‘Explosive transmission’: What you need to know about Spain’s fifth Covid wave 

Spain has seen its Covid infection rate more than double in under two weeks, with epidemiologists confirming it as the start of the country's fifth wave. Here's why it's different to previous waves and how it could affect the vaccine campaign, local restrictions and more.

'Explosive transmission': What you need to know about Spain's fifth Covid wave 
Photo: Josep Lago/AFP

Faster rise in cases than the other Covid waves 

The fifth wave reportedly started on June 22nd when the fortnightly infection rate from the fourth wave was at its lowest: 92 cases per 100,000 inhabitants. 

In just thirteen days it has increased 121 percent, a faster rise than all previous coronavirus waves in Spain, although data for the first wave can’t be deemed fully accurate given the lack of knowledge about Covid-19 in March 2020. 

On Monday July 5th, the Spanish government’s chief epidemiologist Fernando Simón confirmed that in just three days the fortnightly infection rate had climbed 33 percent across Spain. It took only a weekend for the incidence of the virus to increase 52 points up to 204 cases per 100,000 people. 

Coronavirus infections have shot up in particular among people aged 16 to 30 in Spain, but also among younger children (infection rate of 584 cases per 100,000 in 12 to 19 year olds).

It won’t just affect unvaccinated young people 

The infection rate among 20 to 29 year olds may have already tripled up to 640 cases per 100,000 people but according to leading epidemiologist and former WHO directive Daniel Lopez Acuña people in the 60 to 69 age group – most of whom have only had their first dose of the AstraZeneca vaccine – are still at risk. 

Infections among teens and twenty-somethings may also affect the vaccination plans of people in their thirties, with some regions suggesting that the younger groups should be prioritised over people in the 30 to 39 age group. 

For López Acuña there’s “little logic and epidemiological sense” to bringing forward the vaccination of young people, saying that instead people in their sixties should be fully vaccinated “as soon as possible” despite the “explosive community transmission” among young people.

The epidemiologist warned that although many young people are asymptomatic, “that doesn’t mean they may not be admitted to hospital or even be at risk of death”.

Primary Care services in Catalonia and Cantrabria are reportedly overwhelmed by the rise in cases, due to the increased number of young patients with mild Covid symptoms and a huge demand for PCR testing.

However, the number of people being admitted to hospital with Covid-19 across Spain is three times lower than during the fourth wave.

The number of Covid deaths during this fifth wave is also six times lower so far than it was back in April, according to Health Ministry figures.

 (Photo by Gabriel BOUYS / AFP)

High infection rates favour variant development 

According to López Acuña there is a worrying sense of “false security” and that although those infected are usually asymptomatic, high community transmission increases the chances that “variants that can escape from vaccines” will emerge. 

Although the Covid-19 outbreak in Mallorca that has led to hundreds of cases being detected across a number of Spanish regions belongs to the Alpha variant, the incidence of the Delta variant in Spain has quintupled up to 10 percent of all new cases. 

Researchers and public health officials believe the Delta strain, first identified in India, will become dominant in Spain by mid-July.


Coronavirus: How much is the Delta variant spreading in Spain?

Based on its higher transmissibility and model forecasts, the European Centre for Disease Prevention and Control (ECDC) also predicts that 70 percent of new coronavirus infections will be due to this variant in the European Union in early August and “represent 90 percent of all SARS-CoV-2 viruses circulating in the EU at the end of August”.

There has been no increase in reinfections associated with the Delta variant or any indication that existing Covid-19 vaccines protect less against this B.1.617.2 variant than against other variants, according to the latest ECDC data. 

However, a preliminary study by Israel’s Health Ministry found that the BioNTech/Pfizer vaccine is less effective at stemming the spread of the Delta variant than previous strains of Covid. 

Could it mean more restrictions?

Spain’s fourth wave was referred to as a ‘little wave’ by epidemiologist Fernando Simón as the initial rise in cases was slower than previous waves and the infection rate peaked at 149 cases per 100,000 people. 

The emergence and meteoric rise of the fifth Covid-19 wave in Spain has perhaps caught Spanish authorities off guard, having ended the state of alarm in May, eased restrictions and reopened its borders to national and some international travellers.  

It has also highlighted how challenging it may be for Spanish authorities to control rising infection rates during the summer without the special powers the state of alarm provided national and regional governments to quickly roll out new restrictions. However, Spain’s regions can still find the legislative help needed to toughen rules such as opening times and capacities. 

