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Guide to the seventh wave of COVID: “I don’t know if we’ll get it all, but almost”

The third summer of the pandemic has begun, but for most it will be a normal holiday. The collapse that plagues travelers will be at airports, not hospitals. Waves that can ruin your plans will be heat waves. Big music festivals and Sanfermins are back. However, now and always, the coronavirus is still here. After several false alarms this year, a clear seventh wave has arrived and given COVID-19 back some of the visibility it had lost in recent months. Once again, we want to know what SARS-CoV-2 has to offer. It happens for the first time in the absence of preventive measures.

“There is a lot of transmission. As much or more than in the middle of the sixth wave,” FISABIO researcher Salvador Peiro assures “I don’t know if we’ll all be infected, but almost.” He believes that the removal of social distancing measures and the return of crowds will make the seventh wave “very fast”, which will “start to decline in a few weeks due to the depletion of susceptibles”. In fact, the latest data reported this Friday shows a decline in hospitalizations among people 60 and older for the first time since early June.

For now, ICU admissions remain at a minimum. “For the existing transfer, there is very little hospitalization and less ICU,” reassures Peiro, who thinks that the latter is “somewhat separated” from the rest of the receptions. People hospitalized for COVID-19 “are, on average, less severe, with less pneumonia, fewer episodes of lung inflammation, and less need for ventilators.” Remember, though, that “many infections lead to many hospitalizations.” This new push of infections has its own characteristics:

Comparing data, countries and waves has not been easy – or even possible – since the pandemic began. And yet it gets easier and easier. Adding to the lack of data is the fact that high cases have less and less impact on the health care system, and that accidental hospitalizations—those in which the primary reason for admission is not COVID-19—represent a higher percentage. They are not easy to measure, but to trivialize them is a mistake.

Peiro explains that in the hospitals of Valencia for which he has data, accidental hospitalizations represent “between 40 and 60%” of the total over several months. He claims that the fact that some operations are no longer suspended despite SARS-CoV-2 positivity has increased this percentage.

These numbers are good news, but they also need nuance. Peiro explains that accidental hospitalization is something “very subjective” due to the lack of a clear definition. He also remembers that the coronavirus “always worries” him, even if he is not the main character. “Because of the isolation and the covid zone, it occupies many beds, blocks the admission of other patients, complicates the organizational aspects. Even the mildest cases complicate the daily activities in the primary care and emergency room.” It should not be forgotten that SARS-CoV-2 can worsen the condition of a vulnerable person, even if this was not the reason for their admission.

Although the lack of case data has been criticized, Peiro believes that what is missing is the information that really matters whether action is taken or not. “We already have an idea of ​​transmission, although we don’t have accurate data, but surprisingly we report data every three days that are too small to make decisions and we barely know the severity. cases, their age or mortality – which also has many cases – and this is the key to decision-making”.

By the end of 2021, variants of SARS-CoV-2 made life miserable, but it was still easy to identify yourself. “British variant” -later Alpha-, Beta, Delta… and then came Omicron. This last branch made it difficult to communicate with BA.1, BA.2, BA.4, BA.5, BA.2.75… and the public stopped paying attention.

The World Health Organization explains that the original Omicron was a Variant of Concern (VOC), so All descendants are descendants as well. However, the question arises as to whether the new Greek letters or names should be used, even if it is to facilitate communication to the public.

“I don’t think it’s still necessary to give it a new Greek letter, because the phylogenetic trees, although they form their own group because they have differences, are still in a large group of omicrons,” explains the virologist of the National Center. Microbiology Maria Churches. “I suppose they could still be omicrons, and indeed they are.”

At the moment, BA.2 – in decline – and BA.4 and BA.5 – by autonomous community – are the most common in Spain. Iglesias explains that these are the branches to watch out for, but “without any particular alarm” from the public. “As always, those of us who are dedicated to surveillance will have to continue to characterize and monitor the strains circulating as part of our normal routine if something very relevant emerges, but so far the vaccines remain effective in severe cases,” he says.

