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Counting Bodies and Pointing Fingers as Spain Tallies Coronavirus Dead Counting Bodies and Pointing Fingers as Spain Tallies Coronavirus Dead
(6 days later)
MADRID — Spain is recounting its dead.MADRID — Spain is recounting its dead.
Like many nations across the world trying to measure the toll that the coronavirus pandemic has taken, Spain has been stymied by unreliable figures.Like many nations across the world trying to measure the toll that the coronavirus pandemic has taken, Spain has been stymied by unreliable figures.
But in a politically fragmented society, the confusion has led to recrimination and sinister claims, with opposition politicians accusing the fragile coalition government of covering up the real numbers.But in a politically fragmented society, the confusion has led to recrimination and sinister claims, with opposition politicians accusing the fragile coalition government of covering up the real numbers.
“Spaniards deserve a government that doesn’t lie to them,” said Pablo Casado, the leader of the opposition Popular Party.“Spaniards deserve a government that doesn’t lie to them,” said Pablo Casado, the leader of the opposition Popular Party.
Speaking in Parliament last week, Mr. Casado addressed a direct challenge to Prime Minister Pedro Sánchez: “Tell us if it is true that the real number of victims could double the official figures.”Speaking in Parliament last week, Mr. Casado addressed a direct challenge to Prime Minister Pedro Sánchez: “Tell us if it is true that the real number of victims could double the official figures.”
Officially, Spain’s death toll, which remains among the world’s highest, is closing in on 20,000. But there is evidence that it could be far higher, with many deaths — especially those in nursing homes — not properly classified as stemming from the coronavirus.Officially, Spain’s death toll, which remains among the world’s highest, is closing in on 20,000. But there is evidence that it could be far higher, with many deaths — especially those in nursing homes — not properly classified as stemming from the coronavirus.
Mr. Sánchez and other officials reject accusations that they have intentionally underreported Covid-19 fatalities, but the authorities have begun trying again to measure the losses.Mr. Sánchez and other officials reject accusations that they have intentionally underreported Covid-19 fatalities, but the authorities have begun trying again to measure the losses.
Last week, Spain’s justice ministry told civil registries to comb through their death records dating back to March 14, when the country went into lockdown, to find unaccounted-for coronavirus victims.Last week, Spain’s justice ministry told civil registries to comb through their death records dating back to March 14, when the country went into lockdown, to find unaccounted-for coronavirus victims.
Spanish officials are not the first to take another look at how they count the dead. In New York City, the official death toll jumped sharply, to over 10,000, when the authorities began including people who had not tested positive for Covid-19 but were presumed to have died from it.Spanish officials are not the first to take another look at how they count the dead. In New York City, the official death toll jumped sharply, to over 10,000, when the authorities began including people who had not tested positive for Covid-19 but were presumed to have died from it.
A debate over the reliability of coronavirus data has been taking place almost since the beginning of the outbreak and extends from China to the United States. Many countries have not tested enough people to track infections, let alone establish how many deaths have been caused by the virus.A debate over the reliability of coronavirus data has been taking place almost since the beginning of the outbreak and extends from China to the United States. Many countries have not tested enough people to track infections, let alone establish how many deaths have been caused by the virus.
But the debate is taking place with singular ferocity in Spain.But the debate is taking place with singular ferocity in Spain.
The far-right political party Vox has pushed the cover-up accusations hardest. Last week, it posted on social media a manipulated photo of Madrid’s Gran Vía thoroughfare filled with coffins draped in Spanish flags. The government, Vox claimed, was hiding “the suffering of this tragedy.”The far-right political party Vox has pushed the cover-up accusations hardest. Last week, it posted on social media a manipulated photo of Madrid’s Gran Vía thoroughfare filled with coffins draped in Spanish flags. The government, Vox claimed, was hiding “the suffering of this tragedy.”