According to López Acuña, Spain should at least close nightclubs and bars even though most have only just reopened recently after 15 months of restrictions, together with “controls at places where infections are taking place”.

The spike in infections is also likely to affect Spain’s ailing tourism industry, with Germany and Belgium already announcing travel restrictions for Catalonia and Cantabria. 

UPDATE: Spain’s Catalonia reimposes Covid measures as cases spike

Authorities in both these regions, as well as Asturias, Madrid, Castilla y León and the Valencia region have said they are currently studying the possibility of reintroducing restrictions to stem infections. 

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Spain rules out EU’s advice on compulsory Covid-19 vaccination 

Spain’s Health Ministry said Thursday there will be no mandatory vaccination in the country following the European Commission’s advice to Member States to “think about it” and Germany’s announcement that it will make vaccines compulsory in February.

Spain rules out EU's advice on compulsory Covid-19 vaccination 
A Spanish man being vaccinated poses with a custom-made T-shirt showing Spain's chief epidimiologist Fernando Simón striking a 'Dirty Harry/Clint Eastwood' pose over the words "What part of keep a two-metre distance don't you understand?' Photo: José Jordan

Spain’s Health Minister Carolina Darias on Thursday told journalists Covid-19 vaccines will continue to be voluntary in Spain given the “very high awareness of the population” with regard to the benefits of vaccination.

This follows the words of European Commission chief Ursula von der Leyen on Thursday, urging Member States to “think about mandatory vaccination” as more cases of the Omicron variant are detected across Europe. 

READ ALSO: Is Spain proving facts rather than force can convince the unvaccinated?

“I can understand that countries with low vaccine coverage are contemplating this and that Von der Leyen is considering opening up a debate, but in our country the situation is absolutely different,” Darias said at the press conference following her meeting with Spain’s Interterritorial Health Council.

According to the national health minister,  this was also “the general belief” of regional health leaders of each of Spain’s 17 autonomous communities she had just been in discussion with over Christmas Covid measures. 

READ MORE: Spain rules out new restrictions against Omicron variant

Almost 80 percent of Spain’s total population is fully vaccinated against Covid-19, a figure which is around 10 percent higher if looking at those who are eligible for the vaccine (over 12s). 

It has the highest vaccination rate among Europe’s most populous countries.

Germany announced tough new restrictions on Thursday in a bid to contain its fourth wave of Covid-19 aimed largely at the country’s unvaccinated people, with outgoing Chancellor Angela Merkel speaking in favour of compulsory vaccinations, which the German parliament is due to vote on soon.

Austria has also already said it will make Covid-19 vaccines compulsory next February, Belgium is also considering it and Greece on Tuesday said it will make vaccination obligatory for those over 60.

But for Spain, strict Covid-19 vaccination rules have never been on the table, having said from the start that getting the Covid-19 jabs was voluntary. 

There’s also a huge legal implication to imposing such a rule which Spanish courts are unlikely to look on favourably. 

Stricter Covid restrictions and the country’s two states of alarm, the first resulting in a full national lockdown from March to May 2020, have both been deemed unconstitutional by Spain’s Constitutional Court. 

READ ALSO: Could Spain lock down its unvaccinated or make Covid vaccines compulsory?

The Covid-19 health pass to access indoor public spaces was also until recently consistently rejected by regional high courts for breaching fundamental rights, although judges have changed their stance favouring this Covid certificate over old Covid-19 restrictions that affect the whole population.

MAP: Which regions in Spain now require a Covid health pass for daily affairs?

“In Spain what we have to do is to continue vaccinating as we have done until now” Darias added. 

“Spaniards understand that vaccines are not only a right, they are an obligation because we protect others with them”.

What Spanish health authorities are still considering is whether to vaccinate their 5 to 11 year olds after the go-ahead from the European Medicines Agency, with regions such as Madrid claiming they will start vaccinating their young children in December despite there being no official confirmation from Spain’s Vaccine Committee yet.

READ MORE: Will Spain soon vaccinate its children under 12?

Spain’s infection rate continues to rise day by day, jumping 17 points up to 234 cases per 100,000 people on Thursday. There are now also five confirmed cases of the Omicron variant in the country, one through community transmission.

Hospital bed occupancy with Covid patients has also risen slightly nationwide to 3.3 percent, as has ICU Covid occupancy which now stands at 8.4 percent, but the Spanish government insists these figures are “almost three times lower” than during previous waves of the coronavirus pandemic.