September 19, 2020

This is how the worst mortality crisis since the beginning of democracy evolves



Mortality data updated as of August 31, 2020

Never in Spain have more than 12,000 people died in a week … until now. At the peak of mortality of the coronavirus epidemic – between March 23 and April 12 – more than 18,000 people died from all causes in Spain a week for 21 consecutive days. The number of deaths registered is the highest in 45 years of democratic history.

These figures include the 12,000 registered deaths suddenly on May 27 due to the delay in the registration of civil registries, mainly in Catalonia and Madrid.

In 2017, one of the worst flu outbreaks on record, there were no more than 11,500 deaths in one week. The peak of the 2003 heat wave stood at 9,000 deaths in a seven-day period. Figures that show the impact of an unprecedented epidemic in Spain that has collapsed hospitals, funeral homes and civil registers.

This is the result of eldiario.es analysis of the individual microdata of the more than 15 million deaths registered in Spain -from 1975 to 2018- in the death statistics of the National Institute of Statistics (INE) and the daily surveillance figures -2019 and 2020- of the Mortality Monitoring System (MoMo), of the Carlos III Health Institute (ISCIII). See methodology.

The worst mortality crisis in Spain since official records exist

Deaths in each week of every year from 1975 to the present. In black, the average from 2000 to 2019. The 2019 data and 2020 are underestimated as they only include 93% of the population with computerized records and may present delays in notifications


It must be taken into account that the mortality figures during the epidemic are underestimated with respect to the definitive statistics of deaths because they only include computerized civil registries – 93% of the population – and there may be delays in the notification of deaths. On May 27, 12,000 new deaths were registered suddenly (mainly in Catalonia and Madrid) between March 11 and April 30.

Even with that, the death figures already reflect the highest mortality spike in recent history even adjusting the data by population.

Estimates from the Mortality Monitoring System (MoMo) based on the average of previous years indicate that this year the usual thing would have been for 68,000 people to die between March and April. According to the latest available data, civil registries have reported more than 111,000 deaths from all causes during those two months. 43,000 deaths above the historical average.

How does the coronavirus epidemic compare to other spikes in mortality during the first four months of the year? We look at it by comparing 2020 to the daily deaths from the worst flu outbreaks of the past two decades: 2005, 2012, and 2017.

The COVID-19 Crisis Compared to Worst Flu Seasons

Number of daily deaths in each day of the first four months of 2005, 2012, 2017 and 2020

The most affected communities

The differences in the impact of mortality from the coronavirus crisis are palpable between autonomous communities. Madrid, Castilla y León and Castilla-La Mancha, Catalonia, the Basque Country and Navarra are the regions most affected by the increase in deaths during the epidemic. In the case of Catalonia, it also includes more than 7,000 new deaths registered at once on May 27 due to the collapse of civil registries.

They are also the areas in which the virus has acted with the greatest virulence, according to data published by the Ministry of Health. The peaks are clear: in the Community of Madrid, deaths in the deadliest week of the epidemic quadrupled compared to the average of the last 20 years.

A figure that contrasts with the communities in which the virus has entered with less force. In the Canary Islands, the Balearic Islands or Murcia, the mortality figures during the epidemic have been at similar levels or even below the flu outbreaks of the last decade.

It must be borne in mind that in some territories, such as Aragon, Cantabria, Castilla y León or La Rioja, the death figures are more underestimated than in the rest of the regions because they have fewer computerized records, so the peaks may still be greater. In 2018, for example, the MoMo only registered 77% of the deaths that were registered in the provinces of Castilla-La Mancha compared to 99% in the Basque Country.

The following graph shows the comparison of the number of weekly deaths in each community with the deaths registered in the last 20 years.

The mortality of the coronavirus crisis in each autonomous community

Each point represents the deaths in each week of every year from 2000 to the present. In black, the average from 2000 to 2019. The 2019 data and 2020 are underestimated since they only include 93% of the population (in some regions less%) with computerized records and may present delays in notifications

Source: INE, MoMo (ISCII)

If you want to compare the detailed mortality data from 1975 to the present in each autonomous community, click here.

The collapse of hospitals, funeral homes and civil registries is part of an unprecedented situation in the history of Spain. The 20 days with the highest number of deaths since the beginning of democracy are all between the end of March and the beginning of April of this year, according to the deaths registered in the MoMo system.

To date, the day with the highest number of deaths had been January 13, 2017 – flu outbreak – with 1,759 deaths. On March 31 of this year, almost 3,000 people died in a single day.

The peak of deaths, among older people

By age, the biggest difference between the expected deaths according to the MoMo and those officially registered is among the oldest people. The excess of deaths among the deceased with more than 74 years is already 63% over what was expected until April 28. Between 65 and 74 years, 46%.

Unexpected mortality soars among older people

Deaths in every day of 2020 in comparison with the average of previous years in each age group. Underestimated data: only includes 93% of the population with computerized records and may present delays in notifications

Less than 65 years

65 to 74 years

More than 74 years

Source: INE, MoMo (ISCII)

Are there unaccounted deaths from the virus?

MoMo data show an excess of 44,000 deaths between March 13 and May 22 compared to the average for the last decade in the same period of the year. A figure that indicates that there are more deaths than those officially registered by the Ministry of Health: 28,330 until June 25.

Officially counted deaths only include people who have tested positive on a diagnostic test. As some autonomous communities point out, they are a part of the total since it does not include those who die without being tested in residences or private homes.

However, many experts ask for time to know what part of the excess mortality is attributable to the virus. For example, the Government identifies as dead from COVID-19 people who have had the virus regardless of the cause of death.

“If a person had pancreatic cancer with a few months of life expectancy, but COVID-19 has precipitated his death, what is the cause of death? Surely the cancer, even if the infection has advanced it”, explained to eldiario.es Ildefonso Hernández, spokesperson for the Spanish Society of Public Health (SESPAS).

In addition, the excess deaths recorded by the MoMo may also be some that are not directly attributable to COVID-19. For example, indirect deaths may have increased during the saturation of the health system and other accidental deaths may have decreased during the exceptional confinement situation.

Mortality in each CCAA since 1975

To compare in more detail how the COVID-19 crisis is affecting each autonomous community, we show the evolution of weekly deaths in each region from 1975 to the present.

The figures show the total number of deaths in each week of the year registered in each autonomous community, according to the figures of the historical death statistics up to 2018 and the MoMo project for 2019 and 2020. Select a community and explore the data.

Select your CCAA: mortality during the COVID-19 crisis vs every year since 1975

Deaths in each week of every year from 1975 to the present. In black, the average from 2000 to 2019. The 2019 data and 2020 are underestimated as they only include 93% of the population with computerized records and may present delays in notifications

Select a CCAA:

Methodology

For this information, the individual microdata of all deaths registered in Spain between 1975 and 2018 from the National Institute of Statistics (INE) have been analyzed. For each death, the day of death and the death registration community have been identified.

1,298 deaths located on non-existent days (November 31 or February 30) between 1975 and 1983 have been identified. These deaths have been included among those on the last day of those months.

The statistics of deaths registered in Spain from July 2019 to the present come from the mortality monitoring system (MoMo), which has published historical data for the last two years. This tool is used to warn of excess deaths from heat waves or flu epidemics.

These figures are underestimated since the system is fed by deaths registered in the computerized civil registries (94% of final deaths) and may present delays in notifications.

Communities with fewer computerized vital records can detect far fewer than actually occurred. These are the cases of Aragon (it detected 80% of the deaths finally registered in 2018), Cantabria (78%), Castilla y León (77%), Comunidad de Madrid (87%) and La Rioja (77%).

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