Helena Legido-Quigley, an associate professor of public health at the University of Singapore, said there were many reasons that the authorities worldwide should improve the counting of their dead. One is the brutal nature of the pandemic. Untold numbers of people have been forced to remain apart from loved ones as they died — and then unable to hold proper funerals for them.Helena Legido-Quigley, an associate professor of public health at the University of Singapore, said there were many reasons that the authorities worldwide should improve the counting of their dead. One is the brutal nature of the pandemic. Untold numbers of people have been forced to remain apart from loved ones as they died — and then unable to hold proper funerals for them.
“We know how important death rituals are in Spain and so many other countries,” Ms. Legido-Quigley said. “So the authorities should help reduce the huge impact on a society of having now been forced to dehumanize the process of dying.”“We know how important death rituals are in Spain and so many other countries,” Ms. Legido-Quigley said. “So the authorities should help reduce the huge impact on a society of having now been forced to dehumanize the process of dying.”
It is not just a matter of lacking testing capability. The problems of counting the dead are also compounded because not all nations have followed the same methodology.It is not just a matter of lacking testing capability. The problems of counting the dead are also compounded because not all nations have followed the same methodology.
In France, for instance, the counting was changed in early April to add nursing home deaths, which raised the toll by more than 3,000.In France, for instance, the counting was changed in early April to add nursing home deaths, which raised the toll by more than 3,000.
“It would have been very useful if we had at least some clearer European Union guidance on how to count deaths, so as to make the numbers more comparable from the start,” Ms. Legido-Quigley said.“It would have been very useful if we had at least some clearer European Union guidance on how to count deaths, so as to make the numbers more comparable from the start,” Ms. Legido-Quigley said.
Some countries were late in labeling Covid-19 as an official cause of death.Some countries were late in labeling Covid-19 as an official cause of death.
The United States announced a code for recording Covid-19 on March 24, weeks after the first American coronavirus fatality was reported. In Britain, Covid-19 joined the list of infections to be mentioned on death certificates only at the same time as the country recorded its first victim.The United States announced a code for recording Covid-19 on March 24, weeks after the first American coronavirus fatality was reported. In Britain, Covid-19 joined the list of infections to be mentioned on death certificates only at the same time as the country recorded its first victim.
Spain announced its first coronavirus death on March 3. But the infection was identified only in a post-mortem examination conducted weeks after the patient died from what appeared to be pneumonia. And once Spanish hospitals started filling with patients and staffing resources grew scarce, health officials did away with such post-mortems.Spain announced its first coronavirus death on March 3. But the infection was identified only in a post-mortem examination conducted weeks after the patient died from what appeared to be pneumonia. And once Spanish hospitals started filling with patients and staffing resources grew scarce, health officials did away with such post-mortems.
While the central government has yet to adjust its official death figure, numbers released by some of Spain’s regions have been shocking, particularly because they have revealed the extent to which nursing homes have been decimated behind closed doors.While the central government has yet to adjust its official death figure, numbers released by some of Spain’s regions have been shocking, particularly because they have revealed the extent to which nursing homes have been decimated behind closed doors.
Last week, the regional government in Madrid estimated that almost 3,500 people had died in its nursing homes after displaying probable symptoms of the virus. Since they had not been tested, they had not been included in the official tally for Madrid nursing homes — 781.Last week, the regional government in Madrid estimated that almost 3,500 people had died in its nursing homes after displaying probable symptoms of the virus. Since they had not been tested, they had not been included in the official tally for Madrid nursing homes — 781.
Past experience with other epidemics like swine fever suggests that it may take several months, if not longer, for nations to have a true understanding of the coronavirus death toll.Past experience with other epidemics like swine fever suggests that it may take several months, if not longer, for nations to have a true understanding of the coronavirus death toll.
“The main reason for getting right the numbers of this disease is that we have a substantial risk of a second wave,” said Dr. Christopher Murray, the director of the Institute for Health Metrics and Evaluation at the University of Washington, which has compiled forecasts of death tolls in several countries, including Spain.“The main reason for getting right the numbers of this disease is that we have a substantial risk of a second wave,” said Dr. Christopher Murray, the director of the Institute for Health Metrics and Evaluation at the University of Washington, which has compiled forecasts of death tolls in several countries, including Spain.
