Spain is one of the European countries with fewer infections in a second wave at different speeds | Society

Spain took the hit of the second wave before the rest of Europe and is now one of the countries with the lowest incidence of cases on the Old Continent. It reports almost the same infections as France or Germany, around 300 per 100,000 inhabitants; less than the UK, Belgium or the Czech Republic. It is also far from the countries of the European Union with the worst incidents, such as Italy, Poland, Sweden and Portugal, with over 650 cases per 100,000 inhabitants. The data from Spain confirms the drop in cases in all communities, a situation that is already noticeable in hospital admissions.

This scenario, however, is still precarious. Spain is one of the European countries with the highest excess of deaths since July and continues to report twice as many deaths from covid per inhabitant than Germany. In addition, the occupation of ICUs (25%) is at extreme risk and the infections reported by most communities places them at high risk, according to the threshold of the Ministry of Health. That is the threshold -250 cases per 100,000 inhabitants- from which Spain fell this Thursday according to the ministry, although it is a figure that cannot be compared with that of other European countries: Health counts the cases by date on which they are diagnosed, while that the European Center for Disease Control (ECDC) asks countries to report the contagions they become aware of (and which include delays, old diagnoses not previously notified, etc). According to this accounting (which is the one we use in this article), the incidence in Spain is 299 cases per 100,000 inhabitants, also one of the lowest in the EU. The ECDC stands at 150 notified cases the threshold to exit the ‘red alert’ zone.

In the rest of Europe, most countries are bending their curves, but the second waves have been uneven. All countries seem to have passed their peak of infections, although Portugal, Sweden, Poland or Italy are still above 600 cases per 100,000 inhabitants.

Belgium (311 cases per 100,000) and the Czech Republic (551) have been the worst stops, with more than 200 deaths per 100,000 inhabitants in 14 days. Spain in November has been between 80 and 100 (a figure that has translated into about 300 deaths on average daily) and Italy is already above it.

In the curves of countries like France or the Czech Republic – which have risen rapidly and plummeted – the application of very strict measures to contain the virus is noted. Germany’s curve, on the other hand, looks more like a low but long plateau, around 300 cases per 1,000,000 inhabitants. In the absence of a drop, the measures for Christmas have been tightened, aware of the risk that infections will skyrocket. Now it is around 40 deaths per 100,000 inhabitants in 14 days, half that of Spain (although here the death curve, which is the last to go down after infections and hospitalized patients, is already slightly decreasing).

Why is the contagion curve falling?

In Spain, the incidence of 299 infections per 100,000 inhabitants comes a month after the peak of 600 cases (registered the week of November 9) and returns to levels at the end of summer. How did we get here?

Something that differentiates the shape of Spain’s curve from that of most European countries is that it begins to rise slowly already at the end of July. Although in spring the growth of the epidemic was as fast as the fall after strict confinement, in the second wave the increase in cases has been more sustained. “In Spain the second wave started earlier and the measures that were taken had an effect,” confirms Alberto Infante, from the National School of Health and the Carlos III Health Institute. But the decline is being slow: “With tougher measures, the decline would have occurred earlier and mortality would be lower,” he adds.

Since the summer, the infections increased until the beginning of October, to then draw another hump that reached its peak in early November. The virus hit the country unevenly: Catalonia avoided a peak in the summer, but the Basque Country hit the second wave in late August and Madrid peaked in late September. Until a couple of weeks ago there were still communities where the curve grew (Asturias, Cantabria or Andalusia), although now it is decreasing in all of them. So do the hospitalized, perhaps the best thermometer to measure the true incidence of the pandemic.

The experts consulted do not have a unanimous answer to explain the fall in incidence. The factors are many and some of them will only be seen once the pandemic has passed and the real consequences of each measure can be studied: “Everything has contributed. Social restrictions, such as the curfew, perimeter confinements or the closure of the restoration, and also the sustained action of early diagnosis, tracking and carrying out diagnostic tests ”, explains Daniel López-Acuña, former Director of Emergencies of the World Organization Health (WHO). “In addition, although in a variable way, there is more awareness that you have to be careful.”

The use of antigen tests, a weapon that Spain and the rest of the European countries did not have in the first wave, has also influenced the descent of this second wave. They are used mainly to reinforce the detection of active infections (until a few months ago, only PCR was done). According to López-Acuña, they have been one more factor: “The important thing is to have diagnostic capacity, with PCR and antigenic tests when they have to be used.” For Sonia Zuñiga, a researcher at the covid CSIC group, “it is normal that using more antigens has contributed to lower the curves: tests and isolation have begun much more quickly, with the consequence of cutting many possible chains of infections.”

Where you can already see a third wave is in United States, which has an incidence of 700 cases per 100,000 people in 14 days. Its hospitals at the moment continue to fill, although there are fewer people admitted than in Spain or France. In Europe, there is still no rebound that suggests a new wave, but incidence levels are still high and require not to relax the measures.

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