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> but I thought they were incredibly hardened, with backups and contingencies in depth

Some are harder than others, and some have random flaws which nobody can really predict.

Spain seems in the transition to renewables, so it's possible that they have some flaws because they are still in the process, or because it's something which never happened before and is unknown territory. Also, Spain had some economic problems in the last decade, maybe someone build to cheap or was even cheating somewhere.

> Are the grids at this scale really this brittle? Would there be a death toll from this?

Hospitals should have backup-systems. Traffic should be able to stop in time. I guess the most problematic parts are people stuck in elevators and other spaces which only open electrical, as also the loss of cellular phone-connections for calling helpers.

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> the loss of cellular phone-connections for calling helpers.

All the mobile phone installations that I saw had power for at least 24-72hrs depending on how far from civilization they were. The carriers have backups and everything.

The problem in these kind of situations is the saturation of the mobile network, not its availability.

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Hardening focuses first on not damaging equipment and second on providing energy. If things go wrong quickly enough you don't have time to react, because after a power plant disconnects you get sudden bumps in load that can trigger a chain failure near the original point. The last time it happened in Europe was in 2003, which isn't too shoddy.
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What Spain's PM is saying (and is being reported by Spanish newspapers), 15 gigawatts of energy production went down all in 5 seconds. Hardening to tolerate that much of a change, that fast is a more extreme event than a grid the size of Spain's preps for.
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To be fair, a big deal of those 15GW probably went down as a result of the initial outage: equipment is designed to intentionally disconnect completely when the grid is behaving badly, rather than trying to force it into submission and potentially causing serious equipment damage.

In reality this means you might lose, say, 1GW due to a transmission line failing, have a big frequency dip as a result, and then have 14GW drop offline like dominoes because they sense a grid frequency outside of safe operating parameters; disconnect as they go into safety mode; cause the frequency dip to worsen; and pull even more plants offline with them. If you're not careful, a small outage can quickly cascade into an entire grid going offline.

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