The sixth wave begins to give up. The epidemiological data of recent days consolidate the decline in the epidemic curve and the Minister of Health, Carolina Darias, admitted this Friday that “all the data indicates that the curve has flattened.” The incidence of infections, however, continues to skyrocket, with more than 3,000 cases per 100,000 inhabitants within 14 days, and the experts consulted call for caution. First, because the case count is irregular and there are communities that do not report the diagnoses resulting from antigen tests carried out in homes, for example. And, in addition, they plan on the pandemic scenario possible spikes in infections due to the appearance of new variants or sublineages, such as the BA.2 of the omicron, which is already gaining ground in countries like Denmark and where, precisely, its epidemic curve has upturned Not everything has been said and the rate of contagion may turn around again, epidemiologists warn.
In the last week, the incidence has dropped by 10%, while the previous seven days had grown by 7%. “All the data indicates that we have bent the curve. All the drop data is being consolidated day by day, but we have to be careful so that these data continue to be like this” stressed the minister during a visit to the Son Llàtzer Hospital in Palma. The Ministry of Health has notified 118,922 new infections this Friday and the 14-day incidence stands at 3,078 cases per 100,000 inhabitants.
The circulation of the virus continues unchecked and our guard cannot be lowered, insists Joan Caylà, epidemiologist and member of the Spanish Society of Epidemiology: “It is very difficult to know where we are because we have several communities that do not collect self-test data. If there are communities that declare well and others, such as Madrid or Andalusia, that have a greater impact on the population and declare less than what they have, it might seem that the incidence is falling, but it would be necessary to see if this is the case. Some communities, such as Andalusia, Murcia, Madrid, the Balearic Islands, Castilla y León or the Valencian Community, among others, do not report the real cases because they do not count the positives that the tests obtained in the pharmacy show. In fact, Andalusia, which with more than 8.4 million inhabitants is one of the most populous regions, only reported 324 cases yesterday, while Asturias (1.02 million) reported 1,867.
For José Martínez Olmos, professor at the Andalusian School of Public Health, a descent of the curve is being consolidated. Despite the limitations, he points out, all indicators point to it. “There is always underreporting, but it is greater since the omicron appears and the volume of cases blocks health services. But even taking into account that things are measured differently, we have indicators to see that the trend is consolidating. Hospital occupancy, for example, has been going down for days and although there is underreporting, that indicates that the curve is going down”. In Spain there are 18,393 people hospitalized due to covid, almost 300 people less than last week. Specifically, in intensive care there are 2,060, while on Friday of the previous week there were 2,202.
The healthcare pressure is contained and far from the figures that were reached a year ago. Around this time, in January 2021, the third wave was raging in the streets and hospitals were close to collapse with 30,700 people with covid hospitalized and, of them, more than 4,600 in the ICU. With intensive care units with less than half the number of patients then, hospitals are now breathing, but the tension continues to complicate day-to-day life in other healthcare areas, such as primary care or emergency services. The Spanish Society of Emergency and Emergency Medicine has warned in a statement that the “overload” of care persists: “The situation in emergencies continues to be critical, with health professionals exhausted and suffering their own medical leave due to covid.”
The unpredictability of the virus and the threat of new variants keep experts on alert. In fact, the Minister of Health admitted this week that a case of the new sublineage of the omicron, the so-called BA.2, had been detected in the epidemiological surveillance network. This subvariant is growing in countries like Denmark, Sweden or India and the scientific community is closely monitoring it, although Darias pointed out this week that, for now, it does not seem more serious or very different from the majority lineage of the omicron that circulates around the world. .
Preliminary Danish data suggests that BA.2 is 1.5 times more contagious than the classical subtype of omicron. Magda Campins, head of Epidemiology at the Vall d’Hebron Hospital in Barcelona, is cautious: “We recently detected this subvariant and we have to wait. In terms of behavior, it seems that it will be the same. The data from Denmark does not see it behaving in a more serious way, but even if it is, the number of cases will increase and we can have another increase in incidence and put ourselves in tension again ”.
