- BBC News World
Spain kicked off.
The president of the Spanish government, Pedro Sánchez, declared last week that his country is working to start treating covid-19 as a flu and not as an epidemic, as it has been until now.
And he also wants that strategy permeate the rest of Europe.
“We have been working on it for weeks now,” Sánchez replied in an interview on Cadena Ser when asked if he is going “to a flu of the pandemic.”
“Science knows the virus better. (…) We have to evaluate the evolution of covid towards an endemic disease,” said Sánchez, although he clarified that they are waiting for “more conclusive” reports on the omicron variant.
The president justified the new paradigm in the high vaccination in that country -82% of the population with a complete regimen and 36% with a booster dose-, the use of masks, the appearance of drugs such as Pfizer pill -which is effective in 89% of cases to avoid hospitalizations and deaths in patients at risk- and the apparent lower lethality of the virus with the most recent variant.
“This is a debate that we are already trying to open at the European level,” said Sánchez, and reported that they have raised it both with European health ministries and with the European Center for Disease Prevention and Control.
“It is a necessary debate”, he insisted.
The Spanish Minister of Health, Carolina Darias, added that the sixth wave of covid in which Spain finds itself these days is different from the previous ones.
“We have to be able to anticipate new scenarios, so we have to start assessing the adaptation to a new covid-19 surveillance and control system once this sixth epidemic wave in which we are immersed has been overcome,” he said.
And he stressed: “Once overcome. Never before.”
This new approach to the pandemic is called “sentinel watch”.
It has been used for other viruses and involves stopping mass testing and instead control smaller groups to serve as a sample of what is happening in the rest of society.
This can be done with one or more medical institutions that routinely and systematically collect epidemiological information and laboratory samples from patients, but it should not be too extensive a process, as it can reduce the quality of the information, states the European regional office of the World Health Organization (WHO).
With seasonal influenza, for example, “limited amounts of high-quality data from representative sentinel sites are sufficient to understand the epidemiology and circulation,” he explains.
The sites must be distributed in the territory in such a way that they are a reliable sample of what happens in the general population.
It is necessary to use standard definitions that can be compared over time, both within one country and with others.
The information must be reported once a week to national authorities, according to the European office of the WHO.
From there incidence rates of infected patients -symptomatic and asymptomatic-, hospitalizations, patients in intensive care and deaths from the disease can be estimated.
If used with covid, the saturation of the first level of hospital care for mild cases would be avoided, and those who do need it could be cared for, either due to covid or any other disease, said the Spanish Society of Family and Community Medicine in a release.
This position is not shared by all the medical unions in that country.
Not even in all countries.
The transition from pandemic to endemic
The day after is something that other countries are thinking about as well.
In the United Kingdom, the Minister of Education, Nadhim Zahawi, who until September was in charge of the vaccination program against covid-19, said that his country must lead the way out.
“I hope we will be one of the first major economies to show the world how to transition from pandemic to endemic., and then deal with this for as long as he stays with us,” he said when interviewed on January 9 on the channel Sky News.
That country also has a high vaccination rate against covid-19: 70% with a complete schedule and 53% with a booster dose.
In addition, the risk of hospitalization for the omicron variant is about one-third that of delta, according to an analysis published by the UK Health Security Agency. And omicron is displacing delta around the world as the predominant variant.
Another preliminary study conducted in the US by researchers at the University of California, Berkeley, Kaiser Permanente, and the Centers for Disease Control and Prevention (CDC) showed that people infected with omicron were half as likely to be hospitalized compared to delta, 75% less likely to enter an ICU and 90% less likely to die.
Hospital stays, in turn, were reduced from five to 1.5 days with omicron.
“The UK is probably the closest of any country to being out of the pandemic, if not already out and having the disease endemic,” said David Heymann, a professor of infectious disease epidemiology at the London School of Medicine. Hygiene and Tropical Medicine, in a virtual open chat with Chatham House, the Royal Institute of International Affairs.
Endemic is the phase of a disease in which it is usually present, but there is no longer an unusual increase in the number of cases. The flu, for example, is endemic.
“Soon we will be in a situation where the virus is circulating, we will deal with people at risk, but we accept that any other person will get it, and the average person will be fine,” virologist Elisabetta Groppelli, from the University of St. George from London to BBC Health Correspondent James Gallagher on the UK situation.
“If a new variant or a previous variant shows up, for most of us, like any other common cold coronavirus, we’ll have sneezes and a little bit of a headache and then we’ll be fine,” said Julian Hiscox, head of infections and global health. from the University of Liverpool, and is part of the UK government’s New and Emerging Respiratory Virus Threats Advisory Group.
In the United States, a group of six experts who advised President Joe Biden at the beginning of his term on how to manage the covid crisis published a series of articles in which they argued that it is time to approach the pandemic in a different way.
“Neither COVID-19 vaccination nor infection appears to confer lifelong immunity,” wrote Ezekiel Emanuel, a health policy expert at the University of Pennsylvania who coordinated the group’s proposals.
“Covid-19 infections are asymptomatic or mildly symptomatic, and the incubation period for SARS-CoV-2 is short, which precludes the use of specific strategies such as ‘ring vaccination’. Even fully vaccinated people run the risk of advanced SARS-CoV-2 infection. Consequently, a ‘new normal with covid’ in January 2022 is not living without covid-19,” Emanuel said.
The expert said that covid-19 should be taken like other respiratory diseases, such as influenza, since “people have lived normally with threats from these viruses” before.
not so soon
The White House’s top adviser on infectious diseases, Anthony Fauci, believes a new phase is near, but says they are not there yet in the US.
“What’s the box we’re all looking at right now? That box is control, that is, getting the level of infection that causes severe disease low enough that we can incorporate this infection (some people have said that learning to live with her), I think we’re possibly getting closer to that,” he said, speaking at the Center for Strategic and International Studies.
With a complete vaccination rate of 62% of the population, and 23% with booster doses, the United States faces the omicron wave with a record number of hospitalizations for the virus, almost double in proportion to those registered in the United Kingdom.
“The virus is on the way to becoming endemic. There is no question about it. But we are still very much in the middle of this pandemic,” WHO’s Covid-19 technical lead Maria Van Kerkhove told a conference last week. of press.
“We can’t end the pandemic and have the virus become ‘endemic’ in one country, while the rest of the world deals with the pandemic. That’s not how it works.”
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Eddie is an Australian news reporter with over 9 years in the industry and has published on Forbes and tech crunch.