More than a quarter of people in Spain have had Covid-19: Health Ministry

Official data may show that more than 8 million people in Spain have had Covid-19, but the country’s Health Ministry has admitted that a lack of case reporting throughout the pandemic could mean that at least 4 million more have been infected. 

 People walk on the promenade at Barceloneta Beach in Barcelona on December 31, 2021. (Photo by Pau BARRENA / AFP)
The true number of Covid-19 infection in Spain may never be known. (Photo by Pau BARRENA / AFP)

If you have the feeling that more people in your circle in Spain have Covid than at any other stage of the pandemic, you may be right.

Record daily infections, a spiking infection rate that is reportedly slowing down but still growing and the higher transmissibility of the Omicron variant are all ensuring that Covid-19 is now more prevalent than ever. 

On January 14th, Spain officially hit 8 million infections out of a population of 47 million, meaning that roughly 1 in every 6 people in the country has officially been infected with Covid-19. 

However, sources from Spain’s Health Ministry have been willing to admit that the real number of infections is considerably higher, estimating there have been at least 12 million cases, Catalan daily La Vanguardia reported on Sunday. These four million extra infections would mean that more than 25 percent of Spain’s total population has had Covid-19.

Before the Omicron variant, which has led to 2.6 million infections in the last month and a half in Spain, up to 70 percent of cases were successfully tracked and traced, ministerial sources say, a rate which is now far lower.

According to Rafael Ortí, head of the Spanish Society of Preventive Medicine, the real number of positive cases is most likely “double or triple” what is shown in the daily roundups announced by Spain’s Health Ministry.

It’s well reported that during Spain’s first wave that started in March 2020, health authorities didn’t have the testing system in place to compile accurate infection data, but even since health professionals across the country were briefed and equipped with the tools to correctly report cases, underreporting has continued. 

Only six Spanish regions notify the country’s epidemiological surveillance system the results of antigens tests performed at home: Catalonia, Navarra, Galicia, Aragon, the Canary Islands and La Rioja.

The other 11 autonomous governments only report cases confirmed by public health services or by pharmacies.

Antigen tests carried out at home now represent around 45 percent of the total number of tests carried out in Spain. In the week leading up to Christmas, seven million rapid self-tests were sold in the country. 

If people who discover they have Covid-19 fail to inform health authorities about it, there is no telling how many positive cases could have gone unreported.

Track and trace teams estimate that Spain’s real infection rate under the Omicron variant could be twice as high as that reported, citing as reasons for this their own understaffed and overworked teams, the high number of asymptomatic cases and the prevalence of Covid self-tests. 

“The tracking system is overwhelmed with so many infections and variants,” Preventive Medicine specialist Juan Antonio Sánz told Spanish daily Voz Populi.

“My impression is that, of the infections that are registered in the surveillance system, there are at least as many cases that are escaping tracking”.

According to the Spanish Institute of Health Carlos III, more than half of cases in Spain during this sixth coronavirus wave have been asymptomatic. 

It may never be possible for Spanish epidemiologists to truly know just how many people in Spain have contracted the virus over the past 22 months. 

But with authorities seemingly incapable of keeping a handle on the numbers, it’s no surprise that the Spanish government is set to stop looking at the infection rate as a means of evaluating the pandemic and replace it with the less rigorous system used for monitoring seasonal flu.

READ MORE: Spain’s health experts divided over whether Covid-19 should be treated like flu

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Outbreak or seventh wave? Health experts divided as Covid cases rise in Spain

Spain’s decision to stop counting all infections has some epidemiologists arguing health authorities are turning a blind eye to rising cases. But is the country truly heading towards a seventh wave?

Outbreak or seventh wave? Health experts divided as Covid cases rise in Spain

Three weeks since the Easter holidays came to a close and the indoor face mask rule was lifted in Spain, the Covid infection rate among over-59s has increased considerably, for most health experts predictably. 

It’s double what it was on April 1st – going from 459 cases per 100,000 up to 813 per 100,000 – and although Covid hospitalisations have risen by 78 percent in a month, pressure on hospitals remains stable. 

Not that this can be considered a complete picture of the epidemiological situation in Spain as the health ministry decided last March it would stop requesting data from the regions for infections among under-60s. 

This is part of the Spanish government’s plan of managing Covid-19 in a similar way to other endemic diseases such as seasonal influenza. 

The focus in recent weeks has been lifting Covid restrictions, not counting and reporting all Covid infections as frequently and rigorously and keeping a close eye only on the elderly and vulnerable. In a nutshell, returning to life pre-coronavirus.

But for some epidemiologists, the 55,578 new infections and 234 Covid deaths in the past week are indicative of the fact that the virus is still raging strong and that the end of Covid rules may have come too soon.

“We’re not facing a silent wave of the pandemic.  We’re walking blindfolded into a new wave, we don’t want to see it and we don’t want to name it,” Daniel López-Acuña, former director of emergencies at the World Health Organisation, told public broadcaster RTVE.

“There is a considerable rise in the infection rate, and  a rise in the infection rate sustained over time is a new wave, whether you want to call it that or not , López-Acuña added, arguing that if the incidence in under-60s were also analysed, “we would see the same infection rate or greater”.

Epidemiologist Quique Bassat argues that although there is talk among health experts of a seventh wave, “what we don’t know is how long it will last and if this is the beginning of what will end up being a seventh wave, or if it’s really just a new outbreak.” 

For Bassat, who is regularly interviewed on La Sexta and Antena 3 news, a rise in cases after the Easter holidays and the removal of face masks indoors is “what was expected”, but that “doesn’t mean that the population should be scared” and it “isn’t necessary to change the current strategy” of the health ministry.

“Pressure on healthcare is what has to determine if we should take a step back in the de-escalation of Covid-19 measures,” Bassat concludes.

It’s clear that the Spanish government’s approach to this stage of the pandemic is subject to a variety of opinions among the scientific community.

Some health experts, such as immunologist Matilde Cañelles of Spain’s Higher Council for Scientific Research (CSIC), consider it “irresponsible” to stop quarantine for positive cases and not count infections when there are still 30 people dying of Covid every day in Spain. 

Others take a more pragmatic approach and call for the fourth dose (second booster) of the Covid-19 booster vaccine to be offered to over-80s in the country as previously suggested, as the infection rate in this group is now over the 1,000 per 100,000 mark.

For epidemiologist Oriol Mitjà, Covid-19 adviser for the Catalan government, the coming weeks will shed more light on how big this coronavirus wave will be.

“Omicron is a variant with vaccine escape and with the potential to infect up to 60-70 percent of the population. 30 percent were infected at Christmas, 30 percent will avoid it and 30 percent can be infected now,” Mitjà tweeted.