Asturias has also reported this Friday its first case of this subvariant of the omicron in an unvaccinated woman between 40 and 50 years old. Mario Margolles, coordinator of the health area of the General Directorate of Public Health of Asturias, has announced that he will reinforce “the search for similar strains around the initial case and in the community to determine the real prevalence.” “We hope that it will spread more frequently, but regarding the clinical situation, it seems to be of a mild nature and very infrequent of infections of a serious nature.”
With an uncertain epidemic scenario in the short term, the communities are beginning to make a move. Some, in favor of lowering restrictions and others, more conservative, are committed to maintaining severe control measures for a few more weeks. Catalonia, for example, which applied the harshest limitations before Christmas, has been opening its hand and, except for the closure of nightlife, which maintains it, has already lifted the curfew, the limitation of meetings to 10 people and limited capacity in restaurants and theaters. Galicia and La Rioja have also relaxed measures in the restoration and Cantabria, like the Catalan Government, has withdrawn the use of the covid passport to enter certain public spaces.
Navarra remains more conservative, which has extended its restrictions until February 14 and maintains the use of the covid passport. The Basque Country also extends its measures, such as the closure of the hotel industry and commercial and leisure activity at 1:00, until February 13 and has requested the endorsement of the justice system to continue using the covid certificate. In the Valencian Community and in Andalusia, the justice has endorsed extending the mandatory covid certificate to access some public spaces. The Interterritorial Health Council, where Health and the communities are represented, also agreed this week to extend the limited capacity in mass sports competitions: the maximum occupancy will be 75% in open events and 50% in closed spaces.
Caylà considers that the measures in force in Spain are “very lax”: “If we don’t take great care, Easter and summer can be complicated again. We should not be satisfied if we manage to lower the incidence to 500; we would have to have it in 50 cases per 100,000. We must strive to maintain measures to quickly lower the sixth wave and avoid a seventh.” And he is committed to “easy” measures, such as teleworking or expanding the use of the covid passport: “It was a pity that this measure, which is relatively easy to apply, was not more successful in Spain.”
Martínez Olmos admits that, although it is foreseeable that the epidemic curve will continue to decline, “it will not be as fast as if there were restriction measures.” And, although he assumes that, from the perspective of public health, “this is not the time to reduce restrictions”, he points out another element to take into account: “The feasibility of the measure: there is also fear that they will not be extended by the higher courts of Justice”.
For her part, the Minister of Health continues to defend the mandatory mask on the street for as long as necessary and does not specify a withdrawal date, but advocates advancing to another phase of the pandemic with a change in the case surveillance system. More similar to the flu, instead of counting case by case, for example, a series of sentinel centers would be in charge of reporting a sample of cases to estimate the real viral circulation. Darias has indicated that she is working with the communities on a new system to move “from emergency surveillance to surveillance by objectives and of higher quality,” she said this Friday, reports Lucia Bohorquez.
Nursing homes
The sixth wave has also fully entered nursing homes, which have been on the rise for weeks, although vaccination has curbed the worst face of this virus and deaths remain relatively contained. According to the Institute of Social Services (Imserso), in the week from January 17 to 23 (the last one for which data is available), 12,850 infected elderly people have been reported, while in the previous week there were more than 14,000. As for the number of deaths in those seven days, Imserso reported 215, 15% more than the previous week. Such a high number of weekly deaths had not been reported since the beginning of February 2021, when 352 were counted in the week of February 8, although in that wave (the third), they were reported, with far fewer recorded infections (close to of 3,000), 788 deaths of the elderly with covid in a week at the end of January.
In the global count of deaths throughout Spain during the pandemic, the official figure collected by the Ministry of Health amounts to 92,966. This means 1,225 more deaths than those reported last Friday. The previous seven days, between January 14 and 21, 982 deaths were reported.
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