The number of coronavirus deaths being recorded in Spain is finally starting to let up, and some regions are now seeing days go by without a single Covid-19 fatality. According to data from the National Epidemiological Monitoring Network, from April 19 to 25 – the last week with the most consolidated data – eight regions reported fewer than 10 deaths each. Of these, Murcia, the Balearic Islands, Cantabria and La Rioja reported fewer than one fatality a day.
While delays to reporting from the regions could still alter this data, the figures for the following week confirm the trend, and according to Wednesday’s provisional figures from the Health Ministry covering the previous seven days, the improvement in the fatality rate has been consolidated: the vaccination campaign and the fall in transmission due to social restrictions have brought the number of victims down.
Since the end of January, the effect of the vaccines and measures such as curfews and limits on socializing marked a turning point in terms of the constant trickle of Covid-19 deaths in Spain. With the more vulnerable sections of the population better protected – 90% of the over-60s have been administered at least one dose of the vaccine – the progress of the curves for infections, hospitalizations and deaths that was observed last year has changed.
“What we saw a few weeks ago was that the curve of fatalities did not rise during the fourth wave,” explains physicist Clara Prats, an expert in computational models of infectious diseases at the Catalan Polytechnic University. “It should have risen after the increase in infections, but this did not happen.”
Since the end of January, hospitalizations of Covid-19 patients also fell 77%, although the reduction is not so pronounced in intensive care units (ICUs) because the patients who currently require such treatment are younger and require longer stays, the experts explain.
A spokesperson from the Carlos III Health Institute explains that at least 18 days will be needed to consolidate the official statistics, in order to avoid the effects of delays in reporting Covid-19 victims. This means that the latest robust data is for the week of April 19, when there were 452 fatalities after a positive test. That week the highest absolute numbers of deaths – as has been the case throughout the pandemic – were recorded in Madrid, Andalusia, the Basque Country and Catalonia, which are among the regions with the highest population levels.
In relative terms, and excluding the North African cities of Ceuta and Melilla, the highest fatality rates per 100,000 people were seen in the Basque Country (with 2.94), Navarre (1.99) and Madrid (1.68). On the other end of the scale, Asturias, Galicia, the Canary Islands, Extremadura, Murcia, the Balearic Islands, Cantabria and La Rioja reported less than 10 deaths each over those seven days.
If we protect those who are at greater risk of dying, it is logical that the number of deaths will fallRafael Ortí Lucas, president of the SEMPSPH public health society
Since then, albeit with the risk that the numbers may oscillate slightly in the coming days, the trend has continued. “There are more and more places that will have more days without deaths,” explains Alberto Infante, emeritus professor of International Health at the National Healthcare School. “There will be deaths, but they will be more spread out. It will be more difficult to see this in Madrid, Catalonia and Andalusia, which have population levels similar to Sweden. Until the end of the summer, it will be difficult to see a significant fall in deaths, but once the vaccination campaign accelerates with the Janssen medication [which only requires a single shot] the deaths could fall sharply.”
The experts agree that the variables that will influence the fall in deaths are very diverse. To begin with, the level of community transmission and the cumulative incidence – the greater the incidence, the higher the infections and as a result more hospitalizations and deaths. “When the transmission is the same, other variables come into play, such as the demographic structure of the population,” Infante explains. “Also all of the elements that favor the aggregation of people, such as the mere population density: with the same transmission and demographic structure [older people are more vulnerable], there will be a greater probability of contagions in the metropolitan areas of Madrid and Barcelona than there will be in depopulated areas of Spain. It’s all a summation. There is no variable that operates alone: it’s a sum of probabilities.”
In the short term, the epidemiologists insist, the trickle of deaths will continue. “There are cases of older people who, despite being vaccinated, could die,” explains Rafael Ortí Lucas, the president of the SEMPSPH public health society. “The vaccines are not 100% effective. At most, they work at 95%, and in areas such as Madrid and the Basque Country, with a higher incidence [267 and 333 cases, respectively, per 100,000 inhabitants over 14 days], these vulnerable people have a higher chance of coming up against that 5% probability.”
The epidemiologist adds that people who are in risk groups and haven’t been vaccinated, as well as those receiving dialysis or chemotherapy treatments, are also at greater risk. “The key factor is vaccination,” he continues. “If we protect those who are at greater risk of dying, it is logical that the number of deaths will fall. We will enter a scenario where there are selective deaths, of people with existing problems or specific risk factors.”
In terms of the fatality rate, Ortí Lucas explains that “while there is a high incidence, we know that 1% [of people infected] are going to die. The work that has been done to ensure there are fewer than 50 cases per 100,000 inhabitants via unpopular measures, as was the case in the Valencia region, has led to there being seven or eight days there without admissions or deaths in my hospital,” he continues, in reference to his place of work, the Clínico de Valencia. The region currently has the lowest incidence in Spain, only behind the city of Ceuta: 32 cases per 100,000 inhabitants, when the average is 166. Infante insists that people should not let their guards down, despite the state of alarm having come to an end and the good pace of the vaccination drive. “We are doing well,” he says. “What we have to do now is not spoil it. We have to be cautious.”
English version by Simon Hunter.