Whenever writing of mortality rates in a context of being ‘good’, one must be mindful that however low the numbers, for each and every person who died, a family have suffered loss and are in mourning. For them, news of ‘good’ rates will mean very little. Our thoughts are with them and no disrespect is intended in the content of this article. 

The single most important number that is presented daily during the Covid-19 crisis is that of the death rate, the number of lives lost to the disease. 

However, this is not as simple as it would appear.

Finally, The Real Covid-19 Mortality Rate, and it's Great News for the Balearics
Finally, The Real Covid-19 Mortality Rate, and it's Great News for the Balearics

Pre-Existing Conditions

There is much discussion over pre-existing conditions – if a person with cancer dies and is found to be carrying the covid-19 infection, what is the cause of death? If a person in their 90s has a list of pre-existing conditions and all realism says their life expectency was limited to months at most, should the presence of Covid-19 mean they are to be listed as a statistical casualty of the pandemic?

Testing

In addition to those where pre-existing conditions may give reason to question their cause of death, it is widely acknowledged that many of those who have died whilst carrying the disease may have gone unchecked as they were not tested for its presence. 

Doubt

These and other factors have given cause for much doubt and debate about the real underlying mortality rate effect of Covid-19. 

National Rates

Arguably the most reliable and effective method of assessing the effect of Covid-19 is to ignore the Ministry of Health daily crisis numbers altogether, and instead look at the underlying national mortality rate as compiled by the Institute of Statistics. 

In the first 5 months of this year there has been no other factor that would affect mortality rates, no other epidemic or natural disaster, no heatwave or big freeze. Without any such events the mortality rate would not change by more than a few percentage points year on year. We can therefore compare the 2020 mortality rate to that of 2019 and get a good indication, arguably a much better indication than the official Covid-19 death rate figures, as to the real effect of the virus.

To May 24th

The number of deaths in Spain was 24% higher in the period January 1st to May 24th 2020 compared to the same period in 2019, according to the National Statistics Institute (INE).

This figure represents 43,945 more fatalities in this period.

Allowing for some natural year on year variation, it is reasonable to assess the effect of coronavirus as being between 40,000 and 50,000 additional deaths. 

Curve

Proof of the link to the virus can be seen in the month by month figures, with the additional deaths curve sitting perfectly on top of the coronavirus curve.

According to the INE, the week between March 30 and April 5 saw the highest number of deaths in the year, “with 20,575 fatalities, 154.6% up compared to the same week in 2019.”

The elderly were most affected, the INE press release stated “Since the beginning of the year, the largest rise in deaths was among people aged over 90, with a total of 60,032 deaths, 27.2% more than the same period in 2019.”

El Pais reported on the difference in the numbers reported by the ministry of health and the INE figures. “On May 24, the Spanish Health Ministry reported that 28,752 people had died from Covid-19. This figure is 15,193 lower than the total number of deaths recorded by the INE study. The official coronavirus death toll, however, only includes victims who tested positive for the coronavirus via PCR tests. This means that people who died without being tested are not included in the official toll, even if they were suspected cases.”

Variation

The mortality rate varies hugely around Spain. According to the INE statistics the worst affected area in the first 21 weeks of the year was Madrid with a rise of 72.7%, followed by Castilla-La Mancha (58%) and Catalonia (41%).

We in the Balearics knew we had fared much better than many areas, however the INE figures will come as a surprise to most. The lowest increase recorded across Spain is in the Balearic Islands, and it is just 0.5% – a level of change well within the realms of normal year on year mortality change.

An amazing figure, though as stated at the outset, it will be of little comfort to the families of those that have succumbed.