Spain records lowest daily coronavirus death toll in 17 days – but it could soon spike again

Madrid authorities say number of deaths in retirement homes alone could be five times higher than official figures. Graham Keeley reports

Mortuary employees transport a coffin of a Covid-19 victim at La Almudena cemetery in Madrid, Spain (Getty)

Spain has recorded its lowest number of daily coronavirus fatalities in 17 days, but there are fears the death toll could soon spike as the “thousands” of people who died outside of hospital are counted.

Grisly pictures of rows of coffins laid out in ice rinks or car parks used as makeshift morgues have been a stark reminder of the tragic cost of the coronavirus in Spain.

As the country has struggled to cope with the level of infections and hospitals became overwhelmed, thousands of people are believed to have died at home or in care centres.

Spain’s leftist coalition government has been at pains to cautiously suggest the peak of the epidemic may have been reached.

“The fire starts to come under control. This war against the virus will see a total victory,” Pedro Sanchez, the Spanish prime minister, told the country’s parliament.

The daily death toll from coronavirus fell on Friday to 605, the lowest figure since 24 March, the health ministry said. The rate of increase has dropped to 4 per cent, down from 20 per cent two weeks ago.

Total deaths stood at 15,843 – the second highest in the world after Italy. Total cases in Spain rose to 157,022.

But epidemiologists and doctors have said they believe it is likely that the genuine tally of fatalities is far higher.

Authorities in the Madrid region said the number of deaths in retirement homes alone could be five times as high as those announced by health officials.

Ignacio Aguado, the deputy regional president of Madrid, admitted that as many as 3,479 of the 4,750 elderly people who died in March in 710 old people’s homes showed symptoms of coronavirus – but were never counted as official victims.

Only 781 elderly people who were tested for the virus were included in the official death toll.

Madrid’s civil registries issued 9,007 burial licences between 14-31 March, according to figures released by the regional court in the Spanish capital.

However, official figures put the number of deaths due to the coronavirus at 3,439.

In Castilla-La Mancha, the dusty central Spanish region made famous by Miguel de Cervantes’ errant knight Don Quixote, some 3,998 people died after the outbreak started in March – triple the number in the same period in 2019.

Yet the regional health authority only recorded 774 deaths from Covid-19 by 1 April.

Like many other countries, Spain counts deaths only among those who took an official PCR (polymerase chain reaction) test for the illness.

Often these are only carried out in hospital, but many others who died in old people’s homes or at home never take this test.

On the front line, doctors acknowledge that the real picture of mortality is confused at best.

“I doubt the official figures. There may well be people who died from the virus who were not counted and others who were classed as dying from it but in reality the cause of death was something else,” Sara Alcantara, a doctor in an intensive care ward at the Hospital Puerta de Hierro in Madrid, told The Independent.

Dr Alcantara said patients might have died from another ailment like respiratory failure but also had the virus at the same time.

Spain’s justice ministry has now asked officials from the country’s 17 regions to send details off all burial licences granted between 14-31 March in order to attain an accurate picture of fatalities.

However, as most authorities are operating with a skeleton staff the information is unlikely to reach Madrid for months.

The controversy has sparked a political row as divisions over the handling of the crisis have grown after initial unity between parties of all sides.

Spain’s conservative People’s Party (PP) has demanded the government clarifies the real death toll from the virus.

I doubt the official figures. There may well be people who died from the virus who were not counted and others who were classed as dying from it but in reality the cause of death was something else

Sara Alcantara, a doctor at Hospital Puerta de Hierro 

“A nation should count the number of dead properly to say goodbye to them properly and to look after those who are alive,” Cayetana Alvarez de Toledo, the PP parliamentary spokesperson, said.

Salvador Illa, the health minister, defended Spain’s current method for counting coronavirus deaths.

“Spain has a clear definition, one of the strictest in Europe,” he told a news conference this week.

Understanding the real picture of number of deaths and infections will help Spain’s government to make a decision about strategy as it considers how and when to ease its tough lockdown restrictions.

Since 14 March Spain has been subject to a strict lockdown, which has been reinforced in the past two weeks by the cessation of all non-essential activities until the Easter weekend.

Rafael Bengoa, who worked for the World Health Organisation for 14 years and was a Basque health minister, said the death toll, number of infections and the economic impact of the crisis will be key factors in deciding government strategy.

“It will be some time before we know how many people really died from the epidemic,” he told The Independent.

“In the meantime, the government must base its decisions not only on the death toll but also on the economic damage of confinement and this effect. How many people will die from poverty will also be a consideration.”

Professor Bengoa feared a second wave of the virus was inevitable.

“Our ability to deal with this second wave will depend on leadership. This was crucial in dealing with the Spanish flu epidemic after the First World War. Some cities like St Louis in the US defeated it better than others.”