Mortality rates in Spain were 55% higher than usual between March 10 and May 10, the country’s top coronavirus health ministry official said Wednesday.

“This excess of 55% represents more than 43,000 deaths than what is expected,” Fernando Simón, Spain’s director of the center for health emergencies, said. “That mortality was centered in people 75 or older,” accounting for 35,000 of the total excess figure.

However, only 27,118 of those additional deaths are linked to Covid-19. A “significant part” of the more than 43,000 deaths between March 10 and May 10 “cannot directly connect to Covid-19 yet,” cautioned Simón.

“If we count the deaths with coronavirus and compare it with the excess, there’s still a significant number of deaths left that could be explained for several reasons,” he added.

Among those reasons could be an inability or unwillingness to go to a hospital or get medical assistance during the peak of the coronavirus outbreak, Simón said.

“We may have also witnessed some complications in some health centers that didn’t favor survival during a longer period for some of our elderly,” he added.

A number of senior care homes in Spain reported unusually high mortality numbers during the height of the pandemic, but most of the deceased were not tested for Covid-19.

The numbers are emerging now, Simón said, because the country was under strict lockdown during the height of the epidemic, and notifications of deaths may have been delayed due to registry workers not being able to go to their offices — leaving many deaths tallied without a detailed analysis.