Demographics: After a hot and deadly summer, what awaits us in winter?

Deaths have a very defined monthly sequence. December and January are the deadliest months of the year, followed by July and August. In 2021, the peak winter period accounted for 21% of deaths and the heart of summer for just over 16%. Under “normal” conditions, cold is more lethal than heat. This simple description of the usual behavior of the Grim Reaper serves to frame what is happening this year, what has happened in the summer months and what could happen in the winter months in Spain.

Mortality rose especially in July. The data from the daily mortality monitoring system for all causes (MoMo) of the Carlos III Health Institute indicate that there were 11,313 more observed deaths than those estimated.

In August we also had a higher figure, but of smaller proportions (4,859 deaths observed more in relation to the estimates). It is necessary to insist that the MoMo data are estimates, not real figures, but the amount of the increases (16,000 people) is strong enough to have set off alarms. And now comes the difficult part: to explain why this increase has occurred.

Reported, observed, expected and temperature-attributable mortality in July and August 2022 in Spain.

The heat wave is not the only explanation

The simplest thing is to resort to the strong waves of heat that we have had. It has certainly been unusual to suffer 42 days of high temperatures, but if we continue to believe the MoMo figures, the pronounced summer heat is only responsible for about 3,800 deaths, around 24%. Despite its lower incidence due to the massive vaccination process, part of this excess of deaths can be attributed to the covid-19 pandemic, in this case some 4,500 between July and August.

The sum of the two causes amounts to 8,300 people, which raises to another 8,000 deaths without an attributed reason. Worsening of other ailments in people who contracted the disease? Delayed medical attention in chronic patients? Probably one and the other, and it is possible that something else that, at the moment, we cannot know until the statistics of the causes of death are published.

Vaccines are not to blame, quite the opposite

Thus, we are in the presence of a multicausal phenomenon that should be analyzed in detail to prevent it from reproducing in the future with greater intensity.

Heat waves due to climate change will continue, which will force us to establish preventive actions to mitigate their effects. And although the coronavirus is on sale, it is not advisable to lower our guard, particularly in the face of new variants that may arise. It will be necessary to be vaccinated with the fourth dose and as many as are necessary to reduce its incidence. Because what is clear is that vaccination has not been the cause of this excess of deaths, quite the opposite.

The general winter… and the summer

And what will happen in the winter in the northern hemisphere? It is curious that in the year that more deaths have caused the heat, we are worried about the cold. Russia has always played with General Winter to defeat or weaken her enemies. She did it with Napoleon, with Hitler’s armies and now with the gas supply to Europe.

The question is: Will we have more deaths than usual in the middle of winter due to lack of supply and especially due to the severe energy shortage? It must be taken into account that many of the most vulnerable people are also those with less purchasing power and that they can be particularly affected by insufficient heating of their homes. Surely it will not kill them, but it can aggravate any previous ailment.

The President of the Spanish Government, Pedro Sánchez, has tried to reassure citizens by ratifying his commitment that no one will suffer especially from the unexpected energy situation. The facts do not always corroborate the promises of our leaders, but in any case responsible steps should be taken so that the year with the most deaths from heat does not also become the year with the most deaths from the cold or because of it.

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