Saturday, September 25

The slow emptying of hospitals: only half of the beds that were filled in the fifth wave have been vacated

Deaths not. in the week

The contagions of the explosive fifth wave descend at great speed in Spain. Incidence figures are at very similar levels to those recorded in early July. A fall that is not repeated in the situation of hospitals, where emptying is being much slower. To date, only half of the beds that were filled during the fifth wave have been vacated. Care pressure increased by more than 8,000 patients, occupying places in hospital centers between July 1 and August 1. In the last month, that occupation has only fallen by 4,000 people.

This slowness in relieving care pressure did not occur in the previous autumn and winter waves. In the third wave, it took practically the same time (30 days) to go from 12,000 to 30,000 people admitted as it did to return again to the starting point. A symmetrical evolution that was also repeated in the second wave of October and November but that we have not seen in the curve of this latest rebound.

The change is closely linked to the current situation of the pandemic, where hardly any restrictions have been needed to lower the contagion curve, and also to the change in the profile of those admitted by COVID-19 in Spain thanks to the priority vaccination of the most greater. 54% of the patients hospitalized for COVID-19 between July and August were under the age of 60. Between October and February 2020, those under 60 accounted for just 30% of income.

With the consolidated data, the latest increase in transmission has left spikes in infections that were not seen since previous epidemic waves, but with a cushioned effect on income and death levels, far removed from the autumn and winter records. This gap indicates how the magnitude of the wave could have been if we had not had the vaccines against COVID-19.

To see the situation of the pandemic in Spain in more detail, the map above shows the main variables. First, the bed occupancy rate for COVID-19 patients in each province. Then, the general rate of cases per 100,000 inhabitants in the last two weeks and the trend of infections in each province, that is, if the cases are increasing 📈 or decreasing 📉. Finally, the total confirmed deaths in each province since the start of the pandemic are shown.

These data are published by the ISCIII (Instituto de Salud Carlos III) through the National Epidemiological Surveillance Network (RENAVE) and does so by date of diagnosis or, in its absence, the date of onset of symptoms or declaration. It must be taken into account that the data for the last week may be slightly underestimated due to the delays in notifications from the autonomous communities.

The data indicate that in the last two weeks cases are only increasing 🟦 in 2 provinces (in one of them at high speed 🟦🟦), they remain stable ⬜ or in a plateau phase in 2, and they are decreasing 🟩 in 48 (in 43 of them at high speed 🟩 🟩). We show the curves of new daily cases in each province grouped according to their situation: from more alarming ⚠️ to more positive ✅. How many provinces have many cases per inhabitant and are they continuing to rise? Which ones have flattened the contagion curve? And in which cases are there few but the virus is spreading very fast? To avoid detection peaks on a specific day, the average of both figures including the last seven days has also been calculated.

👉 It is important to bear in mind that the current infection figures are not comparable with the curve recorded at the beginning of the pandemic. The number of tests carried out now compared to those that were carried out in March has nothing to do with it, and neither does the strategy. Eight months ago, only the cases of those people who came to hospitals in the most serious condition were detected, that is, “the tip of the iceberg.” Now mild cases are tested and a percentage of asymptomatic or presymptomatic is detected, thanks to contact tracing. Hence, the incidence record in January cannot be compared to the peak incidence reached in the first wave, but it can be compared to that of the second.

Provinces at risk: high incidence of cases and continue to rise

Provinces with an incidence in 14 days of more than 100 cases per 100,000 inhabitants. Cases are going up with high incidents in Melilla and Lugo. For daily cases it shows
the average of the last 7 days.

Flatten the curve and reduce incidence

Provinces with an incidence in 14 days of more than 100 cases per 100,000 inhabitants where the cases they are going down or
are stabilized
. Extremadura, Teruel and Ceuta are in this situation. For daily cases it shows
the average of the last 7 days.

Lower incidence at high speed

Provinces with an incidence in 14 days of more than 100 cases per 100,000 inhabitants where the cases they are going down very fast. They are going down very fast in practically the entire territory. For daily cases it shows
the average of the last 7 days.

