University of Washington predicts 60,000 covid-19 cases per day in Portugal
With fears of contagion in the festive season sweeping Europe and entering the homes of many families, according to projections by the Institute of Metrics and Health Assessment (IHME) at the University of Washington, updated this weekend, updated that Omicron comes opening a new stage in the pandemic in which the current model of testing and tracking cases will not seek to keep up with the rate of transmission, which will also be less controllable than it has been in recent months. The reality will differ between countries and vaccination programs, but globally, 3 billion new cases of infection are expected in the next three months, which means that in this period there will be almost as many infections as in the entire pandemic, yesterday Christopher Murray, director of the IHME, one of the first voices in the scientific community to warn in March, in an article in JAMA, that it would be difficult, through vaccination, to achieve a scenario of group immunity against this new disease, also due to its seasonality. In terms of mortality and pressure on hospitals, the IHME predicts a less severe scenario than the last winter for Portugal, but it remains unclear as to the severity of the disease in infected with a new variant, particularly for those who are not vaccinated and who has the greatest risk. Globally recommend adherence to the vaccine and to the third dose and use of a mask, and to older people and those with comorbidities that avoid gathering in closed spaces, but even with care, contagion should multiply over the next few weeks.
For Portugal, according to IHME projections point to a scenario of infections that is in no way comparable to what has been experienced so far, reaching close to 60,000 new cases reported at the peak of infections, if the testing capacity was maintained and detection, there may actually be a peak of infections of close to 140,000 new infections per day between the end of January and the beginning of February – one of the premises of the experts is that worldwide there will be not only more mild cases but also asymptomatic (90 % vs. 40% in previous variants) and also because of that lower detection capacity. Therefore, at a global level, one of the recommendations left yesterday by the IHME is that the idea of not following up on cases is considered and that hospital admissions should be monitored, above all. On the other hand, these projections do not reflect specific measures to be obtained in different countries – in the case of Portugal, for example, such as weeks of containment that have an effect of not delaying contagions from the end of the year. In terms of mortality, at this time, the IHME points to another 3,000 deaths by the end of March due to covid-19 in Portugal, which may be more in a scenario of greater severity of the variant, this already assuming that all people who underwent the scheme Initial vaccination will receive the booster at least six months after the last dose – yesterday the Secretary of State for Health announced that the booster will be extended to all those over 18 years old, but for now the vaccination of those over 50 years old should start only at the beginning January and, for example, the teachers were vaccinated in April, having already had more than six months of vaccination. The population in their 30s, who completed second doses in early August, complete six months of vaccination in February.
Less impact on hospitalization
“Uncertainty is how severe an Omicron is. Based on our analysis of data from South Africa and the UK, we think it’s much less severe,” Christopher Murray told Sunrise by email. At the moment, the estimate made by the institute is that the fatality rate with the new variant will be 97% to 99% lower, but as infections will escalate. What can lead to the worst-case scenario in terms of mortality? “One of the uncertainties is what Omicron will do to the unvaccinated and never infected. It is possible that in this population it is worse than what we estimated”, continues the researcher, explaining that the projections are made with preliminary data reported by different countries on the severity of the disease, which has pointed to a lower risk of hospital admission, although still without disentangling the risk by vaccination status. In the UK, Imperial College this week estimated a 20% to 25% lower risk of needing hospital care and 40% to 45% of needing to stay in hospital for more than one day. Yesterday, the Health Safety Agency carried out this analysis again, but emphasize that, on the one hand, Omicron has not yet been circulating strongly in the older population as it is in the young, which is also the reality that lives in Portugal and which should change soon, also with Christmas, and on the other hand it is not clear whether what weighs a lower risk is a lower intrinsic severity of the virus or protection provided by previous infections.
Despite many more contagions, the perspective is that hospitalizations will be less necessary than last year, but there is an element that stands out in the projection for Portugal: the latter predicted that people would be hospitalized in ICUs than less currently, a third . Over the next few weeks, the institute’s projections indicate that Portugal will have around 1600 hospitalized patients at a peak of hospitalizations that put no further measures in February and, in a scenario of greater severity at Omicron, more than 2500. « The impact in hospitalization it will be lower than last winter and in mortality as well. Confinement will likely not be necessary. The focus should be on the distribution of third doses of vaccine and on the use of masks, especially for those at higher risk, over 60 years old and with comorbidities”, added Murray, for whom measures like the one implemented this week in the United Kingdom, with reduction of the isolation time of the infected from 10 to seven days negative testing to the sixth day may be required, for example, to avoid the impact of absenteeism. “Many people will have asymptomatic infections. It is also unlikely that the transmission can be controlled. Reducing the isolation time will likely be necessary,” he says. Is this what an endemic looks like? Here the IHME forecast is not yet, as there will continue to be covid-19 outbreaks throughout the summer, predictably less. “We hope that covid-19 will become endemic, but other variants of the virus are likely to emerge. An Omicron will likely not be an endemic version because it will infect a large fraction of the population. Combined with vaccination, an epidemic is likely to remain at low levels from May onwards”. What is certain is that the second Christmas of the pandemic is lived with more people in isolation, more than 200 thousand, less hospitalized but less time off with non-covid-19 patients undergoing treatment and the winter ahead.
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