Meeting at Infarmed 27th April 2021


The 20th meeting of experts and politicians, which brings together the President of the Republic, the President of the Assembly and the Prime Minister is taking takes place in the week when the Government will decide whether Portugal advances to the fourth and final phase of the deconfinement plan, which is scheduled to start on May 3rd. In the afternoon, Marcelo Rebelo de Sousa will hear parties about the possible end of the state of emergency, which he has already said he hopes will end on Friday, April 30.

If the next phase of the deflation progressed in light of Friday’s figures from the Directorate-General for Health, there were three counties on the continent at risk of going back one stage in the reopening , 15 of not moving forward and 18 with an alert for having reached the level of 120 new cases of covid-19 per 100 thousand inhabitants, compared with data from 15 days earlier.

André Peralta Santos, from DGS, underlined that, in the last 15 days, the incidence of Covid-19 remained “stable”. There are 37 counties above 120 cases per 100 thousand inhabitants. Even so, in large urban centres there is a “slight downward trend”.

The growth of the virus in the area of ​​Paredes, Paços de Ferreira and Penafiel “causes some concern”. In Odemira, one of the municipalities with the highest incidence in the country, there is a “reversal of trend”.

Almost all age groups are below the incidence recorded on March 15. The exception is the group between 10 and 20 years.

The group from 0 to 9 years old, which was growing, has now reversed the trend, with 10 to 20 years old being the one with the highest increase at the moment. However, neither one raises “special concern”.

Also, the group over 80 “maintains a downward trend and is, at this moment, the most protected group”.

The North has an increasing trend, although still below 120 cases per 100 thousand inhabitants. The Algarve started a downward trend.

Currently, it is the group between 50 and 79 years old that occupies the most intensive care units. Deaths also maintain a “downward trend”.

Positivity is below the benchmark, which stands at 4%. Peralta Santos considers this data “very positive”.

Regarding hospitalizations, André Peralta Santos points out “clearly positive” data. “There is a marked downward trend in the age group of 80+, which has to do with the effort and vaccination of this group”, he says.

It is the group of 50 to 79 that has, today, the highest incidence in hospitalization, although the numbers are much lower than they were when we reached the “peak”.

The number of deaths also maintains “a downward trend”. The peak was on February 4 (368 deaths per million inhabitants) and today we have 5 deaths per million inhabitants, lower than the ECDC reference indicator.

Transmissibility index in the North above 1

Baltazar Nunes, from the National Institute of Health Dr. Ricardo Jorge, spoke about the evolution of incidence and transmissibility, points out first that there was a “decrease in the rate of transmissibility” (the Rt), compared to the previous meeting, 15 days ago.

Only the North has Rt – the number of people that a first infected person is able to infect – is above 1 (1.05), although the incidence rate is less than 120 cases per 100 thousand inhabitants in 14 days. If the pace is maintained, the region reaches that red barrier between “two weeks and a month” .

Phased reopening of schools with “very positive” result

Analyzing the relationship between the evolution of the incidence and the reopening of schools, the expert says that “there is some very positive result in the way the epidemic was transmitted in schools in this phase of reopening in stages”, until the week of April 16.

Europe improved and Portugal stabilized

Comparing the Portuguese situation with the European situation, Baltazar Nunes says that “the situation at European level has improved” and that Portugal, contrary to what was projected, “stabilized with an R slightly below 1 and an incidence rate between 60 and 100 cases per 100 thousand inhabitants “.

Regarding the effects of vaccination, “from 60% in the population of 80+ there is an inversion of the trend, of decrease”, points out Baltazar Nunes, from the Ricardo Jorge Institute.

Regarding the relationship between the vaccination process and the incidence of the disease, the expert of the Ricardo Jorge Institute (INSA) assures that “there is a clear benefit in reaching high levels of vaccination in the various age groups”, highlighting the “clear signs of the impact of vaccination “in people over 60 in reducing the incidence.

João Paulo Gomes, from INSA, revealed that the United Kingdom variant in Portugal now corresponds to about “89% or 90%” of the total of registered cases, a number higher than the 83% of 15 days ago.

In the last two weeks, Portugal recorded 44 cases of the Manaus variant, bringing the number of cases already detected in the country to 73. The rise is in line with the rest of Europe, said João Paulo Gomes.

As for the South African variant, there were 11 cases in the last 15 days in Portugal, which makes a total of 64 cases diagnosed in the country.

“It is a reflection of any opening of borders. The variants that circulate in one country will also circulate, more freely, in all others”, warned the expert.

The Manaus variant will become “significantly more significant” in Portugal in the near future, warned the expert.

