Spain exits the ‘extreme risk’ coronavirus scenario, according to latest Health Ministry report

Infections are down, but experts warn that the improving figures could change at any time, particularly ahead of two upcoming holidays

A woman undergoes a coronavirus test in Burgos.
A woman undergoes a coronavirus test in Burgos.Santi Otero (EFE)

Spain has emerged from the coronavirus “extreme risk” scenario as measured by the Health Ministry. On Thursday, the 14-day cumulative incidence was 240 cases per 100,000 inhabitants, which puts the country in the “high risk” category as determined by a traffic light system approved on October 22.

This incidence rate is less than half of what it was a month ago, when it reached 521 cases per 100,000 on November 2. The highest figure was recorded on November 9, with 529 cases per 100,000.

During these holidays we could ruin the efforts of nearly two months
Fernando Simón, director of the Health Ministry’s Coordination Center for Health Alerts (CCAES)

Broken down by territories, the latest available data show that there are still five regions at extreme risk due to high incidence rates: Aragón, Asturias, Cantabria, the Basque Country and La Rioja. Another 10 are at high risk: Andalusia, the Balearic Islands, Castilla-La Mancha, Castilla y León, Catalonia, the Valencia region, Extremadura, Madrid, Murcia and Navarre. Two more, Galicia and the Canary Islands, are at low risk.

In terms of pressure on the healthcare system, 10 regions are at the extreme risk level due to high occupancy of intensive care beds by Covid-19 patients: Aragón, Asturias, Cantabria, Castilla-La Mancha, Castilla y León, Catalonia, the Valencia region, Madrid, the Basque Country and La Rioja.

Spain entered the second wave of the coronavirus earlier than other European countries, and is now posting lower incidence rates than many of its neighbors, including the United Kingdom, Belgium, Italy, Sweden and Portugal. The generalized drop in cases is starting to result in decreased hospitalizations.

According to the European Center for Disease Prevention and Control (ECDC), which also uses a traffic light system, the threshold for red zones is set at 150 notified cases per 100,000 people, which leaves Spain still within this category.

Unstable situation

Spain’s overall downward trend could change any day. On Thursday, health authorities reported 10,127 new cases and 254 deaths. Spain is still one of the European countries with the most excess deaths since July, and continues to notify twice as many Covid-19 deaths per capita as Germany.

The situation has been described as “unstable” by the epidemiologist Antoni Trilla. Experts fear that the holidays coming up on December 6 and 8 (observed only on Tuesday in some regions, and on Monday and Tuesday in others) will result in greater social contact and an uptick in infections, as was the case during the long weekend in October. The Madrid region is sealing its borders between December 4 and 13 to prevent widespread travel.

“During these holidays we could ruin the efforts of nearly two months,” warned Fernando Simón, director of the Health Ministry’s Coordination Center for Health Alerts (CCAES), at a news conference on Thursday. Simón seemed very skeptical about Spain’s chances of reaching Christmas with an incidence rate of just 25 cases per 100,000, which is the government’s goal.

On Wednesday, central and regional officials approved a set of guidelines for the Christmas holidays that includes special restrictions on mobility and social gatherings between December 23 and January 6 to prevent a new surge in infections.

Measuring risk

Coronavirus risk is measured by more than one variable, and health authorities use two sets of parameters to determine its value. The first set measures transmission by looking at six statistics that include incidence rates at seven and 14 days for different age groups, the proportion of diagnostic tests that come back positive, and the rate of traceable cases. The second set measures the healthcare system’s ability to cope with the pandemic, based on occupancy of regular and intensive care beds.

The threshold for extreme risk is set at an incidence rate of above 250 cases over 14 days or 125 over seven days (these go down to 150 and 75 for the 65-and-over age group), a test positivity rate of over 15%, and a traceability of under 10%, meaning that contacts can only be determined for 10 out of every 100 positive cases. As for the healthcare system, extreme risk is reached with 20% of regular beds and 25% of intensive care beds occupied by Covid-19 patients. When a territory has values above these limits in two or more parameters of the first set and one of the second set, it is considered to be in the extreme risk category.

With reporting by Daniele Grasso and Jessica Mouzo.

English version by Susana Urra.

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