Virus on retreat in Spain despite flare-ups, says health chief

The doctor spearheading Spain’s fight against coronavirus has said recent regional outbreaks — particularly in Catalonia — are worrying but that in most of the country the infection rate is going down.

Fernando Simón, the chief epidemiologist leading the government’s battle against Covid-19, told the Financial Times that there were indications of community transmission in Lleida, the capital city of the Catalan county of Segrià, which has been subject to a partial lockdown since the weekend. Community transmission occurs when cases are so widespread it is not possible to identify the source of infections.

Local authorities also imposed a partial lockdown in the Galician area of A Mariña on Sunday, and late last month reimposed restrictions in several counties in the province of Huesca in Aragón.

“The one that is worrying us more right now is the one in Catalonia,” Dr Simón said in an interview, referring to the largest current upsurge. “Always when we have increasing cases, we have to worry and to check there are no outbreaks or transmission that are not identified and caught.”

The number of new cases was now falling in all three areas, he said, but suggested that the trend was not yet definitive in Segrià: “We think the control measures implemented are good but we still have to follow it for a few days longer . . . to identify if the impact has been effective or not.”

However, in most of the country the virus remained in retreat, Dr Simón said. “We are not going up in general in Spain, we are going up in these specific areas. Outside these areas, the number of cases is still going down,” he said.

Spain was one of the worst hit countries when the pandemic peaked in Europe in March and April. Infections and deaths fell sharply under the country’s lockdown, which was phased out by June 21, but a number of outbreaks have flared up since.

Dr Simón — and more generally the government’s response to the crisis — are the subjects of much debate in Spain, a politically polarised country where controversy has raged over whether the initial response to the virus was fast or decisive enough.

Asked about Spain’s caseload figures, he said the true death toll might not be known until the autumn, noting that some death certificates may have been filled out inadequately at the peak of the pandemic.

He resisted the idea that Spain’s excess death total of around 43,000 — the number of deaths above the historical average — was a more accurate guide to the pandemic’s toll than the official coronavirus mortality count of 28,388. The country’s excess death rate remains one of the highest in the world, at just over 1,000 fatalities per 1m people, second only to Ecuador.

But Dr Simón said that all the excess deaths were related to the pandemic — although not all were directly caused by Covid-19 — since the crisis may have made people unwilling or unable to go to hospital for complaints such as heart attacks and strokes.

“Some excess deaths may be related to something else,” he said. “But all of them are related to the pandemic.”

Locator map of Spain showing: Cinca Medio, Bajo Cinca and La Litera; A Mariña county in Galicia; and Lleida

Since Spain’s general lockdown ended last month, there has been an increase of more than 80 per cent in one of Dr Simón’s preferred metrics — the number of diagnosed cases in which symptoms began in the previous 14 days. This reached 1,351 on Monday. However, the number of coronavirus cases is down from a peak of around 9,000 a day in late March. 

Dr Simón said Spain was now detecting a higher proportion of coronavirus infections than before — some 20 to 30 per cent of all cases compared with about 10 per cent at the peak of the pandemic in the spring.

He indicated that in the areas affected by the new outbreaks, the detection rate could be up to twice as high because of large-scale testing in response to the rise in cases. He added that a majority of the cases were asymptomatic, up from about 40 per cent of new cases several weeks ago to 60-70 per cent now.

Almost 20,000 people in a population of about 200,000 had been tested in the Segrià area, he said, with around 700 testing positive for the coronavirus.

Prof Fernando Rodríguez Artalejo, an expert in epidemiology at the Autonomous University of Madrid, said the recent upticks were predictable given the end of the nationwide lockdown.

 “The good news is at the moment they are being controlled well and quickly,” he said. “What would be very bad is if many outbreaks took place at once, the response could take time and it might be necessary to lock down many people for weeks.”