Nearly 96% of new Covid cases do not need hospital treatment

AS SPAIN and the rest of the world waits with bated breath for a widely-available and effective Covid-19 vaccine, health ministry figures may help to put some minds at rest: Even though the number of cases in the country has risen by 78% this summer since lockdown ended, only 4.43% have had to go to hospital, and only 7.1% of these have needed to be admitted to intensive care.

According to data released by minister Salvador Illa's department, as at Friday, the number of 'positives' registered in the previous two months was 193,014 – partly through more widespread PCR-testing and manual contact-tracing that enabled the medical service to get to people who had been near a Coronavirus patient before they displayed symptoms.

Of these, 8,557 have had to go to hospital, meaning admissions have only risen by 6.85% in two months, and the mortality rate is 688, having risen by 2.43%.

Effectively, 95.6% of diagnosed cases since the end of lockdown have not needed in-patient treatment and have been in self-isolation at home.

And 99.64% of those diagnosed in the last two months have survived, since the death rate has been just 0.36%.

The 193,014 cases registered in summer, after June 21 when the State of Alarm was declared over, represent 73.37% of the total all year – currently 439,286.

In two months, 608 were admitted to intensive care, being 5.22% of the annual total – before the end of June, a total of 11,637 were admitted to intensive care, or an average of 2,909 a month, compared with 304 per month in July and August.

Deaths from Covid-19 in the four months prior to the end of lockdown totalled 28,323, or an average of 7,081 a month – and the country's leading contagious and infectious disease hospital, the Carlos III in Madrid, placed this figure at 43,348, or an average of 10,837.

But in the past two months, after the end of lockdown, an average of 344 people per month have died from Covid-19, being 2.43% of the number during lockdown or, taking the Carlos III numbers as the total, 1.59%.

Whilst 688 deaths from any cause at all is 688 deaths too many, the drastic drop in fatalities despite a sharp rise in diagnoses – from an average of 61,568 per month before the end of lockdown to 96,507 per month in summer, a rise of 50% on cases detected in spring – is, unquestionably, good news.

It means that, despite Spain being, on paper, in a worse situation now than it was in March, it is actually in a far better situation, and the spike in cases in the last two months could be largely due to swifter testing.

According to the ministry of health, when the Coronavirus pandemic hit Spain with little warning and literally became a medical crisis overnight, the country was unprepared for it and tests were only carried out on those who attended hospital with symptoms.

Tens of thousands of people with only minor symptoms, who remained at home because of lockdown and did not seek medical treatment as they did not feel unwell, were never diagnosed.

Unless patients expressly sought medical advice and assistance and described symptoms compatible with Covid-19, they would not have been tested, even if they had been in contact with someone who had the virus.

Testing was not widely available, and contact-tracing systems had not been set up, since it all happened so quickly, meaning the only asymptomatic cases found were those of patients who had already had the virus and recovered but who still showed up as 'positive' in follow-up tests.

Now, though, regional health authorities have carried out an average of up to 70,000 PCR tests a day throughout the summer – nationwide, a total of 516,318 were carried out in one week between August 21 and 28.

By contrast, in April, when daily nationwide testing rose from 20,000 to 40,000, the health ministry considered this a success – even though this 'success' involved only around two-thirds to a half of the number of tests carried out at present.

Additionally, the task of PCR-testing has not fallen exclusively on the shoulders of hospitals, the way it did in the first four months of the pandemic – now, the majority of tests are carried out in local GP or walk-in clinics.

Last week alone, 143,935 contacts of patients were tracked down and tested – of these, 40,642 were tested in hospitals, and 103,293 in medical practices close to the person's home.

At the start of the summer, health authorities had employed or redeployed 1,581 professionals to spend their entire working hours tracing contacts of confirmed patients, but now, this number has risen to 2,191 and the Radar Covid mobile phone App, designed to send the user an alert if they have been near someone with the virus, has gone live in eight regions, with the rest set to follow shortly.

Widespread testing – especially in areas with a high number of cases – has led to huge amounts of 'positive' results in patients with no symptoms; in fact, at least seven in 10 diagnoses through PCR-testing have turned out to be asymptomatic, meaning the health service is managing to get to them in time and order them into isolation.

During the lockdown period, those with no symptoms did not know they were carrying the virus, and continued to go about their daily lives, passing it onto others without realising.

The Greater Madrid region is the worst-hit, once again, with at least one in three of Spain's cases being detected in or near the capital city, and regional president Isabel Díaz Ayuso has been carrying out mass testing in suburbs and satellite towns.

In the two weeks between August 14 and 28, her government ordered over 15,000 PCR tests in the suburbs of Carabanchel, Usera, Villaverde and Vallecas, and the commuter towns of Móstoles, Alcobendas, Fuenlabrada and Parla.

These 15,000 tests have enabled the regional health authority to trace about 450 people who had the virus but with no symptoms, meaning they were able to stop them continuing to spread it.