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The cumulative regional incidence of COVID-19 cases per 100,000 inhabitants was consistent with the spatial patterns observed during the rising phase of the pandemic. The provinces of Castile and León (Castilla y León) (e.g. over 1,500 cases per 100,000 inhabitants in Segovia and Soria), Castile-La Mancha (Castilla-La Mancha) (e.g. over 1,000 cases per 100,000 inhabitants in Ciudad Real), Extremadura, Madrid, La Rioja, Biscay (Bizkaia), Navarre (Navarra), Huesca, Lleida and Barcelona showed figures well above the national average (362.5 cases per 100,000 inhabitants). In absolute terms, there was a significant rise in the amount of daily COVID-19 cases in the provinces of Madrid and Barcelona, where nearly 17,000 and 12,000 cumulative cases had been recorded by 31 March.  
 
The cumulative regional incidence of COVID-19 cases per 100,000 inhabitants was consistent with the spatial patterns observed during the rising phase of the pandemic. The provinces of Castile and León (Castilla y León) (e.g. over 1,500 cases per 100,000 inhabitants in Segovia and Soria), Castile-La Mancha (Castilla-La Mancha) (e.g. over 1,000 cases per 100,000 inhabitants in Ciudad Real), Extremadura, Madrid, La Rioja, Biscay (Bizkaia), Navarre (Navarra), Huesca, Lleida and Barcelona showed figures well above the national average (362.5 cases per 100,000 inhabitants). In absolute terms, there was a significant rise in the amount of daily COVID-19 cases in the provinces of Madrid and Barcelona, where nearly 17,000 and 12,000 cumulative cases had been recorded by 31 March.  
  
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[[File:Logo Monografía.jpg|left|thumb|300px|Gráfico estadístico: Evolución ingresos UCI por COVID-19 durante la fase descendente de la pandemia. 2020. España.]]
 
[[File:Logo Monografía.jpg|left|thumb|300px|Gráfico estadístico: Evolución ingresos UCI por COVID-19 durante la fase descendente de la pandemia. 2020. España.]]

Revision as of 10:39, 16 March 2022


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The COVID-19 pandemic in Spain. First wave: from the first cases to the end of June 2020

Monographs from the National Atlas of Spain. New content


Thematic structure > The COVID-19 pandemic in Spain > Downward phase of the pandemic

  • Gráfico estadístico: Evolución de casos de COVID-19 durante la fase descendente de la pandemia. 2020. España.
  • Mapa: Casos de COVID-19 durante la fase descendente de la pandemia. 2020. España.

The downward phase of the COVID-19 pandemic lasted longer than the rising phase, i.e. from 21 March to 30 June 2020. The evolution of the main variables was brought under control after several weeks of strict lockdown, during which only professionals of essential activities were allowed to work and travel. It shall be borne in mind that Spain ranked second in the international context in terms of the amount of COVID-19 cases and the number of deaths from COVID-19 from the end of March to mid-April 2020.


  • Gráfico estadístico: Evolución hospitalizados por COVID19 durante la fase descendente de la pandemia. 2020. España.
  • Mapa: Hospitalizados por COVID-19 durante la fase descendente de la pandemia. 2020. España.

The effects of the state of alarm and the subsequent lockdown proved effective in deterring the progression of the pandemic in Spain. These public health measures impacted society in many different ways, i.e. from the most obvious ones, such as tempering the negative effects on health and slowing down economic activity, to the more intangible ones, such as the mood of the population.

The highest amount of new COVID-19 cases was registered on 23 March 2020, when 8,444 new cases were recorded. From 1 April onwards, the fall was continuous. After 12 April 2020, the amount of new daily COVID-19 cases stood below 3,000. On 3 May, the amount of cases stood around 500. Lower figures were reached after early June 2020.

The cumulative regional incidence of COVID-19 cases per 100,000 inhabitants was consistent with the spatial patterns observed during the rising phase of the pandemic. The provinces of Castile and León (Castilla y León) (e.g. over 1,500 cases per 100,000 inhabitants in Segovia and Soria), Castile-La Mancha (Castilla-La Mancha) (e.g. over 1,000 cases per 100,000 inhabitants in Ciudad Real), Extremadura, Madrid, La Rioja, Biscay (Bizkaia), Navarre (Navarra), Huesca, Lleida and Barcelona showed figures well above the national average (362.5 cases per 100,000 inhabitants). In absolute terms, there was a significant rise in the amount of daily COVID-19 cases in the provinces of Madrid and Barcelona, where nearly 17,000 and 12,000 cumulative cases had been recorded by 31 March.

  • Gráfico estadístico: Evolución ingresos UCI por COVID-19 durante la fase descendente de la pandemia. 2020. España.
  • Mapa: Ingresados en la UCI por COVID-19 durante la fase descendente de la pandemia. 2020. España.

By the end of June 2020, these figures had risen to 37,000 in Madrid and 32,000 in Barcelona. Biscay (Bizkaia), Navarre (Navarra), Valencia and Ciudad Real registered figures of around 5,000 cumulative cases during the first half of 2020.