In good condition but bad trend

Provinces with low incidence: less than 100 confirmed cases per 100,000 inhabitants in the last 14 days. No province in this situation. For daily cases it shows
the average of the last 7 days.

No provinces in this group

Low incidence of the virus and cases do not rise

Provinces with low incidence: less than 100 confirmed cases per 100,000 inhabitants in the last 14 days. They register few cases and cases are stabilized or going down. Asturias is the only one in this group. For daily cases it shows
the average of the last 7 days.

The provinces that occupied the most hospitals in the 5th wave

Provinces that have been above the 10% bed occupancy by Covid-19 patients since July 1. It shows
the average number of people occupying hospital beds in the last 7 days..

Where they have recorded a spike in mortality

Provinces that have registered more than 5 deceased with Covid-19 per 100,000 inhabitants in the last 30 days. It shows
the average daily deaths of the last 7 days.

Source: Instituto Carlos III

Since the pandemic began, the evolution of the stages of the disease has followed the same pattern: the rise in infections is noted first in hospitals, then in ICU admissions and, finally, in the death toll. And vice versa: the last indicator where the fall in infections is noted is deaths. But after March, this sequence was cut. Deaths barely rose after the increase in infections. The pattern is repeating itself in this new wave, where the rise in positives has been less noticeable in hospital occupancy and in mortality figures.

The drop in deaths since the end of March overlaps with the advance in vaccination. The more elderly population vaccinated, the more the deceased have fallen throughout the country. Although a large part of the provinces have registered a clear upturn in deaths in the last month, they have done so in figures far removed from those of previous waves.

Palencia, Huesca, Zamora, Burgos, Ávila and Cáceres have been the ones with the highest mortality rates per inhabitant in the last 30 days. In Palencia and Huesca, 20 people have died for every 100,000 residents in the last month. In Burgos, Zamora, Cáceres and Ávila around 10.

It must be taken into account that the communities notify their deceased with a long delay compared to confirmed cases, as explained by Therefore, the data of the last weeks could be underestimated.

To have more information on each province, the following tab provides data on the most recent infections, deaths and hospitalizations in each of them, as well as the trend of these indicators in recent weeks.

Source: Instituto Carlos III (data updated to)

Hospitals empty at a slower rate

The reduction in infections is already noticeable in the incidence levels of a large part of the territory: a score of provinces are already below 200 cases per 100,000 inhabitants in 14 days. Cáceres leads the ranking, followed by Ceuta, Melilla and Lugo.

The high levels of infections had their effect on the pressure for care, which is now more relieved than at the beginning of August. However, the fall in the occupancy of beds with a Covid-19 clinic is decreasing at a slower rate. There are still 6 provinces with bed occupancy levels above 8% capacity. These are the cases of Bizkaia, Cáceres, Madrid, Toledo, Álava and Melilla.

The following table allows ordering the provinces according to different criteria: the number of cases and the incidence per 100,000 inhabitants in the last 14 days. The hospital occupancy levels and accumulated deaths in the last 30 days per 100,000 inhabitants are also shown.

Half of the provinces reduce their incidence by more than 70%

Lugo and Melilla are the exceptions to the general decline in infections in all provinces. Transmission continues to fall at high speed and more than half of the provinces have managed to reduce its incidence by 70% since the peak of infections registered at the end of July.

Barcelona, ​​Tarragona, Palencia, Burgos, Soria and Asturias stand out as the provinces where the new positives have reduced the most since the worst moment of the fifth wave. In the case of the city of Barcelona, ​​it went from registering an incidence of 1,450 cases at the end of July to the current 170, according to the latest figures. The best situation is for Asturias: it is the community that registers the lowest contagion rate in the country, with 117 cases per 100,000 inhabitants in two weeks, and also one of the ones that has managed to lower the curve the fastest.

The following graph compares the curves of incidence in 14 days and daily deaths by diagnosis date of the 52 Spanish provinces. The figures are adjusted to the population of each one of them.

How the curve of each province compares in cases and deaths per inhabitant

Evolution of the
incidence of cases in 14 days in 14 days and daily deaths (mean 7d) in Spain. Cases are shown by date of diagnosis and deceased by date of death. Stand on top to highlight a province