CORONAVIRUS

Spain reports 9,200 coronavirus deaths in November, the highest monthly figure since April

Several regions, such as Andalusia, Asturias and Aragón, have reported more fatalities in the second wave of the pandemic than the first

Two workers remove the body of a coronavirus victim from a seniors residence in Barcelona.
Two workers remove the body of a coronavirus victim from a seniors residence in Barcelona.Emilio Morenatti / AP

The second wave of the coronavirus pandemic left a dramatic mark in the month of November. The Spanish Health Ministry has notified close to 9,200 Covid-related deaths in the country over the course of the last calendar month, making it the second-worst on record since April. The figure includes the victims that the ministry has reported between October 30, the last day of that month when the number of victims was reported, and yesterday, the last day of November. It is likely, however, that once the data for recent weeks is refined, the figure will be even higher.

Delays in notifications and the poor quality and updating of the Health Ministry’s data continues to make an analysis of the health crisis in Spain difficult. Even if the Health Ministry’s revised data is used, the number of coronavirus fatalities in November is still 6,279. The difference is due to the fact that the ministry only includes victims notified in November where the actual date of death took place in the same time frame. The regions, meanwhile, have not only notified deaths from the previous month in that period, but have also done this in past months too, which is what explains the difference between the figures.

As such, the 9,200 Covid-19 victims that were included in November’s reports actually contain 2,800 deaths that took place during a different month. The same will happen in December, with deaths reported that actually correspond to November. Even using the 6,279 figure for November, the month continues to be the worst since April, which saw 15,672 victims once the data had been revised by the ministry.

A health worker carries out a PCR test in the Spanish municipality of Rubí.
A health worker carries out a PCR test in the Spanish municipality of Rubí.Cristóbal Castro

According to Monday’s report, which covers Friday, Saturday and Sunday, new infections continue to fall. A total of 19,979 were reported by the ministry yesterday, the lowest weekend figure since August 24. In total, 1,648,187 cases have been confirmed in Spain since the start of the pandemic.

The 14-day cumulative number of coronavirus cases per 100,000 inhabitants also continues to fall, and is now under 300, having come in at 275.51 in Monday’s report. The improvement in this data point should translate into a fall in fatalities in six or eight weeks, according to one expert.

Pressure on Spain’s hospitals is also improving. The occupation rate of beds by Covid-19 patients is at 11.85%, compared to 15.51% a month ago. The occupation of intensive care unit (ICU) beds is also going down, to 26.47% – practically the same as on October 30, when the figure was 26.59%. At one point, the percentage exceeded 32%.

Most-affected regions

The data that is available so far for this second wave shows that the pandemic is affecting Spain’s regions differently. Andalusia, Asturias, Murcia and Aragón, as well as the North African cities of Ceuta and Melilla, reported more victims last month than at any other time during the pandemic – and this is despite the fact that the data is provisional and will likely end up being much higher. In Asturias, for example, at least 54% of the region’s total Covid victims were registered last month – that’s to say, more people died in November than between March and October. For Andalusia, that percentage is 48%.

These two regions did not suffer that many infections nor victims during the first wave. “It’s logical for the regions that were less affected in the first wave to be more so in the second, because sections of the population that were not exposed to the coronavirus then are being affected now,” explains epidemiologist Patricia Guillem, from the Universidad Europea de Valencia. “In several of these regions there has been a very rapid outburst,” adds Guadalupe Fontán, a specialist in health management from the Spanish General Council of Nursing, attributing the outbreaks to young people who ignored restrictions on socializing. “They took the virus to their family units and now we can see that it is reaching seniors.”

Of the regions where the situation has worsened, Asturias and Aragón are the areas that have the worst rate of victims per 100,000 inhabitants in November, with 52 and 47, respectively, where the average in Spain is just under 14. Andalusia is also at 14 while Murcia is at 16. The best area for this data point is the Canary Islands.

The official coronavirus death toll according to the Health Ministry now stands at 45,069. Thanks to the measures that are currently in place across the country – including nighttime curfews, and restrictions on social meetings – most of the data for Spain has been improving since the second week of November. Except, that is, for the number of deaths. The total reported over the last seven days, 1,938, exceeds that of November 2, which came in at 1,220.

It’s logical for the regions that were less affected in the first wave to be more so in the second, because sections of the population that were not exposed to the coronavirus then are being affected now
Epidemiologist Patricia Guillem

The regions that are being affected by this worsening death toll have different approaches to evaluating the situation. The director of the Asturian health system, Concepción Saavedra, admits that while the first wave did not have a huge effect in her region, “from the week of October 30,” the second wave saw a rise in cases “that surprised us because it was all so fast.” Hospitalizations, she explains, went up by 77% and the occupation of ICU beds doubled. “That is why we asked for a full lockdown on November 3,” she adds.

Saavedra considers the reasons for this rapid rise to be due to “the excellent behavior [of citizens] during the first wave,” which meant that “only 2% of the population had immunity, according to seroprevalence studies,” meaning that many more people were affected in the second wave. “First it was the under-29s, but once the over-65s began to get infected we started to see hospitals and ICUs occupied.”

Now the pressure on Asturias’s healthcare system is beginning to ease, but it will take time for this to be notable given that Covid hospital stays and ICU treatments tend to be long. “That said we have tripled the number of ICU beds [from 96 to 258] and there are another 200 beds ready,” she says, should the situation after Christmas get worse.

“In Aragón, we have had a period of excess mortality above the expected several weeks after each spike, and now we are in that period,” explains a spokesperson from the regional healthcare system. “From November 16 to 24 there were 697 more deaths than expected, a rise of 60% [...].” According to the MoMo, the spokesperson continues, in reference to the excess mortality system run by the Carlos III Health Institute, the trend in Aragón is above the historical average for the last 10 years, “meaning that there is an excess mortality above expected deaths” in the region. “With respect to the first period of mortality,” the spokesperson adds, “the fundamental difference is that in the spring, 83% of the mortality took place in residences, a percentage that has fallen to at least half in the two following periods.”

The 14-day cumulative number of cases per 100,000 inhabitants continues to fall and now stands at 275.51

The general director for Public Health in the Murcia region, José Carlos Vicent, admits that this second wave “has taken its course with greater intensity than the first,” but he underlines that the figures are starting to improve, and called on everyone to continue “following all of the protection rules,” in particular the use of masks at all times, also on bars and sidewalk cafés, only taking them off to eat or drink, Virginia Vadillo reports.

According to José Martínez Olmos, a professor from the Andalusian School of Public Health, “the virus has had a huge impact in the region due to the behavior of the public and because the regional government has not adopted the measures that have been called for: strengthening the primary healthcare system, having at least one track-and-tracer for every 5,000 inhabitants, mass testing and alternative accommodation in hotels for positive cases in special circumstances.”

This expert underlines the fact that November has been a “terrible month” in Granada and Seville, cities with high numbers of tourists and students, and which saw a spike in cases due to a recent public holiday, on October 12, Javier Martín-Arroyo reports. “We have gone too fast, and if we relax the restrictions now we run the risk of the third wave,” Martínez Olmos explains.

English version by Simon Hunter.

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