review of the situation in Spain and in the world

The seventh wave of coronavirus grows strongly in Spain. The pressure on hospitals is increasing and the incidence in those over 60 years of age is close to reaching 1,000 cases per 100,000 inhabitants in the last 14 daysthe maximum since the Ministry of Health established it as the only measure of the current expansion of COVID-19 at the end of March.

The minister, Carolina Darias, has asked for “prudence” this Friday and has recommended the use of the mask indoors due to the increase in infections. The sublineages of the omicron variant –two in particular, BA.4 and BA.5– they appear to be responsible of this new wave of the pandemic. Waiting for the administration of the fourth dose and new vaccines that stop the immune escape of the successive variants, experts urge extreme caution With the holidays just around the corner.

The rate of new admissions, at maximum

The latest Health data shows that around 450 people are admitted, which places the ICU above 5% occupancy, in ‘low risk’ for that indicator with the new coronavirus control strategy. In addition, more than 10,000 are hospitalized, leaving the plant saturation close to 8.5%, at medium level.

The Rioja is the region with the most stressed intensive care units in Spain, with a 11.3%, double that at the national level, which places it in the middle level. Six communities are above 5%, at low risk, with Catalonia and Madrid in the lead.

Although these data are still far from those of the previous wave, the Christmas wave – there is a certain consensus that the increase registered in May should be part of the current wave – it is pertinent to remember the indicator that brought with it the new control strategy of the coronavirus: the rate of new hospitalizations.

This rate, which shows the rate of new admissions per 100,000 inhabitants in the last seven days both on the ward and in the ICU, is crucial for find out how fast hospitals are filling up and, as shown below, they are at their highest since the new strategy was launched.

The incidence of people over 60, on the rise

Since the end of March, the Health statistics they only compute the cases registered among those over 60 years of age and the most vulnerable groups. This Friday, more than 136,000 cases were recorded compared to the previous week and there are already more than 12.8 million officially registered throughout the pandemic.

With 996 cases per 100,000 inhabitants until last Tuesday, the rate exceeds the maximum of May of this year with the new system, when 857 infections were recorded. By communities, there are already ten that exceed 1,000 cases, and two of them have exceeded the 1,500 barrier, Madrid and La Rioja, which places them at high risk for that indicator. Only Andalusia remains at low risk, with 365 cases.

Although the data is already high, the reality is that the new strategy leaves out the rest of the positives. Currently, confirmed cases of coronavirus are not reported to the health authorities even if those infected go to a health center, and the reality is that many people pass the disease at home or go to work if the symptoms do not prevent them.

Given this public and statistical invisibility of the pandemic situation, an informal indicator that this reality exists is Google searches, which reveal that queries on the internet about covid symptoms have skyrocketed againas has already happened in other periods.

Despite this increase in cases, the truth is that most of them are not serious. However, health professionals remind once again that, although the symptoms are largely mild, the arrival of the holidays and increased mobility do not help keep the virus at bay, but rather overload the system and prevent continuing with the usual health activity. “The more cases we have, the more chance there is that, even though we have fewer serious cases, there will be a higher number. [de esos casos graves]”, explained to TVE Amós García, head of Epidemiology of the Government of the Canary Islands.

COVID cases rebound in people over 60

For the moment, this rebound has not translated into a considerable increase in deaths, although it must be remembered that between the rise in cases, admissions and possible deaths there is a gap of between two and three weeks. In the last week, 312 deaths have been reported, and there are already more than 108,000 deaths in Spain from coronavirus.

On this point, the doctor and epidemiologist Daniel López-Acuña reminds DatosRTVE that “the excessive mortality that has occurred over these six months in Spain has been of great importance”. With data up to June 29, the daily mortality monitoring system for all causes (MoMo) counted nearly 12,000 excess deaths compared to what would be expected. López-Acuña does not rule out reaching a figure similar to that of 2021 in 2022, around 24,000 deaths.

BA.4 and BA.5, the sublineages in the spotlight

If the omicron variant was responsible for the explosion of cases last Christmas and continues to be the dominant one in Spain, its different sublineages are marking the successive waves of the pandemic. If to date BA.2 was the majority, BA.4 and BA.5 are now setting the pace.

The Ministry notes that the “ability to partially evade the immune response generated by vaccines and previous infection […] could be associated with an increased incidence of cases”. “According to data derived from genomic surveillance, BA.5 is the one with the highest expansion rate,” the report continues, but for Health “the risk associated with these lineages is considered low”.

COVID cases and hospitalizations rebound strongly

Despite this, experts ask that the guard not be lowered and that the new vaccines be adapted to the new variants and sublineages. Despite the fact that the fourth dose for the most vulnerable population has already been approved, the deadlines for its administration are still unknown, a situation that Daniel López-Acuña urgently asks to reverse. The also associate professor of the Andalusian School of Public Health demands that those over 80 years of age and people living in geriatric residences be vaccinated, since “they were the first to be vaccinated and in whom the effectiveness of the immune protection conferred by the vaccine has been diminishing”.

And although Health confirmed a few weeks ago that there would also be a fourth generalized dose for the entire population, the volume of booster punctures in groups under 50 years of age remains low. López-Acuña recalls that 15 million people in Spain have not come to their appointment to receive the additional dose.

Spain, a reflection of what is happening in the world

The upward trend in Spain reflects what is happening in the rest of the world. According to the latest report from the World Health Organization (WHO) and data monitored by Johns Hopkins University, the curve of cases, which has been declining since March, is growing again, especially in Europe.

The WHO has counted between June 20 and 26 more than four million positives in the last week, bringing the total number of infections to more than 545 million worldwide since the pandemic broke out. By region, together with Europe –and specifically the countries of the European Union–, Oceania is also experiencing a very pronounced rise in the contagion curve.

Hans Kluge, the regional director of the WHO in Europe, confirmed to the AFP agency that “the virus will circulate at high levels during the summer”, when a large part of the countries have lifted social protection measures. “We must continue to track the virus because the opposite makes us increasingly blind to the modes of transmission and evolution,” Kluge summed up.

The former director of Acción Sanitaria Daniel López-Acuña agrees and regrets that measures such as the removal of masks indoors or the isolation of positives were hastily eliminated. “What we have been seeing as part of public discourse and social pedagogy is a trivialization, an eagerness to want to think that we can get the flu and end the pandemic when we are precisely in a situation that requires us not to let our guard down”.

As for the deaths, the levels remain stable compared to recent weeks, so the increase in infections worldwide does not seem to be causing a high number of deaths, at least for now. However, Hans Kluge warns of inaction: “The virus is not going to disappear just because countries stop monitoring it. It keeps infecting, it keeps changing and it still kills”.

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George Holan

George Holan is chief editor at Plainsmen Post and has articles published in many notable publications in the last decade.

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