IDOIA ALBERDI ETXANIZ | EITB AVERAGE
The covid-19 pandemic has shown, even more if possible, the importance of scientific dissemination. Ana Galarraga Aiestaran has been in this work for years from the Elhuyar Foundation and explains several keys to understanding the new scenario of the pandemic.
Given the current situation and scale of the pandemic, there has been a general interest and need to know and be informed about the covid. The incidence rate, the number of positives, hospital admissions, the reproduction rate … data and more data on covid-19 that have made headlines since the beginning of the pandemic and that draw different graphs. They arrive every day from different sources and we want to know reality quickly.
The latest indicators place us in a new wave of infections, but how should we interpret these numbers in the current scenario? What has changed compared to a year ago? What do the ascending lines of the graphs tell us? Where should we fix our gaze? The scientific communicator of the Elhuyar Foundation Ana Galarraga Aiestaran (Zarautz, Gipuzkoa, 1970) clears up some of these doubts.
It is important that in both the pre-vaccination and post-vaccination scenarios, there are two keys to understanding and interpreting the information correctly: quality data and adequate communicationa, two factors that are often failing, according to Galarraga.
· Almost nine out of ten of the citizens are vaccinated and, nevertheless, the transmission of the virus does not stop. What’s going on?
As has happened with many other factors, I believe that with the vaccination there has been a communication error. In fact, when vaccination began, it was set as a goal that 70% of people over 18 years of age must be vaccinated to achieve herd immunity.
Group immunity means that vaccinated people act as a barrier and are able to cut off the passage of the virus. But, it turns out that this is impossible with this virus and with the vaccines that we have today. On the one hand, we are facing a virus whose transmission is very fast and strictly complying with all preventive measures is very difficult. On the other hand, the vaccines we have are not sterilizing, that is, they do not prevent infection. They are very effective in preventing serious infection, they were designed to do so. But from the beginning it was known that they were not going to end the broadcast. However, they do make that transmission more difficult: they make infection more difficult and the infected person, if vaccinated, overcomes the infection more easily, so they are not as contagious as if they were not vaccinated. What is the difference in the latter case? Well, if an unvaccinated person is direct contact with an infected person, they must be isolated. In the event that it is vaccinated, it is not isolated and the transmission of the virus can continue.
· Incidence rate, reproduction rate, hospital admissions … Where should we now fix our gaze compared to previous waves and how should we interpret the data?
When establishing the measures, a year ago and now, in addition to incidence, two other variables were taken into account: hospitals and ICUs. With vaccination, the relationship is not so direct, but the trend is similar: if the incidence increases a lot, there are more viruses circulating, so there is a greater risk of reaching vulnerable people. They are the ones that will then (approximately 10 days later) arrive at hospitals and ICUs.
Therefore, incidence continues to be an indicator and, if it increases, measures should be taken, but perhaps not for the entire population, but rather preventive measures to protect the most vulnerable groups. The correct interpretation of the data requires, first of all, to have quality data. And we don’t have them. To know the incidence, for example, it is essential to carry out a test on each of the direct contacts, and it is obvious that the tracking that is being done is not enough. In any case, and for comparative purposes with last year, I consider that the most significant data is the hospitalization rate (hospitalized / infected), and the effectiveness of the vaccine is evident there. Therefore, in my opinion, we should know the following data: how many of those hospitalized and admitted to the ICU are vaccinated and how many are not, and make a comparison on different age groups. For example, this image is very significant:
In fact, we already knew that, once vaccination was generalized, the majority of those admitted for SARS-CoV-2 infection would be and are vaccinated. This does not at any time call into question the efficacy of vaccines. In addition, the 3rd dose is being very effective in protecting the most vulnerable.
· While the vaccination rate in developing countries is very low, in the so-called first world, children under 12 years of age will be vaccinated. Does this decision make sense?
I think that dichotomy is false. The fact that we refuse to be vaccinated will not cause these vaccines to be sent to those countries. This requires other types of agreements and strategies, such as the COVAX plan. But it is true that the priority should be that, both for ethical and epidemiological reasons.
And, also in our case, I think that before vaccinating children, the priority should be to vaccinate those who are not vaccinated. Most of the unvaccinated are in the 30-40 age bracket. They have a lot of social life, they are both with children and adults and they are very mobile. They are key, therefore, in the transmission. The focus should be there.
Finally, from the individual point of view, it will not bring any benefit to children because the virus is not harmful to them either, but it will help them to be able to lead a normal life at school, at games, at the sport … and that is especially important in the case of those who are in a precarious socioeconomic situation, because they have fewer resources and if these activities are suspended they suffer more. In addition, from an epidemiological point of view it will help cut transmission.
· Is the covid certificate an effective measure for prevention?
Something similar to what happens with childhood vaccination occurs with this issue. It can help, but there are other more effective measures that should be taken before: monitoring ventilation, placing CO2 meters and adopting protocols for different results, placing HEPA filters, reinforcing public transport, ensuring prompt confinement thanks to rapid control of contacts, offer help to people who due to confinement are going to suffer problems or job and / or economic losses, the mandatory nature of indoor masks and their free use, the standardization of tests in closed and controlled places such as schools, universities, companies, gyms, leisure centers etc …
It is true that ensuring that all of us who are in a closed place are vaccinated gives a certain peace of mind, but it can also be a relaxation.
· In the current scenario, what are the most effective measures to stop infections?
They haven’t changed much. It is clear that crowds are to be avoided and that it is safer to gather in small, close groups. Along with this, and knowing that the coronavirus is transmitted by aerosols, the mask is essential in closed places. In the street, alone, there is no danger. And the vaccine, of course, is essential.
· The omicron variant: is the alert justified? Are current vaccines effective against this variant?
The effects of the mutations it contains on both transmission and symptoms, the effectiveness of treatments and the protection offered by vaccines are still being investigated.
In any case, I believe that it has not been treated in a correct way, neither communicatively nor politically. Rumors are contrary to scientific thinking; that is, without scientific evidence nothing can be said. Keep in mind that it is easier for a lie to spread than to deny it later. Politically it is not fair to close the door to southern Africa, because they have done their job, detect it and communicate it, and, furthermore, we now know that before the warning came from Africa, the variant was already in Europe. Therefore, that decision has no scientific basis either.
· What could we call group immunity today?
The message has to be this: the more people are vaccinated, the more protected the most vulnerable will be. There are no 100% effective drugs, and no vaccines. Along with this, we must try to keep the incidence low so that the virus does not mutate and does not reach the most vulnerable people.
This virus affects us all but not to the same level. Socio-economic conditions such as age, income, housing, migrant status, gender, profession, ethnicity … are tremendously determining and we should demand policies and practices aimed at overcoming the huge gaps that are being created. Instead of thinking only of oneself, the person should think of the community and act on it. If not, this crisis will leave wounds that cannot heal. And more will come. That is why the One Health strategy is so important. We must take care of our health as well as that of the environment and animals.