Hardest hit: While we were focused on Italy, we’ve ignored Spain

The world’s focus has been on Italy, where the coronavirus toll has been particularly hard. Perhaps partially due to the nation’s late reaction to the threat the virus posed, perhaps partially due to a variety of other factors, Italy has been slammed unlike most of the rest of the world. As bodies have been stacked in churches and doctors have reported being forced to ration health care (and, later, adding that patients over 60 weren’t being offered limited life-saving treatments), the death rate has risen from 6% to 7% to 8% to 9%.

Now Italy’s death rate is closing in on 10%. It was 9.5% as of Monday. That isn’t a true death rate, of course; it’s a simple calculation of deaths versus infections. But 9.5% of known infections are ending in death — a rate that’s much higher than anywhere else in the world.

Except Spain.

In some ways, Spain is Europe’s forgotten epicenter in the coronavirus fight. The stories out of Italy gripped the world early on. Italy and Spain both reported their first positive case of COVID-19 on the same day, January 31. Spain actually recorded its first death a week earlier than Italy — on February 13. Italy’s first death didn’t come until February 21.

But things accelerated really quickly in Italy. By March 6, Italy had more than 4,600 infections and nearly 200 deaths. Spain had only 400 infections and 8 deaths.

By the following Wednesday, when Italy was quickly trying to lock itself down — realizing too late the exponential spread of the virus within its borders — something happened in Spain: COVID-19 began to spread with dizzying speed. The nation had gone from 401 cases to nearly 2,300 in just 5 days … from 8 deaths to 55.

A week later, Spain had a whopping 14,000 cases and nearly 640 deaths.

It was out of control.

Today, the stories coming out of Spain are just as dire as those coming out of Italy … maybe moreso, because Italy seems to be peaking (more on that in a moment) while Spain has shown no sign of being at its peak. Just yesterday, officials turned the olympic-sized skating rink at Madrid’s Palacio de Hielo into a makeshift morgue. The city’s hospitals are said to be on “the very of collapse.” A whopping 14% of the country’s health care workers are infected. And people are dying because of a lack of supplies, like oxygen.

After reporting another 500 deaths overnight, Spain stands at 39,676 total cases and 2,800 fatalities. Its death rate is 7.1% … and climbing. In a nation of 47 million people, how far can Spain’s death count rise? As high as Italy’s, with its 60 million people? Perhaps. In the meantime, it’s safe to say that the situation is just as dire in Spain as it is in Italy … it’s just that Spain hasn’t gotten the same media attention from the outside world that Italy has gotten.

Two European countries, two very similar stories.

In Italy, at least, the peak may be at hand. The last two days have shown declines both in deaths and new cases. The death toll is still rising quickly, to be sure … just not as quickly. There were 601 deaths in Italy on Monday — still more than the 572 that were reported on Friday, but fewer than the 651 reported on Sunday. And the 651 deaths reported on Sunday were fewer than the 793 reported on Saturday — Italy’s deadliest day thus far in the battle against the virus. For two straight days, Italy’s infection count and death total have lowered. On the graphs, the linear scale is finally showing some curve at the top.

There’s no curve at the top of Spain’s line. Since March 10, when only 8 new deaths were reported, the situation has grown grimmer every day. March 17 was a particularly deadly day, with 191 deaths recorded. Friday’s death count was 262. Saturday’s was 288. Sunday’s was 391. Monday’s was 539.

New infections are still climbing, too. More than 6,300 new cases were reported on Monday — 35% more than had been reported on any other single day.

With the exception of Iran, those two nations clearly stand alone as outliers — and, perhaps, examples of what coronavirus can become without early efforts to mitigate its spread. Iran has a death rate of 7.8%, but seems to have reached its peak — though the nation did report 1,411 new infections yesterday, it’s largest single-day jump thus far.

What does all of this mean for the United States? Maybe a lot. Maybe a little. There are plenty who would argue that the U.S. didn’t implement its social-distancing policies soon enough. But they were implemented before the spread here had reached the tipping point that it reached in Europe. There are also plenty who argue that the U.S. policies don’t go far enough. And, to be sure, the U.S. isn’t going to implement the draconian lockdown policies that China put into place, when it was able to halt the spread in Wuhan after just 3% of the population was infected. Nor is the U.S. going to put the tracking measures in place that South Korea did, which has resulted in only 9,000 infections in the nation of 51 million people — and it’s too late for the U.S. to take that route even if it wanted to.

