20.268 residential coronavirus deaths during the first wave

A first study by the Spanish government points out the "insufficient" number of workers

For a few months now, regional and state governments have been working together to prepare a technical team to prepare a report on the impact of the pandemic on care homes, as well as the factors that caused these spaces to be one of the main sources of infection in the first wave. The draft report that is currently on the table - which has been reported by El País and to which ARA has had access - estimates that more than 20,200 people died during the first wave in these centres. In total, 20,268 people died betweem the beginning of the pandemic and July 23, a figure that represents 6% of the people who lived in care homes throughout the state, according to the official draft being prepared by the Ministry of Social Rights. This figure, however, is higher than that of some OECD countries such as the United Kingdom (5.3%) or Belgium (4.9%) and shows the Spain was highly affected.

The total number of deaths that the report includes has been "cleaned up and corrected" by data provided by the institute for the elderly (Imserso) and the Autonomous Communities. Of these 20,268 deaths, however, only 51% (10,364) were confirmed by a test, that is, by means of a PCR or a serological analysis. On the other hand, 9,904 deaths were reported as covid-19 because they presented had "compatible symptoms". As explained by Ministry of Health sources on other occasions, during the highest peak of the first wave, when not enough tests were available, this medical assessment was a way of registering cases of coronavirus on official lists. For this reason, the report notes that there are official records, such as the National Epidemiological Surveillance Network, that use "international criteria that do not count cases if they are not confirmed by a PCR test", and therefore deaths are lower.

In addition, in order to further examine the impact of the pandemic on the residences, the draft also analyses excess mortality that was recorded among the population living in care homes between the months of March and July. The report states that 72% of elderly people in residential homes receive some kind of benefit for dependency and it is based on this data that the draft notes an excess mortality of 18,375 people in this group. The figure is the difference between the 15,473 deaths that were expected throughout the State in this group and the 33,848 deaths that were registered this year between March and July (without discriminating the cause of death).

This scenario was not avoided in Catalonia either. The spread of the virus in the 1,073 Catalan residences during the first wave was dramatic, in part because of the impossibility of accessing diagnostic tests that would allow facilities to split into sectors and infected residents to be separated from healthy ones, as is being done during the second wave. In Catalonia, on 26 March the situation was already out of control, with 85 deaths in a single day, and on 12 April the death toll peaked at 205 in just 24 hours, according to public data from the Department of Health. The Catalan records show a total of 6,283 deaths in geriatric centres between 8 March and 23 July, the same period as the Spanish government's draft report looks at.

Lessons Learned

The draft of the Ministry of Social Rights - on which the residential centres depend - points out that the vulnerability of the elderly, resulting from the high capacity for contagion, as well as the lack of protective equipment for the workers in the residences, an "insufficient ratio of personnel" in the centres or common infrastructures "which are not always adequate", led to the rapid spread of contagion in the residences. In addition, the draft also puts the focus on the "very negative" effects of isolation during the most severe phases of lockdown. In fact, it stipulates that this situation should only be reached if it is completely "unavoidable". In fact, Catalan residences have been working for months to avoid banning visitors again.

The work also includes a set of measures to avoid repeating the same mistakes. Among these measures, the result of "lessons learned", the development of more homogeneous action plans between communities and the Spanish government to address the impact of the pandemic, as well as a more effective formula for collecting data, stand out. "The protection of people in these centres, due to their vulnerability to infection, must be considered an absolute priority during the management of the pandemic," states the draft to which the ARA has had access. However, a final report is expected to be approved in the next few days.

Impact in Madrid

This Friday the Community of Madrid also presented a report on how the epidemic has affected the residences in the region. Specifically, the Madrid government has carried out a seroprevalence study in residential centres which concludes that 53% of the residences in Madrid have a medium to high immunity to covid. The study details that 14,324 residents (out of a sample of 55,542 people) have antibodies to covid-19; that is, they have already passed the disease. This is the first seroprevalence study carried out specifically in these centres in the whole of Spain. The study was carried out using blood samples and surveys of users and professionals at 517 centres between July and September.

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