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Coronavirus in Spain: Monthly deaths in April fall to lowest point since last summer

With fewer than 3,000 Covid-19 fatalities recorded for the first time in six months, health experts are cautiously optimistic about the impact of the vaccination drive

Vaccination center in Seville.
Vaccination center in Seville.PACO PUENTES (EL PAÍS)

The Spanish Health Ministry recorded 2,757 Covid-19 deaths in April, the lowest monthly figure since last September. While the pandemic continues to take a heavy toll on the country, the rollout of Covid-19 vaccines is prompting optimism. As more than eight million doses were administered in April, the number of daily fatalities fell from around 200 in March to 90.

Although the exact number of daily deaths will not be known until the Carlos III Health Institute consolidates the data – a process that usually takes three weeks – the downward trend is clear. A similar number of daily fatalities has not been recorded either by the Health Ministry or the regions since last summer.

Regions that were hit hard by the third wave, such as Valencia, the Balearic Islands and Asturias, recorded half the number of deaths in April as in March. But in Navarre, Aragón and the Basque Country more fatalities were reported in April than the previous month. Despite this, the data shows a clear difference with the first months of 2020.

“The transmission of the virus continues to be elevated, but the majority of the most vulnerable groups are protected thanks to the vaccines,” says José Luis Alfonso, professor of preventive medicine and public health at Valencia University. “We can also see this in the fall in the hospitalizations of older age groups. They are no longer getting sick from the virus, or if they are it is a mild version. The vaccination drive has been a great step forward.”

While experts are optimistic about the situation, they insisted on the need for caution. The worst may have passed thanks to the immunization drive, but there are still many uncertainties, such as the new variants of the coronavirus.

“It makes me afraid just to say it, but I think we are a bit closer to the end,” says Elena Vanessa Martínez, president of the Spanish Epidemiology Society (SEE). “If this pandemic has shown us something it’s that each time we begin to think that something is safe, reality hits us in the face. But there is no doubt that we are on a good path. One of the things that we can be proud of and that also explains the current situation is that we were able to prevent Easter week from becoming another Christmas or summer [when increased social activity led to new waves of infections]. Measures were adjusted and this meant that the uptick was not greater nor did it turn into a new wave.”

Santiago Moreno, the head of the infectious disease department at Madrid’s Ramón y Cajal Hospital, says there “are enough reasons to think that we have left behind the worst of the pandemic.” “The vaccination and mortality data make us optimistic, but I also feel angry and helpless when I see that people continue to get infected and die. In my hospital, we have 100 hospitalizations and 30 patients in the intensive care unit from the virus,” he says.

Last summer, the 14-day cumulative number of cases per 100,000 inhabitants dropped as low as 10, and on some days not a single death was recorded. But experts explain that these levels were only reached thanks to the strict spring lockdown, when millions of Spaniards were confined to their homes. The coronavirus began to spread again over summer and Spain was hit with a second wave between October and November. Infections began to rise again in the lead-up to the Christmas holidays. And in January, Spain recorded more than 11,000 deaths, the second-highest monthly figure of all the pandemic, as confirmed by the data consolidated by the Carlos III Health Institute. It is important to note, however, that many people died in the first wave without being tested for the coronavirus, meaning they were not included in the official toll.

But experts do not think the pattern from last year will be repeated again. “The situation is not like it was then,” says Alfonso. “Now the vaccination drive is targeting increasingly younger age groups and research has already confirmed that the vaccines are safe for adolescents. This is going to significantly reduce the incidence rate now that we have managed to reduce the mortality rate.”

The Covid-19 vaccination campaign is racing ahead – nearly two million doses are administered every week, nearly twice the number of just one month ago. And the speed of the drive is expected to accelerate even more as more shots are delivered and new vaccines are incorporated.

But the end of the pandemic is far from over, say experts. There is still a long way to go before 70% of the population is vaccinated, which should begin to translate into herd immunity. At the current speed of the drive, this goal could be met by the end of summer.

“Until then, we still have a lot of work ahead of us,” explains Martínez. “It’s true that there is pandemic fatigue and some measures are becoming increasingly hard to apply, but if we want to have a more relaxed summer, one that is similar to those before the pandemic, we still have to lower the incidence rate a lot and cut off the thousands of chains of contagion that are still active.”

Alfonso also highlights the importance of vaccinating the global population. “Even if we do our job in our country, there is a very real risk that vaccines will not be effective against new variants,” he says. “That’s why mass vaccination is needed across the world. Every time the virus reproduces, there is the risk that a mutation will happen. The fewer opportunities we give it, the better.”

The experts also point out that there are still many questions that need to be resolved, such as how long vaccines provide immunity for, will booster shots be needed and will the coronavirus turn into a seasonal disease. “I think that there’s no reason why this would be the case,” says Santiago Moreno. “It’s true that there is the risk of new variants and the global population needs to be vaccinated as soon as possible, but if we can respond reasonably quickly to this challenge, I’m convinced that we can have the pandemic under control in a year-and-a-half. It doesn’t have to be a new flu that returns every winter.”

English version by Melissa Kitson.

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