Still, there’s an interesting contrast happening in the U.S. The death rate here started somewhat high, before steadily lowering. It’s stabilized now, at 1.2%. As of Tuesday, there had been nearly 50,000 infections in the U.S. and 600 deaths.

The U.S. doesn’t seem to be anywhere near its peak; after between 41 and 57 deaths each day for four straight days, the U.S. recorded 111 deaths on Sunday and 140 on Monday. New infections increased by more than 9,000 on Sunday and by more than 10,000 on Monday, after previously increasing by no more than 5,600 cases in a single day.

But a look at Washington state — home of the first localized outbreak of coronavirus within the U.S. — reveals a situation that seems quite stable, perhaps offering hope to the rest of the nation, especially its rural areas that hunkered down well before things got as bad as they had gotten in the greater Seattle area.

Washington is still sitting on just 2,221 total cases of coronavirus. With 111 deaths, it has a higher percentage of known cases ending in death — 5.0% — than any other state, but a large part of that was due to the disastrous nursing home outbreak in King County. In fact, take away the Seattle metro area, which accounts for 87 of the state’s 111 deaths and has a death rate of 7.4%, and the death rate in the rest of Washington drops to 3.2%. That’s still high, compared to the rest of the nation, but still not outside the realm of what should’ve been expected, considering the virus was out of control before efforts were taken to protect at-risk populations.

Meanwhile in New York, which seems to be the U.S.’s greatest risk of replicating what’s happening in Spain and Italy, the death rate remains just 0.7% — again, providing hope that what’s happening in Europe will not happen here. The real test will come if and when New York’s hospitals are overwhelmed, which is a very real threat, especially considering the virus isn’t really close to its peak there. But Italy’s death rate was never under 1% — not even when it was at a similar point in the outbreak as New York is now.

In closing, there’s this: South Korea’s low death rate was marveled at for so long from around the world, at just 0.6%. Then, a little more than a week ago, it slowly began to climb. It has now surpassed the U.S. death rate, at 1.3%.

Ben Garrett

Ben Garrett is a journalist from East Tennessee. He is publisher of the Independent Herald, a weekly newspaper serving the Big South Fork region of the Cumberland Plateau, with a sideline in website development and digital marketing. He is also an erstwhile blogger.

1 comment

  • I don’t even know why we are talking death rates when we know the calculation cannot be correct because there is no way to know how many people have the virus. You could say it is a ratio of deaths/verified cases of coronavirus but you are still talking about a subset of those who actually have the virus. So at this point I don’t think it is very informative. I think we should look at the number of death’s per population and even then for it to be a meaningful comparison between countries you would have to qualify each country with where they are on the infection curve. But in the final windup the only really important number in terms of health will be how many deaths/population the virus caused. Of course the degree of severity of strain on healthcare resources will help determine that ratio.
    Which brings up another question I have for those saying that the coronavirus outbreak proves that America needs universal public health care: Tell me again what kind of healthcare does Italy have? And how is healthcare funded in Spain? And do you think that might be why they have so many fewer ventilators per 1000 people than we do here in America where we have all those greedy for-profit health-care providers? Funny how when you unleash the desire for profit and prosperity the public benefits so much more than when you leave it to the bloated taxpayer funded government bureaucracies who answer to no one. The capitalistic free market will always do a much better job of matching resources to need than some central government rule by fiat. ALWAYS.
    If it wasn’t for the seriousness of the situation with all the human suffering one would find it quite comical to google and search the internet for information on healthcare systems in Spain and Italy compared to the United States. National Public Radio speaks with glowing awe about how that Spain’s healthcare system is “the best”. In fact the title of one article on their site is “What Makes Spain’s Health Care the Best?” lol. But it isn’t lol – it is just sad because that kind of thinking means a lot of people are suffering and dying right now from rationed health care because the government didn’t/couldn’t spend the money to provide the health care resources that the public needs. All in the name of single-payer health care. Your government at work.

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