To this situation we have to add the variant BA.2.75, which has received a lot of media attention, even though it is hardly found outside India at this time and it is not clear that it can prevail over the dominant BA.5. . The reason is almost comical: Spanish Twitter A catchy name came out“Kentarus” that can grab headlines.

Iglesias asks for calm and patience due to the lack of data on BA.2.75. “It does have a certain impact peak that might be interesting to monitor, but we still have to see how it develops at the level of transmission and circulation in the community.” Spain, at the moment, has not seen this option on its borders. “Centaurus,” as other unofficial variant names such as “devil,” “deltacrón” and “delta plus” have been, has a marketing push, but it remains to be seen whether it will achieve biological success.

In recent days various media outlets have christened the BA.4 and BA.5 variants as “The most contagious viruses known to man“This is a title that has already been shared in one way or another BA.2, Original Omicron and also Delta. Is it possible that each new variant is more contagious than the last? If new variants continue to emerge, will SARS-CoV-2 continue to break this record forever?

The basis of this misunderstanding lies in Article In which the researcher calculated that the R0 – the average number of cases produced by each infected person – was greater than 18. “We killed R0 based on bad science,” criticized epidemiologist Adrian Aguinagalde. on Twitter. One reason is that this known number is used in populations that lack prior immunity, making it difficult to apply in 2022, when most people are vaccinated, infected, or both.

“Just because something has a 50% ‘growth advantage’ in a population doesn’t mean it’s 50% more ‘contagious,'” the Emory University biostatistician explained on Twitter. Natalie Dean. And the key: “Part or most of this advantage may derive from immune evasion.”

All viruses evolve with their hosts’ immune systems in an endless arms race. Each winning SARS-CoV-2 variant follows the same cycle: it grows in number, dominates the others, and eventually begins to decline before changing.

In this process, population immunity plays an important role. Therefore, the variants do not compete on equal terms: when the “young” and the new version appear, the previous one is already “old”, accumulated negative mutations and fought the immune system of a large part of the population. The fight is not fair and the new version prevails. In fact, we don’t know what would have happened if both of them had seen each other’s faces at the same time in their youth.

As a result, it is impossible to conclude that each new variant is more contagious. of course than the former, only that it has an advantage in a certain moment and context. Otherwise, in a few years, the Omega variant would be hundreds of times more contagious than the Omicron, and the coronavirus would break the record for the most contagious virus in history for the second time in a row.

Epidemiologists, doctors, immunologists, and even engineers were consulted about masks during the pandemic. We know they work, but we also know that public health decisions must be made in a sociopolitical context that goes beyond scientific articles. documents. Today, masks are recommended indoors and in public, but could they become mandatory again in mid-2022?

“Masks were the most accepted protective measure by Spaniards, less problematic and more consented, probably because they are less invasive and expensive,” explains Igor Sadaba, a sociologist at the Complutense University of Madrid, based on 2020 data. He believes that “not requiring so much effort” has become very common, understood as “the possibility of self-defense and civil solidarity with others.”

That was in 2020 though. “The pandemic and the measures taken have caused extraordinary fatigue, exhaustion, mental and social exhaustion. We were not used to this, which has not happened before, and we have also normalized the virus, and many believe that these measures are not necessary, no matter how recommended they are,” Sadaba continues. He believes that the “chaotic” rules of consumption did not help the population to understand the use of the mask.

For this reason, the sociologist finds it difficult to commit to returning during the remaining period of the pandemic. “In my opinion, reintroduce the mask [obligatoria] It would be possible, but we would have to see a very high-risk situation, because otherwise we would live in a world of picaresque and exceptions. ICU, it is unlikely that this scenario is achieved.

Does this mean we can forget about COVID-19? “There is a disconnect in the perception of the risk posed by COVID-19 between the scientific community, political leaders and the general public,” said the WHO committee that decided Maintain a public health emergency of international concern. The pandemic is not over yet, but everyone hopes that it will soon give us a break before the cold returns.

Source: El Diario





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