“The faster we learn,” he said, “the better our chances” to be prepared for another wave.“The faster we learn,” he said, “the better our chances” to be prepared for another wave.
Dr. Murray said he expected public pressure to force governments to move faster than in the past to provide more accurate counts, and also to loosen restrictions on the disclosure of death statistics, which are often applied because of privacy rights.Dr. Murray said he expected public pressure to force governments to move faster than in the past to provide more accurate counts, and also to loosen restrictions on the disclosure of death statistics, which are often applied because of privacy rights.
In several countries, the internal flow of information has been problematic.In several countries, the internal flow of information has been problematic.
In Spain, the central government says it had to rely on numbers provided by the regional administrations that manage the country’s public hospitals. That has set off a blame game, and some regional leaders have been among the most outspoken critics of the government.In Spain, the central government says it had to rely on numbers provided by the regional administrations that manage the country’s public hospitals. That has set off a blame game, and some regional leaders have been among the most outspoken critics of the government.
Updated June 16, 2020 Updated June 22, 2020
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
José Antonio Monago, the conservative leader in the western region of Extremadura, suggested this month that there had been a government order to “hide the real number” of coronavirus victims. “Whoever dies from the disease does not deserve to fall into oblivion,” he said.José Antonio Monago, the conservative leader in the western region of Extremadura, suggested this month that there had been a government order to “hide the real number” of coronavirus victims. “Whoever dies from the disease does not deserve to fall into oblivion,” he said.
Spain’s interior minister, Fernando Grande-Marlaska, rejected the accusation as “very serious” and unfounded.Spain’s interior minister, Fernando Grande-Marlaska, rejected the accusation as “very serious” and unfounded.
About 88 percent of Spaniards want politicians to set aside their differences during the national health emergency, according to a survey published on Wednesday by Spain’s public center for sociological research.About 88 percent of Spaniards want politicians to set aside their differences during the national health emergency, according to a survey published on Wednesday by Spain’s public center for sociological research.
Yet as more new figures emerge from the regions, the mutual recriminations have continued. This week, health officials in Catalonia almost doubled their own tally of deaths in the region — to 7,097 — after reviewing data collected by undertakers.Yet as more new figures emerge from the regions, the mutual recriminations have continued. This week, health officials in Catalonia almost doubled their own tally of deaths in the region — to 7,097 — after reviewing data collected by undertakers.
Quim Torra, the region’s leader, said on Thursday: “We now have a much clearer situation in Catalonia. I wish the rest of the state would do the same.”Quim Torra, the region’s leader, said on Thursday: “We now have a much clearer situation in Catalonia. I wish the rest of the state would do the same.”
Amid the political bickering, those whose days are spent overseeing the dead, like priests and pallbearers, have taken to making their own back-of-the-envelope calculations. They have been trying to understand the true numbers behind why Spain has had to convert some buildings into emergency morgues, including the country’s largest skating rink, the Ice Palace in Madrid.Amid the political bickering, those whose days are spent overseeing the dead, like priests and pallbearers, have taken to making their own back-of-the-envelope calculations. They have been trying to understand the true numbers behind why Spain has had to convert some buildings into emergency morgues, including the country’s largest skating rink, the Ice Palace in Madrid.
“I think the official numbers of the dead obviously don’t add up,” said Juan Antonio Alguacil, who heads a Spanish association of funerary employees.“I think the official numbers of the dead obviously don’t add up,” said Juan Antonio Alguacil, who heads a Spanish association of funerary employees.
He said that in late February, before Spain officially registered its first coronavirus death, his colleagues had already been handling an “illogical” increase in the number of pneumonia cases.He said that in late February, before Spain officially registered its first coronavirus death, his colleagues had already been handling an “illogical” increase in the number of pneumonia cases.
“If we want to heal the moral and psychological wound that this pandemic will leave,” Mr. Alguacil said, “we have to get the full truth as soon as possible from our authorities about what really occurred.”“If we want to heal the moral and psychological wound that this pandemic will leave,” Mr. Alguacil said, “we have to get the full truth as soon as possible from our authorities about what really occurred.”