Spain has only added 7,100 official deaths from coronavirus sinceJuly, which means 15 deaths per 100,000 inhabitants . This rate places it as the third country with the worst data in Europe.
Germany registers 10 times fewer deaths and Italy just a third. Portugal (8), France (9) and Belgium (12) are the closest European countries. In addition, Spain has reported 150 deaths a day from covid-19 this week, which makes this disease the main cause of death.
The only two countries that surpass Spain in the death rate from coronavirus are Romania and the Czech Republic – which imposed more or less rigid measures depending on the cities, for example, in the hardest hit, such as Prague, there was home confinement – but they suffered less from the first wave with relatively low death toll from March to June.
With the death figures, it is necessary to be cautious, because the information that Spain transmits to the European institutions comes from the information systems of the Ministry of Health, which has had constant problems of delay and under-reporting . For example, their count of deceased is 30% lower than that published by the autonomous communities.
Even so, Spain this week has exceeded the average of 150 daily deaths, official and confirmed with diagnostic tests. It is the same daily average number of deaths that caused all respiratory system illnesses in 2019, and 10 times more than traffic accidents in 1996, which was one of the worst years in the historical series.
The second wave has not hit all of Europe at the same time. In Spain it was earlier. In France or Italy the cases skyrocketed two or three weeks ago. The normal thing is that the death toll continues to rise – it usually takes a few weeks from when cases rebound until hospital admissions and then deaths do.
Both countries are trying to avoid it, with a rigid confinement, the first; and with the closure of leisure venues at six in the afternoon, the second. The following graph shows this evolution, through the curves of 16 countries (in red) and the European average
The curve for Spain follows a somewhat different pattern from most countries. In August, cases grew faster than in any other territory and in early September Madrid had the highest incidence on the continent. But then there was a decline in the capital and a plateau on a national scale, just as the virus advanced in France or Belgium.
There has been speculation about the effect of the first restrictions and also fear: perhaps the bad data for August caused the Spanish to be more cautious in September. But the weather can also play a role: if cold and increased indoor living are behind the rebound in Europe, it’s no surprise that warm Spanish weather has delayed those effects.
The situation now is that since October both the cases and the admissions and deaths. They have picked up again very quickly in Spain : positives and hospital arrivals have practically doubled.
The lethality of the virus
The table above also collects the most basic fatality data. This is called gross CFR lethality ( case fatality ratio)., that is, ratio of cases per deceased) and represents the number of deaths for each confirmed case. This figure is around 0.8% taking the numbers from July.
In other words, for every 100 known cases, almost one person has died. Spain’s fatality is slightly worse than average. There are worse countries, such as Romania, Bulgaria or Hungary, where many cases are likely to remain undetected.
But contrary to what the spokesman for the Center for Health Alerts and Emergencies (CCAES), Fernando Simón, has repeated, we are not at the level of Germany, where only 0.4% of known cases have died in these months. These figures are an approximation: the CFR lethality will increase, because some of the recent infections have not yet had time to cause the death of the sick.
It is also important to distinguish between lethality by confirmed cases (CFR) and by infected (IFR). The second is the most interesting: what percentage of infected people end up dying? Knowing this figure requires knowing how many infections there are undetected, because they are asymptomatic or people who do not go to the doctor.
Big differences by communities
The mortality differences since the summer are also important between autonomous communities. Aragon had an early second wave, with outbreaks beginning in July among farm workers.
The incidence stopped growing afterwards, but it has never really decreased and the deaths have been happening for months. It has the worst mortality since July: 54 deaths per 100,000 inhabitants. It almost doubles the figures in Castilla y León (32), Madrid (30), La Rioja (29), Navarra (26) or the Basque Country (23). At the opposite extreme are the Canary Islands, Cantabria or the Valencian Community, where deaths are four or five times less.
Finally, it must be remembered that the official figures of confirmed deaths from coronavirus only reflect part of the impact of the pandemic. First, because of the notification problems already mentioned. The most extreme case is Catalonia: it has informed the ministry of 306 deaths from covid confirmed by PCR since July, that is, only 20% of the 1,400 that it counts as “suspected of covid”, a figure that is surely more accurate because it places its lethality in line with the rest of European regions.
The other key piece of information is the number of deaths according to civil registries, which is known as the excess of deaths. During the second wave, these registries – according to the INE – have observed 13,000 more deaths than last year and previous years.
That figure includes deaths from covid that the official statistics have ignored, but also the probable increase in deaths from other pathologies, of people who have not been diagnosed in these months of crisis or who have received worse treatment. They are also anomalous deaths, which cannot be attributed to the covid-19 disease, but to the health crisis that the virus has caused.