Daily hospital admissions due to COVID-19 reached the highest levels from 21 to 31 March 2020, when over 5,000 admissions were registered every day. From 1 to 3 April 2020, figures stood around 3,000 hospital admissions per day. By 11 April 2020, these figures had been reduced to 1,000 hospital admissions/day, and by the last week of April they stood by 500. From then until late June, daily hospital admissions were below 200/100,000 inhabitants. A very high hospital admission rate due to COVID-19 was to be observed in the province of Barcelona and in the Spanish hinterland, with figures well above the national average (185.2 hospital admissions per 100,000 inhabitants). The provinces of Segovia, Cuenca and Ciudad Real stood out with over 500 hospital admissions per 100,000 inhabitants. In absolute terms, the provinces of Madrid and Barcelona registered 28,000 and 14,000 hospital admissions in total.

  • Gráfico estadístico: Evolución de fallecidos por COVID-19 durante la fase descendente de la pandemia. 2020. España.
  • Mapa: Fallecidos por COVID-19 durante la fase descendente de la pandemia. 2020. España.

The evolution in the number of admissions to Intensive Care Units (ICUs) due to COVID-19 peaked on 24 March, when 547 new patients were admitted to ICUs. From this date onwards, figures gradually decreased. On 9 April 2020, 100 admissions were approximately recorded every day. After 9 May, there were less than 10. The spatial patterns registered in the amount of patients admitted to ICUs is opposite to the spatial distribution observed in the total amount of hospital admissions due to COVID-19. The Northwest, the South and Aragón registered from 10 to 15%, whilst the national average stood by 7.6%. The high percentage registered in the province of Las Palmas shall be pointed out, where 23.0-26.9% of the total amount of patients in hospital due to COVID-19 were admitted to ICUs.

  • Gráfico estadístico: Pirámide fallecidos por COVID-19 durante la fase descendente de la pandemia. 2020. España.
  • Mapa: Fallecidos por COVID-19 de más 80 años en la fase descendente de la pandemia. 2020. España.

Deaths from COVID-19 registered the highest figures towards the end of March 2020, being 909 the highest amount of deaths registered in one single day. There was a slight drop during the first week of April (between 700 and 800 deaths per day). From 22 April onwards, figures stood below 400. During the first half of May, slightly over 100 deaths were reported every day. From 13 May onwards, figures stood below 100. Towards the end of June 2020 figures were close to ten deaths per day. In absolute terms, the provinces of Madrid and Barcelona registered 7,600 and 5,300 deaths during the first half of 2020. In relative terms, however, the provinces of Castile-La Mancha (Castilla-La Mancha) and the south-east of Castile and León (Castilla y León) registered the highest mortality rates due to COVID-19 (between 100 and 250 deaths per 100,000 inhabitants), whilst the national average stood by 58.9.

The age-sex pyramid of the deceased from COVID-19 during the downward phase of the pandemic shows the increased vulnerability to COVID-19 of older age groups in both sexes. Women showed higher fatality rates during this period than in the previous phase, especially in the older cohort (over 90 years of age). In the case of men, a higher incidence was observed in groups from 75 to 89 years of age. The amount of deaths in young adult population was very low. From a spatial point of view, a sharp contrast was shown between the North and the South in relation to the amount of deceased over 80 years of age. Galicia, Asturias, Cantabria, the Basque Country (Euskadi/País Vasco), Castile and León (Castilla y León), Aragón and Catalonia (Cataluña) registered figures above the national average (62.6%). The province of Ourense showed the highest percentage: 80% of the deceased were over 80 years of age.

In short, the older age-sex pyramid in northern Spain meant a higher amount of deaths from COVID-19.



The phases in which the analysis of the first wave of the pandemic has been divided is based on the amount of COVID-19 cases registered, i.e. the First cases show data from the beginning of the crisis until 8 March 2020, the Rising phase includes data from 9 to 20 March 2020 and the Downward phase runs from 21 March to 30 June 2020. Data on the amount of COVID-19 cases were downloaded from the National Epidemiological Surveillance Network website in October 2020. Data on other variables were not available for download at that date, so a specific request had to be made for this publication to the National Epidemiological Surveillance Network. It shall therefore be noted that “all results are provisional and shall be interpreted with care as they only furnish evidence of the information available at the time these data were provided”. For the analysis of COVID-19 cases, the amount of cases by symptom onset date as well as the province of residence have been taken into account as follows: “the symptom onset date has been used from the start of the pandemic up to 10 May. From 11 May onwards, when the symptom onset date is not available, the diagnosis date minus 3 days is used in general, and the diagnosis date itself is used if no symptoms are perceived” (National Epidemiological Surveillance Network). Hospital admissions due to COVID-19 as well as admissions to ICUs were registered according to the diagnosis date and province of residence. When the diagnosis date is not available, the date of declaration to the regional authorities is used. Deaths from COVID-19 refer to the date of death. Were this date not available, the date of declaration to the regional authorities or the diagnosis date was used. For all variables and phases shown, data are cumulative for the date represented, given the difficulty to display daily data on the scales used.


