[News]Simón recognizes that the epidemic is out of control in some areas and asks influencers for help

[SougarLord]

The press conference of Fernando Simón, director of the Center for the Coordination of Health Alerts and Emergencies, Fernando Simón, began with a hopeless phrase: In Spain, unfortunately there have been no major changes compared to the previous week, a high number of cases continues to rise, We have 7,039 new infections, 3,349 cases diagnosed as of yesterday (377,906 in total) and the number of deaths is 122 with a death date in the last 7 days.

 

The epidemiologist said that the rise in the number of deaths is due to a late notification from Aragon and to another community that is the one that is reporting the most deaths, which is Madrid, the same one that is reporting the most cases at this time, representing a third of the cases diagnosed yesterday and a third of the cases with a symptom onset date in the last 7 and 14 days.

 

In total, there are 1,126 active outbreaks that are increasing and as the communities make more effort, more are detected, but what interests us now is to assess how they evolve: the temporary ones are decreasing and the bulk of the outbreaks are focused on the social sphere (family gatherings and nightlife represent around 40 percent of outbreaks and cases) and we know that in recent days outbreaks in health centers have increased (7.7 percent of the total).

 

                        

 

Simón stressed, in any case, that an important diagnostic effort is being made; The cases are different from those reported before, and not because the virus has changed but because a very large volume of cases is being detected: the number of CRP is increasing a lot, now we are doing above the 60,000 CRP daily on average, the doctor pointed out. Simón added that many cases are being detected because these tests are being done in areas where there is a risk of transmission, that is, where a case with any symptoms is identified and this means that there is well-directed PCR and that it does not look where the probability of infection it is practically nil.

 

The disease is mainly affecting young people, the current average age is 39 years and in men 37. If we observe only the last 15 days, the age drops to 35 in both sexes. However, at the peak of the epidemic the mean age was 62-63 years and at the beginning of May it was 53 years. What we detect now is very different and so are the hospitalization rates, which are low: 4%, as well as the fatality that has also been decreasing: 0.4%, which is what we expected depending on the type of cases we are in. observing.

 

If we let the pandemic continue upwards, we will end up having many hospitalized, many admitted to the ICU and many deaths.

 

Simón wanted to send a strong message, much more emphatically than on other occasions: Things are not going well, make no mistake. It is a time to stop. The fact that we detect a lot does not mean that there is no transmission, we have more and more transmission and it is important. If we let the transmission continue upwards, we will end up having many hospitalized, many admitted to the ICU and many deaths. Please don't be confused. It is not worth thinking that because he is young, nothing happens because that young person generates cases in elderly or vulnerable people.

 

Simón continued issuing a warning message and also of help by going to the influencers: We have detected problems with seasonal workers, and there will continue to be cases but the number of people associated with these outbreaks has been reduced, community transmission in Lleida has decreased, La Litera (Huesca), Aragón ... The next step was generated by the nightlife associated with vacations. I understand that people want to party but there are ways and means to do it. All of us who can influence the po[CENSORED]tion must make people aware of what to do. There are many "influencers" in Spain with very high visibility that can help control the epidemic. It is true that what we see now is not the same as before but we cannot let it continue upwards.

 

Positivity of CRPs in Spain above the WHO threshold.

Asked why he is launching this message now and not before, Simón said that I have been saying for many weeks that you have to be careful and that this is not over, but I get the feeling that those messages were not strong enough or did not get other people who could help do so. I thought I had to clearly say that you have to do better.

The epidemiologist was asked by the international press about the positivity of the PCR that we have in Spain. It currently stands at 7 percent compared to 1 percent a couple of months ago and is above the threshold established by the WHO of 5, which may indicate that the epidemic is getting out of control.

 

Simón replied that the WHO indicator is one more indicator, but the global incidence also influences, the way in which the search for cases is carried out, the total number of infected that we believe is detected compared to what was previously detected. In Spain we have a bad evolution, but the geographical distribution is very particular: a community increases its cases, then it stabilizes and when it reaches areas with a large po[CENSORED]tion it has a significant impact on the national indicator. It is true that we are not in a favorable situation and although there is a territorial disparity, everyone is going up. And although at the national level we cannot speak of the epidemic being out of control, in some places, yes.

 

Regarding the trackers, Simón said that they have to be evaluated in terms of the po[CENSORED]tion but also in terms of the evolution of the epidemic. In addition, in Spain we have 35-40 large cities where a large percentage of the po[CENSORED]tion is concentrated compared to rural areas with a very affordable po[CENSORED]tion to monitor all of them daily. In this sense, he recalled that contact tracing applications, such as Radar Covid, can help but are not a panacea, it does not imply that they are correctly monitored.

