Malta was mentioned by the European Centre for Disease Prevention and Control (ECDC) as one of seven European countries that registered a higher mortality rate than expected at the end of March in people aged 65 and over, despite the low number of deaths or mortality rates registered related to coronavirus.

There is no explanation given by the ECDC about this spike noted in its eighth update on the COVID-19 pandemic in European countries. Between 23 and 29 March, the European mortality monitoring system (EuroMOMO) showed “all-cause excess mortality” in the 24 participating countries – including Malta.

The implication is that Malta, as well as other countries in Europe, is attributing deaths related to coronavirus to other causes, resulting in under-reporting.

The Health Ministry stopped publishing the annual mortality report after 2015, medical professionals told The Shift.

“All-cause excess mortality above the expected has been observed in recent weeks in Belgium, France, Italy, Malta, Spain, Switzerland and the United Kingdom. The excess was mainly observed in the age group of 65 years and above,” the disease prevention centre said.

The figures released this week came just as the Maltese authorities announced on Wednesday the first two deaths related to coronavirus in 24 hours. Both patients were over 65 years.

During the daily COVID-19 updates, Superintendent of Public Health Charmaine Gauci said on Thursday that both patients – a 92-year-old Gozitan woman and an 80-year-old Maltese man – had underlying health conditions before contracting the virus.

Yet, a number of concerned Gozitans approached The Shift, saying they were worried about the way the situation was being handled at the Gozo Hospital especially because of elderly patients.

In fact, during Thursday’s press conference, Gauci was specifically asked to confirm that three nurses and a number of helpers had tested positive at the old people’s ward, Sant’ Anna at the Gozo Hospital. Gauci did not confirm or deny – she only explained the preventative measures taken for people working in the medical sector.

The question confirms the information given to The Shift from several Gozitans who are extremely worried that the authorities are not giving a clear picture. Some have even turned to Facebook to express their anger.

This criticism is not the first aimed at Steward Healthcare since the pandemic – the government has had to issue a call for a pre-fabricated hospital to be built close to Mater Dei and it is not yet clear when the new air ambulances connecting the two islands will start.

On Tuesday, Gozo Shadow Minister Chris Said told The Shift that the situation at Gozo Hospital could have been avoided if the relocation promised by Gozo Minister Clint Camilleri last month had gone ahead. The patients at Sant’ Anna had to be moved to a separate location away from the hospital to reduce risk.

Said criticised the government and the Gozo Ministry for failing to implement a series of measures to prevent the spread of coronavirus – especially in the elderly – by relocating them outside the hospital.

Health Minister Chris Fearne was asked about the relocation of Sant’ Anna’s patients during a press conference where he announced the death of the Gozitan patient. “Ten days ago I made arrangements with Gozo Hospital and Steward Healthcare to move the elderly,” he said.

The agreement was for the move to take place in mid-April. “I spoke to Steward Healthcare and the patients will be moved in the coming days – the plan has not changed,” Fearne explained.

There was no explanation on why this failed to happen, resulting in the death of a patient in Gozo.

The European Centre for Disease Control highlighted that there were several reports of COVID-19 outbreaks in nursing homes across Europe. In Bergamo, Italy, long term care facilities reported around 600 deaths among 6,400 residents during the past 20 days and 2,000 out of 5,000 staff were absent because of illness, quarantine or isolation.

In France, more than 3,000 coronavirus cases were been reported in 511 nursing homes, which led to 254 deaths among the residents. Similar reports from the Netherlands, Belgium, Germany and Sweden highlighted the vulnerability of the elderly in long-term care settings and the importance of infection control measures to protect the vulnerable population in nursing homes, the report said.

The centre emphasised that it was essential to introduce and maintain measures to slow down the spread of the virus in the population to allow healthcare systems to put higher capacity measures in place to absorb more severe COVID-19 cases while responding to other health needs.