Downscaling Scheme

Gráfico estadístico: Evolución de casos COVID-19 durante la desescalada. 2020. España.
Gráfico estadístico: Evolución de ingresados en la UCI por COVID-19 durante la desescalada. 2020. España.
Gráfico estadístico: Evolución de hospitalizados por COVID-19 durante la desescalada. 2020. España.
Gráfico estadístico: Evolución de fallecidos por COVID-19 durante la desescalada. 2020. España.

Seven weeks after the state of alarm coming into force, the Spanish National Government enacted the Downscaling Scheme at the Cabinet Meeting on 28 April 2020. The Ministry of Health published an Order on 3 May 2020 implementing the Downscaling Scheme based on a joint governance decision-making process amongst the National Administration and the Regional Authorities.

The Downscaling Scheme aimed at “achieving the gradual recovery of daily life and economic activity, whilst keeping public health as a benchmark, in order to minimise the risk of the epidemic and prevent the capacities of the National Health System from being overwhelmed”. The transition to ‘new normal life’ was to be carried out under three basic pillars, i.e. gradualness, asymmetry and adaptation. Gradualness was shaped on the aforementioned downscaling phases which were progressive. Asymmetry referred to the fact that this process was to be carried out by means of agreements amongst the National Government and the different Regions. Adaptation referred to eventual changes to be introduced depending on epidemiological indicators.

The decision for a territory to upgrade from one downscaling phase to the next was taken by the National Minister of Health together with the regional authorities of this territory. This entailed at least one bilateral meeting between the national Ministry of Health and the regional authorities responsible for this territory. Regional governments were to submit their proposals for upgrading one week in advance and should include mandatory reports describing the epidemiological situation in this territory. This included a list of measures to be taken if being upgraded, as well as an analysis on the capacity of the regional health system to cope with an eventual rise in the amount of new COVID-19 cases. Basic features of the different downscaling phases are shown.


DOWNSCALING PHASES

Phase 0 or getting prepared for downscaling. Common easing measures for the whole country were accepted, allowing for out-of-home mobility mainly in the private sphere, as well as implementing measures on activities with little or no risk of infection provided that security instructions were followed. All public places were provided with visual signs and protective measures during this phase. Some small islands (Formentera in the Balearic Islands and La Gomera, El Hierro and La Graciosa in the Canary Islands) were allowed to upgrade to phase 1 during this period taking into account that hardly any new COVID-19 cases were being registered.


Phase 1 or initial phase. Partial opening of small businesses and restaurants was allowed in some territories depending on certain indicators, e.g. outside terraces of bars could be used, yet limited to one third of capacity; tourist accommodations could open with certain restrictions, except for common areas. Places of worship were also open and limited to one third of capacity. The usual agri-food sector and professional sport activities were resumed, yet some hygiene measures were to be introduced.


Phase 2 or intermediate phase. Partial opening of other activities was allowed. Restaurants could be open, yet limited to one third of capacity, only for table service (standing at the bar was not allowed) and with tables lying well apart from each other. Schools were opened, yet only for three purposes, i.e. to carry out backup activities, to ensure that children under the age of six could attend school if both parents had to work outside their homes, and to hold the Spanish pre-university exams. Hunting and sport fishing were resumed. Cinemas, theatres and auditoria were opened again yet seats were to be assigned beforehand. Visits to monuments, conference halls, cultural events and exhibitions were reinstated, yet only with a third of the usual capacity if inside, and 400 attendees seated if outside. Places of worship were to limit their capacity to 50%.


Phase 3 or advanced phase. General mobility was allowed. However, the use of masks was recommended in public transports and on the street. Shops, restaurants and bars were to limit their capacity to 50% and social distancing of at least two metres was to be respected.


New normal life. This meant the end of social and economic restrictions. However, epidemiological surveillance, self-protection and enhanced capacity of the National Health System were kept.


At least two weeks were to be spent in each phase, and upgrading from one phase to the next depended on specific indicators


Este texto es un resumen del Plan de Desescalada diseñado por Presidencia del Gobierno el 28 de abril de 2020

  • Mapa: Proceso de desescalada. Semana 1. 2020. España.
  • Mapa: Proceso de desescalada. Semana 2. 2020. España.
  • Mapa: Proceso de desescalada. Semana 3. 2020. España.
  • Mapa: Proceso de desescalada. Semana 4. 2020. España.
  • Mapa: Proceso de desescalada. Semana 5. 2020. España.
  • Mapa: Proceso de desescalada. Semana 6. 2020. España.
  • Mapa: Proceso de desescalada. Semana 7. 2020. España.
  • Mapa: Proceso de desescalada. Semana 7. Fase final del estado de alarma. 2020. España.
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Co-authorship of the text in Spanish: Carmen Bentué Martínez, María Caudevilla Lambán, Carlos López Escolano, Raúl Postigo Vidal, María Sebastián López y María Zúñiga Antón. See the list of members engaged


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You can download the complete publication The COVID-19 pandemic in Spain. First wave: from the first cases to the end of June 2020 in Libros Digitales del ANE site.

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