Portugal already has six cases of the Indian variant. All were detected in the Lisbon and Tagus Valley region. João Paulo Gomes pointed out that the European population is “increasingly immune”: In this sense, of the various existing variants, only those variants that are more resistant to the vaccine should survive. The current situation in terms of variants in Portugal “is not an impediment to the continuation of the deconfinement plan”, concluded João Paulo Gomes. Henrique Barros, from the Public Health Institute of the University of Porto, highlights the “very revealing” role of the continuation of the vaccination plan, which has been essential to prevent infections, hospitalizations and deaths. “Diaries of Pandemia II”: of the respondents, only 90% say they want to be vaccinated against Covid-19. Vaccination refusals are in the majority between the ages of 40 and 60.

There is also a relationship with the “nature of income”: the people with the most income and education are those who claim to want to be vaccinated. “Those who seem less interested in the vaccination process have less income,” he says..

Henrique de Barros also recalls that vaccination efficacy scenarios were made in January according to the vaccination plan designed, and we predicted at that time that we would save 140 thousand cases and 9 thousand hospitalizations and avoid more than two thousand deaths. What can be seen now is that the reality proved the scenario and was “clearly better than the conversational predictions in terms of morality”.

In other words, “the acceleration of vaccination prevented contagion and significantly reduced deaths in the elderly,” he says.

Lethality is five times lower than in the beginning

Henrique Barros, from the Public Health Institute of the University of Porto, highlights the “very revealing” role of the continuation of the vaccination plan, which has been essential to prevent infections, hospitalizations and deaths.

The probability of dying from covid-19 has undergone a “brutal variation” over the past few months, the expert said, speaking on Infarmed by videoconference, adding that the hypothesis of a fatal outcome of the disease is, in April, around five times lower than at the beginning of the pandemic.

The expert points out that lethality remains higher in men.

Speaking now of the relationship between lethality and variants of the virus, Henrique de Barros says that people infected with the UK variant “appear to have a significantly increased likelihood of dying.” But the value is similar when compared to the Spanish strain, which was dominant in Portugal in the summer. The South African variant, on the other hand, increases the risk of infection.

Henrique de Barros ends up saying that the lethality, for the diagnosed cases, is currently at 2%, but varies depending on several factors.

“Even with the presence of more lethal and more transmissible variants, it is possible, with protective measures and vaccination, to guarantee the values ​​we believe in: in September, if everything goes smoothly, we hope to have no cases”, he ends.

In conclusion, the expert points out that the lethality in Portugal varies according to the sex of the infected, the nationality, the region and the variants. Thus, it is superior in men and in people with a nationality other than Portuguese . At the regional level, with the North as a reference, the remaining regions are associated with a higher risk of lethality, with the exception of the autonomous region of Madeira , where there is a lower risk of mortality. And, as for the variants, although the information is still scarce, it is estimated that the Brazilian variant may cause more deaths .

Over 80% want to be vaccinated as soon as possible

Carla Nunes, from the School of Public Health at Universidade Nova de Lisboa stated that the behaviours of the Portuguese are being “in agreement with the state of de-confinement”. On April 16, 8.6% of respondents in a study presented by Carla Nunes had revealed to have been with a group of 10 or more people, against 1.8% on February 19. Confidence in health care has risen, albeit “very slightly”.

Over 80% want to be vaccinated as soon as possible

“There were no major changes” regarding the perception that the Portuguese have regarding the vaccine. According to Carla Nunes, among the respondents who have not yet received a dose, 81.7% are available to do so as soon as possible. There are 7% who say they do not want to do it and 11.3% who have not yet decided.

Regarding vaccine safety, between March 20 and April 2, 87.8% considered these drugs to be reliable or very reliable, against 1.6% who said otherwise. Between April 3 and 16, 87.6% said that vaccines are safe or very safe, with 2% understanding that they are not.

Between March 20 and April 2, 87.4% of respondents considered the vaccine to be effective or very effective, against 3.5% who said it was not. In the following fortnight, the parameters “effective” and “Very effective” rose to 89.9% and the “not effective” dropped to 1.7%. Vaccinations

Vice Admiral Henrique Gouveia e Melo, coordinator of the “task force” for vaccination, pointed out that mainland Portugal will reach the mark of three million vaccines inoculated by Wednesday (with Madeira and the Azores, the threshold is exceeded). ” By the end of the week, more than 22% of the population will have their first dose. ”

The official says that there is a “slight positive evolution of availability, in the second quarter, with 9.2 million vaccines, however, the age limit of two types of vaccines that the country is using [AstraZeneca and Janssen] may condition the use of up to half a million vaccines ”. In the third quarter, these two vaccines may “withdraw about 2.7 million from the plan”.

Marcelo highlights the effect of vaccination on mortality reduction

At the end of the presentations, the President of the Republic highlighted the “interrelationship between vaccination and pandemic management”, emphasizing that “lethality and mortality go in reverse with the progress of vaccination”.

Marcelo Rebelo de Sousa, who speaks to the country this Tuesday at 8 pm – with the possibility of not extending the state of emergency on the table – stressed that “the progress of vaccination deserves to be welcomed and highlighted”, also stressing the “increasing adhesion of the Portuguese” to taking drugs against covid-19.