Record number of covid cases: but don’t panic

Yesterday, specialists explained to government officials and the country what is currently happening with Omicron, and what the near future holds.

Not all of what was said at the Infarmed meeting is good news, but that doesn’t mean a return to tighter restrictions. In fact, it is the opposite, experts recommend a relaxation of the current measures to combat the Covid-19 pandemic.

In an article by Catarina Warrior of CNN Portugal, the government aim to reassure public doubts based on what was said at that meeting.

1. Are we going to get to 130,000 cases a day?
These scenarios, which indicate between 40,000 thousand and 130,000 cases of covid-19 next week, “are projections conditioned to certain characteristics”, explains Baltazar Nunes, from the Doctor Ricardo Jorge National Institute of Public Health. “That is, they depend on the effects that the reduction in contacts, as a result of the containment measures applied in recent weeks, will have on the incidence and also on the loss of protection of the vaccine that will occur,” he explained. Thus, according to Baltazar Nunes, if there is a decrease in contacts of around 30%, there will be a reversal of the trend and the incidence will start to decrease, then remaining on a plateau. Otherwise it will continue to rise.

In addition to the reduction in contacts, it is necessary to look at the level of vaccination that will be achieved and the loss of protection provided by the vaccines. The expert says that the breakdown of immunity has an impact on what will be the future of this wave. “There are three loss of protection scenarios,” he says, explaining that each corresponds to different values ??of case estimates, ranging from 40,000 to 130,000 daily cases. In the best scenario, protection remains at 95% for severe disease and 70% for infection, and in the most severe it goes to 88% for severe disease and 30% for infection. On the other hand, considering that the value of people who have to stay in confinement as risky contacts “is triple” that of those infected, Baltazar Nunes believes that between 4% and 12% of the population may have to remain in isolation already in next days. At this moment, and according to all experts, Portugal has historical values ??of cases and incidence. There is a growth of 12% per day. According to estimates presented at the Infarmed meeting,many cases but fewer admissions . And that’s good, very good.

2. Do vaccines protect from hospitalizations and death from Omicron?
“Vaccination has remained effective in reducing the risk of hospitalization and death”, guaranteed Pedro Pinto Leite, from the General Directorate of Health. According to experts, the incidence of covid-19 in the country is, at this moment, at a historical maximum, having increased in all age groups. And this situation is increasing hospital admissions, especially in the ward (but at levels below those of a year ago). According to data from Pedro Pinto Leite, in Lisbon, where Ómicron first began to spread, it has already caused a 50% increase in admissions. However, the risk of being hospitalised, particularly in people over 50 years old, is two to six times lower in those who have full vaccination.
“The risk of hospitalization remains lower in groups with complete vaccination compared to those who do not have it”, guaranteed the specialist. In other words, and according to the expert, people over 50 who are not vaccinated run a risk two to six times greater of going to hospital when they get sick with covid-19. And as for the risk of death “it is substantially lower in those who have the complete vaccination schedule”. In people over age 60, the risk of dying from covid is three to five times lower than in people who are not vaccinated, according to graphs presented at the meeting.
In people over 80, the situation is even clearer. Data presented show that for every 100 elderly people who were not vaccinated or who did not have full vaccination 27 died, that is, one in four lost their lives. With vaccination, this figure rose from eight to nine deaths per 100. The booster dose, on the other hand, improved the situation even further, making only one in 20 at risk of death.

Ana Paula Rodrigues, from the Doctor Francisco Jorge National Institute, also underlined that one of the factors that is contributing to the current lesser hospitalization is “the immunization given by the vaccine”. And she recalled a study according to which the two doses of the vaccine can avoid the risk of hospitalization at values ??ranging from 52% to 72%, depending on the time that has passed since the moment of vaccination.

Experts also recalled that vaccination is responsible for the low numbers of deaths and admissions to intensive care units, when compared to the vacancy in January last year. According to Pedro Pinto Leite, at the moment “the number of deaths is 19 per million inhabitants, less than the 20 defined as a reference by the European Center for Disease Prevention and Control”.

