the high temperatures, but probably not all.

All these figures were worse in March. For every three Madrileños who were expected to die in normal circumstances, there were five instead. This proportion was three deaths in Castilla-La Mancha for every two expected deaths, and seven deaths in Catalonia for every five expected.

These numbers confirm that the excess deaths recorded during the current crisis cannot be compared with anything else in the last few years. Heat was blamed for around 2,000 deaths in 2019 and around 800 in 2018. But none of those numbers are comparable to the 58,000 since March of this year.

English version by Susana Urra.