An apparently more transmissible variant, which in southern Africa – with less vaccine coverage but also a younger population – is triggering hospitalizations, confirming that in several European countries the community will already be circulating the festive period at the door and , here, two holidays that disturb the normal reporting of laboratories. There are several reasons for uncertainty surrounding the evolution of the pandemic in the coming weeks, after last year there were also fluctuations in the testing and reporting of symptoms around December and the festive period, when infections seemed to decrease before they escalated into January. According to what Nascer do SOL found, there is, however, a new tool to be finalized in a joint effort between a network of Unilabs laboratories and the Dr. Ricardo Jorge National Health Institute, which hopes to be able to follow the increase in cases of the new variant in different parts of the country. In the UK, it is already being used to define who should or should not have stricter isolation rules at this stage, to try to slow down an eventual abrupt spread of Omicron as we live in South Africa.
At issue is a fault in one of the genes of the new variant, or in the S gene, which had already occurred, for example, in the Alpha variant, and which can be detected in PCR tests. It was with this element that in South Africa, and in particular in Gauteng, experiencing an increase in infections unparalleled since the beginning of the pandemic, it was estimated that Omicron already represents more than 80% of cases. Also in the UK, same by route and based on the results of the PCR test, it was estimated that it now represents close to 0.5% of cases in the country.
In Portugal, SOL found, some suspicious cases were detected with this flaw, still of reduced expression, but must be genetically confirmed in the sequencing carried out by the Ricardo Jorge Institute to confirm a correspondence between a flaw in the S and A Omicron gene, since Subvariants of the circulation reduction delta have also been detected in recent months with this feature.
The validation of the technique, already suggested by the World Health Organization for countries where a delta variant is dominant, such as Portugal, is expected in the coming days, when the genetic results of those flagged by Unilabs with this characteristic arrive. “If it is validated, there will be a real-time estimate of where the variant is going,” explained a source close to the process to Nascer do SOL.
UK chooses to notify
In the UK, where this technique is already being used, the rules were changed this week so that a person who takes a PCR test and has a positive result in which this trait is identified is soon notified that it is a suspected case of Omicron . In these hypotheses, the authorities defined that the person must remain in isolation and all close contacts must be self-isolated for ten days, even if vaccinated or under 18 years old, people hitherto excluded from this rule. There will be no need to wait for genetic confirmation of the case, explained this week the BBC.
In Portugal, specific rules for surveillance of Omicron cases have not yet been defined and the 19 confirmed cases so far have considered the tightest isolation from all contacts for 14 days determined by local health authorities. A situation that this week led to the unexpected closure of the pediatric service at Hospital Garcia de Orta, where a doctor from Belenenses SAD works, where the first cases of the variant in the country were confirmed, associated with the return of a player from South Africa on 18 March November. A measure that the Ministry of Health justified yesterday with having dealt with a new situation and that the hospital, which followed the guidelines, also defended the treatment for a week, arguing that it could not run the risk of having more cases.
dominant within a month
As projections at European level, based on various scenarios, which may be the increased transmissibility of the new variant – linked to mostly mild symptoms but which greatly increase the circulation of the virus, it also makes the universe of the minority of potentially serious cases larger – they admit that Omicron could become dominant within a month in Europe in the shorter scenario or early March in the slower. The World Health Organization hopes to provide more answers in the coming days, said Maria van Kerkhove this week. The variant has already been detected in 38 countries and in Europe there are signs of community circulation of the virus, that is, with no history of travel to the countries where it was detected in Africa, Belgium, Germany, Spain and the United Kingdom, revealed yesterday the European Center for Disease Control and Prevention. Also this Friday, at a new press conference, Soumya Swaminathan, scientific director of the World Health Organization, said that there is no reason for panic, but for countries to prepare and be prudent. For a week, epidemiologist Manuel Carmo Gomes, heard by i, explained that some information coming from South Africa is apparently contradictory, such as the doctor who saw some of the first cases in Gauteng and the students considered it very light and the intensivist from Soweto which warned of the increase in young people in intensive care. In both cases, noted Carmo Gomes, there seems to be protection conferred by vaccines, which in South Africa only reached a third of the population. “We have to wait to understand what happens in a Europe that is much more vaccinated but also more aged”, he summed up.
In Gauteng, one of the assessments is the increase in admissions of young children, up to nine years old, which rose from 5% of the total at the end of September to 13% now. The head of the National Institute of Infectious Diseases explained that there could be two reasons: children are not vaccinated and have more immature immune systems, so they are at greater risk, on the other hand there may also be more hospitalizations as a precaution against the new variant . What contrasts with the reality in Portugal is the detail of the information published by the South African health authorities, with a daily analysis of admissions and discharges in hospitals by covid-19, with information on age group.
Diagnoses slow down but positivity rises
For now, data published in recent days by DGS, which SOL analyzed, show a slowdown in diagnoses: in the last seven days they rose 10% compared to the previous seven days, after increases in the region of 30% and 40%. Nationally, Algarve and Centro continue to register as the highest incidences. On the other hand, the age group in which infections have the highest incidence, the SOL knows, continues to be that of children up to nine years old, having also risen among the oldest, which leads to an increase in mortality. Yesterday the country again registered more than 20 deaths in 24 hours associated with covid-19. Another warning sign for experts monitoring an epidemic, despite the increase in testing, is the increase in the positivity rate, above the 4% defined as the red line.