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.
The number of COVID-19 cases is the indicator that most accurately shows the epidemiological situation at any given time, whilst the data on hospital admissions and deaths are shown with a certain time lag. However, all these data are influenced by the limited diagnosis capacity during the initial phase of the pandemic.
73,103 COVID-19 cases were registered in the province of Madrid during the first wave of the pandemic as well as 46,989 in the province of Barcelona and around 8,000 in the provinces of Biscay (Bizkaia), Navarre (Navarra), Valencia and Ciudad Real. The month of March was the period for which the greatest increase in absolute terms was registered. In relative terms, however, there was a clear concentration in the provinces of Biscay (Bizkaia), Araba/Álava, La Rioja, Navarre (Navarra), Barcelona, Lleida, Cáceres and the provinces of Castile and León (Castilla y León) and Castile-La Mancha (Castilla-La Mancha), where the cumulative incidence was very high. The data for the provinces of Ciudad Real, Albacete and the axis linking Salamanca-Madrid-Navarre (Navarra) –between 1,000 and 3,000 cases per 100,000 inhabitants– are particularly noteworthy, reaching in some cases five times the national average figure (577.8). The territories with the lowest cumulative incidence in absolute and relative terms were Asturias, Badajoz, Murcia, Andalusia (Andalucía) and the Canary Islands (Canarias).
The impact of the first wave of the pandemic amongst healthcare professionals was very severe, i.e. one in five cases were healthcare workers. Also, a large part of this impact fell on women, as the group of healthcare professionals is largely female. These noteworthy data could be linked to the difficulties in supplying personal protective equipment at the beginning of the pandemic, the initial lack of knowledge on how the virus itself behaved and the easier access to diagnosis for healthcare professionals. The peak time of infection amongst healthcare professionals was March. Figures showing the amount of healthcare workers infected during the first wave of the pandemic were worrying, i.e. 15,344 cases in the province of Madrid, 3,354 in the province of Barcelona, around 2,000 in the province of Biscay (Bizkaia) and 1,000 in the provinces of Valencia and Ciudad Real. In proportional terms (infected healthcare workers compared to the total number of cases), provinces such as Biscay (Bizkaia), Araba/Álava, Cuenca and Granada (between 20 and 25%) were more than 5 percentage points higher than the national average (15.3%), and some others, like Asturias, Tarragona, Guadalajara and Santa Cruz de Tenerife, were even over 25%.
The provinces with the highest hospital admission rates due to COVID-19 (hospital admissions due to COVID-19 per 100,000 inhabitants) during these months were Madrid, Ciudad Real, Albacete, Cuenca, Soria and Segovia. This pattern matches well the distribution of cumulative incidence as the figures (between 500 and 800) were double that of the national average (232.8). The rest of provinces in Castile and León (Castilla y León), Castile-La Mancha (Castilla-La Mancha), as well as Biscay (Bizkaia), Araba/Álava, Navarre (Navarra) and La Rioja also registered higher figures than the national average. On the other hand, these rates were lower in the coastal provinces of the Northwest and South. In absolute terms, nearly 40,000 hospital admissions were reached in the province of Madrid, 18,000 in Barcelona and around 3,000 in Biscay (Bizkaia), Valencia and Ciudad Real.
The cumulative number of admissions to Intensive Care Units (ICU) due to COVID-19 peaked in the province of Madrid with 3,105, Barcelona with 1,373 as well as Valencia, Alicante and Saragossa (Zaragoza) with around 300 each. In proportional terms (those admitted to the ICU with respect to those admitted to hospital due to COVID-19), the distribution was inverted with respect to the previous variable. Las Palmas de Gran Canaria stood out with the highest percentage, i.e. over 20%.
The number of deaths from COVID-19 increased most sharply from 14 to 30 March, from 108 to 913 deaths, and remained above 600 until 11 April. Mortality in people over 80 years of age was similar, peaking at 500 from 27 March to 8 April. From 2 May onwards, the total number of deaths and deaths over 80 years of age was less than 200 cases. It dropped to less than 50 cases during the month of June.
F, From a spatial perspective, higher mortality (total deaths per 100,000 inhabitants) was observed in inland Spain: the provinces of Soria, Segovia and Ciudad Real reached between 200 and 260 deaths per 100,000 inhabitants compared to 62.8 for the national average. In absolute terms, the provinces of Madrid and Barcelona stood out registering 8,640 and 5,581 deaths.
The importance of providing specific protection for the most vulnerable groups and those with the highest risk factors is one of the most relevant experiences learned from this period. The age-sex pyramid of the deceased from COVID-19 is clear: see the ranges for men aged 75 and over and women aged 85 and over. The provinces in the northern half of the country recorded the highest proportion of elderly (figures above 70%), being 62.6% the national average. This spatial distribution matches well the general population distribution by age, where the northern part of the country has the most aged population.
Co-authorship of the text in Spanish: Carmen Bentué Martínez, María Caudevilla Lambán, Carlos López Escolano, Raúl Postigo Vidal, María Sebastián López and María Zúñiga Antón. See the list of members engaged
Adaptation of the text and translation into English for this international version: Andrés Arístegui Cortijo (Translator in chief)
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.