 

Back to school: There is scope for action.

 

Regarding the return to school, he said that there is a margin of action, and the centers must apply the guides of the ministries and Education. There is also room for action for the communities to support, there is also room at the central level for Health and Education to write guides and protocols that guarantee the correct response to situations that may arise. All this is being done, not everything is implemented now, and margin but the truth is that it must be done and done well. That said: we cannot have our children without studying, we cannot mortgage the competitiveness of our promotions of children, we cannot make two promotions not have the level of education that any other, I think it will be achieved. It's one year, let's hope it's not two. But you have to learn to live with the virus in the safest way possible. The centers must make an effort to open, but a child who has a computer and Wi-Fi is not the same with another who shares a room with other siblings and parents and who does not have a computer or Wi-Fi. An effort must be made to provide face-to-face education.

 

As for the Health and Education meeting scheduled for next Thursday, Simón did not want to intervene in the supposed package of measures that could be approved.

 

Massive PCR in centers.

Regarding the massive PCR that are proposed for centers in some communities such as Asturias, Simón said: To diagnose cases we have to direct our strategy where there may be infected people. It is true that there can be them anywhere but not with the same probability. The PCR performed on a person who tests negative without symptoms does not imply that they cannot be positive the next day. If a PCR is done and it comes out negative, the next step is to make antibodies and the next step is: what do these antibody tests mean that no technician trusts? That is, they are options, but we do not have to pretend that they are generalized and that they are examples for everyone. In areas and times, specific transmission situations ... it can even be recommended by the ministry and everywhere. But posing it in a generic way costs me. And the problem is when you do the PCR: At the beginning of September, once every 15 days, once every week?

 

Use of masks at school.

Regarding the masks in schools, Simón said that their role in the transmission of the epidemic is not clear among children, although those who are infected, in general, have mild symptoms. Different options can be used to reduce transmission in schools; there are children for whom wearing the mask is complicated, unless we turn children under 6 into automatons. In the older ones, the use of masks can be guaranteed and must be valued, but they also involve provisioning, disposal but also that their use outside the classroom is carried out correctly. At school we talk about school time, but also about entry, exit, dining room ... These are important measures and we must assess how to apply them correctly and apply them well because doing it wrong could even be counterproductive, although it is an option. It will be necessary to see if it is used at a general level or some communities do it and others do not.

 

Viral load in children.

 

Regarding the studies on viral load in children, there are studies that indicate that they have a higher or lower viral load, until recently there were more studies that assessed that there was a higher viral load in children, but in addition to the Swiss studies there is one done in Spain which indicates that transmissibility among children is much lower than among other social groups. We have information in both directions. A higher viral load, a priori, could imply more transmission, but having a higher viral load in the esopharynx implies that it is necessary to be able to expel it and children have less or perhaps the relationships between children and adults are not as close as we thought . There are studies that go in both directions and now it is difficult to make a decision responsibly both in one direction and the other. In this situation you have to try to get on the prudent side.

 

Immunity.

As for those immunized, we know from our seroprevalence study, that it was very close to the peak moment and several waves were also made, that in Spain they had antibodies and, therefore, had been in contact with the virus on a 5, 2 percent of our po[CENSORED]tion. Spain carried out this study in which the same people were surveyed every three weeks and we could assess how many of them, how many were not previously infected and had been infected in that period, but we could also know how many had previously been positive and no longer so they were. With our study we detected that every three weeks or a month, in Spain 7 percent of the positives initially stopped being so. This means that when a seroprevalence study is done very far from the peak moment, it may be that the actual incidence indicators that your study gives are undervalued because you have fewer cases than you actually had. But we know what we had and what we are having now and the increase is not exaggerated. What does this imply? It is true that there is more incidence, more people immunized but we have not gone from 4 to 40 percent or much less, we could be instead of 5 percent, in October in the next wave, in a 9 or 10, I don't know but not much above those figures. And then it will be very difficult to assess those that lose the antibodies, what do they mean because losing the antibodies does not mean losing immunity either, it means that the antibodies that circulate in the blood are lost but these are produced by cells and these can produce antibodies again when they receive the right stimulus but we consider that they are capable of producing them again. We are not certain but we believe that memory immunity allows the recovery of circulating antibodies to sufficient levels, at least for a few months.