Second Wave Excess Deaths in Madrid higher than in Catalonia

BarcelonaIn the Community of Madrid, between 1 September and 12 November, 2,340 more people died than would have been expected, 335 of them in the first week of November. In a normal year there would have been 7,500 deaths, according to the Daily Mortality Monitoring System (MoMo). But in the middle of the second wave, a total of 9,840 have been recorded. MoMo is the source that allows us to see excess mortality, which comes from almost 4,000 civil registrations without discriminating the cause of death. Although it also suffers from delays in notification and daily changes and readjustments, it is the most authoritative source for knowing how many excess deaths there are in a region.

The system also shows an excess mortality in Catalonia. Between 1 September and 12 November, the National Centre for Epidemiology of the Carlos III Institute notes that there were 1,953 more deaths than expected. If it was estimated that there would be 11,689, there have finally been 13,642. In the first 12 days of November 520 excess expected have already been registered.

In October last year, in the pre-pandemic period, the MoMo overestimated the mortality rate in Catalonia: it calculated that there would be 5,072 deaths, but in reality there were 4,928, 144 less. In the case of Madrid, the margin of error was also very short, since it anticipated that there would be 3,269 and finally there were 3,356, 87 more. These data, which take into account the population of each community as well as the historical series of mortality, do not allow us to identify now which of these deaths are directly attributable to the coronavirus (by contagion) or if the covid aggravated previous pathologies and in fact were produced by another disease.

In fact, no government records allow this to be done and it is likely that the real impact of the virus, in terms of infections and deaths, will never be clarified. On Saturday, Catalonia passed 15,000 deaths attributable to covid during the entire pandemic, and Madrid has already has more than 18,000, according to the daily reports of their respective governments. Yet, according to the Ministry of Health - which centralises all the data that is then taken into consideration in Europe - there have been 7,382 covid deaths in Catalonia, half of those validated by the Generalitat. And in Madrid, 11,082, a third less than those reported by the regional executive. Therefore, before analysing the trend and establishing parallels or comparisons, data experts recommend having a very clear idea of what can be expected from each record.

Governments

Data from the funeral homes expand the picture

First it was Madrid and, twenty days later, Catalonia. Since then, the trickle of infections and hospitalisations has accelerated in both territories. So have the deaths. An upward trend that is borne out by government records. However, each administration is following its own criteria and, therefore, records cannot be compared.

Both Catalonia and Madrid report covid mortality data using death certificates from funeral homes and mortuary health. In other words, they include any dead person with a suspicion or positive diagnostic test for coronavirus, provided that this appears on their death certificate. Between 4 July and 12 November, the Government notified 2,500 deaths related to covid-19. Since October, when Salud announced the beginning of the second wave, 1,747 have been reported. This means that the second wave has caused some 233 deaths for every million inhabitants.

As for the Community of Madrid, 3,227 deaths have been reported by funeral homes, both suspected and confirmed, between 4 July and 12 November. Since mid-September, 80% of these deaths have been recorded, for a total of 2,610. This means that there are approximately 484 deaths per million inhabitants.

Ministry of Health

Only deaths confirmed with a test are considered valid

But according to data from the Ministry of Health, deaths in Catalonia and Madrid are half of what the regional governments say. This is not a mistake, nor is it a distortion: it is that their criteria are more restrictive. According to the World Health Organization (WHO), the Spanish government only includes in its register those hospital deaths that tested positive in a PCR test -now it also accepts antigen tests-. These data, despite being lower than those provided by the Autonomous Communities, allow for unifying criteria and homogenising the data of the 17 Communities.

The exclusion of deaths certified outside of health centres - and even those that in the first months only had the diagnosis of a clinician - does not appear. As an example, and according to the report published yesterday by the ministry, in Catalonia a total of 7,382 people have died because of covid. But according to data from the Catalan Health Department, the virus has caused 9,314 deaths in hospital and care centres. The same happens with Madrid. The ministry headed by Salvador Illa counts 11,082 deaths in Madrid's hospitals, while the government of Isabel Díaz Ayuso reports a total of 12,053 and adds 4,936 more in care centres.

On the other hand, and while Catalonia has not yet reached the peak of healthcare pressure, it seems that in Madrid admissions have fallen, reports Mariona Ferrer and Fornells. But the situation in the ICUs remains tense. Yesterday there were still 406 critical patients in hospital, almost the same as on 21 September - at that time there were 409 -, after the decision to confine 850,000 inhabitants by neighbourhood. In practice, this means that 91% of ICU beds that existed before the pandemic (444) are occupied by covid patients, when on 2 October this percentage reached 114%.