3. Did 20-year-olds spread Ómicron in the country?
“The great dissemination of Ómicron had to do essentially with the age group from 20 to 29 years old ”, explained scientist João Paulo Gomes, explaining that, unlike other age groups in the last two weeks of 2021, in the group of young people among 20 and 39 was the only one where the percentage of Omicron already exceeded that of Delta. In all other age groups, Omicron had not yet surpassed the previous one. Currently, it is among the youngest that Omicron continues to have greater weight. According to Pedro Pinto Leite, “the age group between 20 and 29 years old remains the one with the highest incidence”, with 3784 per 100,000 inhabitants, followed by 40 to 49, with 2921 per 100,000, and 30 to 39, with 2920.

4. Is Omicron more transmissible but less severe?
“The data generated by the scientific community at lightning speed allow us to understand why this variant is more transmissible and less severe”, said João Paulo Gomes , thus confirming that, as suspected, Omicron is more contagious but less serious.

It became more transmissible due, explained scientist João Paulo Gomes, to the changes that exist in the structure of the virus with Omicron. This variant “has more mutations in the binding area to our cells”, which facilitates the entry of the virus into the body. Furthermore, the changes have given Omicron a higher rate of replication in the upper airways, which generates more aerosols – which result from sneezing and coughing. “And it also has a greater capacity to escape the immune system”, notes the specialist.

Baltazar Nunes also recalled that the high value of the R – which indicates how many people will be infected by a positive case – that is seen in the country is a sign of the strength of the transmission of the new variant. But if it’s more contagious, studies indicate it’s less serious. João Paulo Gomes guarantees that there are studies that have discovered three facts on this subject. The first is that Omicron is 70 times faster in the upper airways but 10 times slower in lung cells. The second, and based on a study by the University of Cambridge, it was found that Omicron cannot enter the lungs because of a protein. In other words, “Omicron has less affinity with proteins that exist in the lungs and do not exist in the airways”, which is why it can enter more easily. In this way, it becomes less serious, as it has less capacity to multiply in the lungs, he explains.

Third, in animal trials, more precisely on hamsters, it was clear that those infected with the Omicron variant had less damage than those who received the Delta or other variant.

5. What is the impact of the booster dose on Omicron?
“The effectiveness of the vaccine against hospitalisation in the Omicron variant after the booster dose reaches high values of around 88% “, guarantees Ana Paula Rodrigues, from the Doctor Ricardo Jorge National Health Institute (INSA), explaining that everything depends, among other factors , on each person’s age. With regard to its effectiveness in preventing infection, the scientist says that the values ??are between 40% and 70%. Although the protections are generally inferior to the Delta variant and immunity drops more quickly, with the booster dose this protection increases a lot, says the expert.

6. Will the SARSCov-2 infection become mild?
“No”, says Ana Paula Rodrigues from INSA, explaining: “We expect a different pattern from this wave with a high disease burden, high prevalence and incidence, but a lower weight of the most serious infections. But that doesn’t mean we’re going to have a mild infection. That’s not it, as we are talking about an infection by an agent that is a serious infection”. According to the specialist, this wave with this variant is “more benign than the one we had before”.

7. Will the pandemic end now?
“The announcement of the end of the pandemic is capable of being quite exaggerated.” It was with this sentence that Henrique Barros ended his presentation on the theme “The end of the pandemic? Certainties and uncertainties”. Stressing that the virus will remain present in society, the specialist considered, however, that with vaccination and testing, the time has come to change. The expert says he believes that the virus is no longer such a serious threat, that it is necessary to return to daily life and calls for the number of new cases to be stopped every day : “There is no reason for us to continue to reason in terms of number of cases and much less measuring the evolution of the infection and the risks it poses to us, counting the cases daily as we did until now”.

See the original article in Portuguese, at CNN Portugal