Should we be alarmed by the increase in covid infections?

BarcelonaInfections are growing and Catalonia is once again experiencing a wave of covid, the seventh in just over two years. Most of the cases are not registered because, by protocol, the tests are only carried out on people over 60 years of age and the positive tests bought in pharmacies have ceased to be counted. Knowing how the pandemic evolves is now more difficult than ever, but there is indisputable evidence to identify a significant increase in infections: primary care is making more visits again and hospitals are treating more patients. And this is happening. The counselor of Health, Josep Maria Argimon, doubts that the impact of this onslaught will be similar to those experienced in previous waves, but the demand in crescendo It is coming in summer, when the health system is very affected by staff vacations, especially nurses, who tend to be the most difficult positions to cover. And, according to primary and hospital care professionals, this lower availability of troops adds to the unknown behavior of the variants that circulate, with greater transmission capacity. It is already known that the more infections there are, the more the system is overloaded.

The main cause of the spike in infections in recent weeks can be found in the expansion of the BA.5 omicron subvariant, more contagious than its predecessors. This mutation already represents 60% of the total samples sequenced and in a matter of days it is expected to be the predominant one. However, Argimon does not believe that it involves more serious cases per se and, for this reason, despite the fact that the contagion curve and admissions are on the rise (in three weeks the number of people admitted to ICUs has doubled), the health authorities do not foresee any measure or restriction in the short or medium term that can change the recently reacquired normality. “Contagions have increased, but for now we have to wait and see,” said Argimon, who did admit “concern” about how the new wave combined with vacations for health workers could affect the health system.

Although this year’s conditions are slightly different from other waves, old problems are reproduced. In addition to the vacancies typical of the summer period, sick leave is added. The virus is transmitted freely and health personnel are also infected and sick and have to be between five and seven days off work to avoid becoming a source of contagion in health centers. “There are not enough substitute staff, or the one there is is very tired and honestly cannot make much more additional effort,” explains the epidemiologist at the Hospital Clínic Antoni Trilla to the ARA.

stop testing

Primary care has been noticing an increase in demand for respiratory infections for weeks. According to the latest data from the Catalan Infection Surveillance System, which will be updated this Tuesday, the coronavirus accounts for half of the diagnoses in the last week (about 22,000, 19% more than the previous week) in all age groups. . “We see added pressure between the months of June and September due to the holidays. With reduced staff and without reinforcements, if we have a significant increase in covid, the scenario that is drawn for us is tense ”, explains the CAP Rambla de Sant Feliu de Llobregat doctor and member of the Catalan Society of Family and Community Medicine (CAMFiC ) Jordi Mestres.

The doctor acknowledges that the increase in visits due to suspected covid is not as “exaggerated” as that of last year for the same dates, but he warns of the increase that is taking place among those over 60 years of age, which worries and forces the CAP to carry out a more exhaustive surveillance. Fortunately, the majority of cases that are treated, says Mestres, are mild and he attributes it precisely to the BA.5 variant, but he warns that the more community transmission there is, the greater the risk of vulnerable people becoming seriously ill.

The trickle of infections is already translating, inevitably, into an increase in hospitalizations. Trilla has warned that the impact of the coronavirus is being felt in the plants, mostly by older people with other diseases that are complicated by contagion. In the conventional hospitalization areas dedicated to covid there are 1,383 people, many of them because, in addition to needing cures or an intervention such as emergency or scheduled surgery, they have tested positive in the test that allows the centers to sectorize and avoid nosocomial infections. (outbreaks within the hospital). Instead, in the intensive care units (ICU) Health only records people who are admitted for covid and the data shows that critically ill patients have almost doubled in the last three weeks: if at the beginning of June there were 26, today already there are 46.

However, Argimon has underlined the need to normalize the circulation of the virus and has limited himself to recommending a more rigorous use of the mask in closed spaces among vulnerable people, due to their age or because they suffer from a serious underlying disease. The rest of the population that may suffer symptoms, in addition to asking them to apply common sense (avoid contact with people at risk or wear a mask in case of social interaction), requires them not to saturate the health system. That is to say, that they do not go to the CAP, that they stay at home until they are well and that they take antipyretics. He has also stressed that it would be important not to test at home to confirm or rule out positives. “It is very difficult not to do them because we have been doing it for two years and recommending it. But probably, if you have a fever, fatigue, and a headache, it’s covid. 50% of the viruses circulating today are SARS-CoV-2”, he concludes.

Severity and vaccines: what do we know about the BA.5 subvariant?

The subvariants of omicron BA.4 and BA.5, the second of which is expected to be predominant in a few days, have a very high capacity to infect people who have already overcome covid, also if they were infected with other subvariants of ómicron, and vaccinated with the complete schedule.

Studies suggest that these mutations, which began to circulate in Europe last March, are more contagious than their predecessors because they present changes in the Spike protein (the key to access cells and infect them without being recognized).

Even so, nothing indicates that they cause more serious diseases. At the moment, the data collected in South Africa (where it was detected for the first time) on its severity indicates that it would be even less aggressive than the original omicron or the stealthy one.