The Minister of Health starts the meeting with experts. Marta Temido explains that today there are seven presentations.
They are: “epidemiological situation in the country. André Peralta Santos, Directorate-General for Health
Evolution of incidence and transmissibility, Baltazar Nunes, from the National Health Institute Dr. Ricardo Jorge
Update on the surveillance of genetic variants of the new coronavirus in Portugal, João Paulo Gomes, from the National Health Institute Dr. Ricardo Jorge
Local risk indicators ,, Óscar Felgueiras, from the North Regional Health Administration and Faculty of Sciences, University of Porto
EVOLUTION of critical areas in space and time, Carla Nunes | National School of Public Health, Universidade Nova de Lisboa
Schools as surveillance structures, Henrique de Barros | Institute of Public Health of the University of Porto
State of play on the vaccination plan, Henrique Gouveia e Melo | Coordinator of the Task Force for the Vaccination Plan against COVID-19 in Portugal
The first to speak, as usual, is the DGS specialist, André Peralta Santos.
André Peralta Santos, from DGS, said that Portugal currently has a “moderate incidence” of the virus, “close to 71 cases per 100 thousand inhabitants and with a slightly increasing trend”.
There are “some municipalities” with an incidence of more than 120 cases per 100 thousand inhabitants, the majority in Alentejo and Algarve. In the last week, there was also “some growth” in the areas of Greater Porto and Trás-os-Montes.
There is a “very noticeable” reduction in incidence across all age groups. There was an increase in the age group from zero to 9 years old. The decrease is greatest in the group over 80 years of age.
There are 22 municipalities with more than 120 cases per 100 thousand inhabitants, with a total of 636 thousand people, representing 6.5% of the population.
Hospitalizations maintain the downward trend, both in the ward and in the ICU, although the rate of descent has slowed. In mortality, the same phenomenon occurs.
There is an increase in testing in the active population,” said Peralta Santos.
As for testing, there was general “intensification” and, above all, the municipalities with the highest incidence are testing more. The rate of positivity has decreased and, although some municipalities are above the 4% defined as a red line by experts, most of the country remains below that threshold.
According to Peralta Santos, there is a general increase in testing in the active population , “less expressive” in the younger population. And there is an “improvement” in laboratory reporting, with a 6% delay now.
The DGS official also mentions the “good news” that Portugal is below the mortality threshold established by ECDC
Baltazar Nunes, from the National Institute of Health Dr. Ricardo Jorge, first points out the “systematic growth” of the transmissibility index, the R (t), since the beginning of February. “We have gone through a phase of growth in the number of cases per day”. Currently, the R (t) is 1.04, nationally. The whole country has R (t) above 1, except Lisbon and the Tagus Valley.
There is a reversal of the trend and new cases per day are increasing”
Baltazar Nunes, from the National Institute of Health Dr. Ricardo Jorge, first points out the “systematic growth” of the transmissibility index, the R (t), since the beginning of February. “There is an inversion of the trend, moving now to a growth of new cases per day”. Currently, the R (t) is 1.04, nationally – the whole country has R (t) above 1, except Lisbon and the Tagus Valley.
On April 8, to which the most recent data report, the R was at 1.09 (at the last meeting at Infarmed, it was at 0.89). “The time it takes for the number and cases to double is 35 days,” said Baltazar Nunes.
As for the rate of incidence of the disease per 100 thousand inhabitants in 14 days, the expert estimates that Portugal reaches 120 thousand cases per 100 thousand inhabitants “between two weeks and one month”.
Two weeks to a month to exceed threshold
As for the rate of incidence of the disease per 100 thousand inhabitants in 14 days, the expert estimates that Portugal reaches 120 thousand cases per 100 thousand inhabitants (threshold of the risk matrix) “between two weeks and one month”.
With regard to the incidence by age, Baltazar Nunes indicates that there is a “very significant increase in the trend in the age groups below 9 years old , mainly close to 5, 6 years old” – an increase that explains the opening of the first cycle of schools . Although with lower values than in the younger age groups, there is also an increase in the incidence in the groups of 10 to 19 years of age and 25 and 50. But, on the other hand, the reduction of the incidence in people over 65 years old is a “very positive” sign.
Stressing the importance of vaccination in reducing the number of cases in people over 80, the specialist at the Dr. Ricardo Jorge Institute points out that vaccines have prevented, so far, 78 to 140 deaths by covid-19 in Portugal. “There is a significant effect of vaccination coverage on the population aged 80 and over.”
Compared to the rest of Europe, “Portugal has a much lower incidence level” , even though the R is increasing. The country today has fewer restrictive measures than many other European countries and there has been ” an increase in the number of contacts , mainly in the age groups under 69″, although it is less than what happened at Christmas time.
The increase in Rt and mobility in the country, which is advancing in the process of deflation, obliges to compensate with other health security rules.
Baltazar Nunes listed the main ones, such as increasing testing , isolating cases and tracking contacts , reducing the number of contacts outside the family bubble , and reinforcing measures in places such as school and work.
Last but not least, increase vaccine coverage, especially over the age of 65 .
United Kingdom variant accounted for 83% of cases in March
João Paulo Gomes, from INSA, said that there was a “significant reduction” of the original variant in Portuguese territory, which appeared in Spain, and that it has been progressively replaced by the United Kingdom variant. In March, this represented 83% of cases of covid-19 in Portugal. In the North it is “clearly less represented”, at 71%; in the Algarve and Madeira, it reaches 94%.
South Africa variant with “very significant growth”
The Manaus (Brazil) variant represents 0.4% of cases in Portugal. South Africa, on the other hand, showed “very significant growth”, rising from 0.1% in February to 2.5% in March.
There are now 29 cases of the Brazilian variant, a number in line with what is recorded at European level. João Paulo Gomes recalled that these values are “residual”, confessing himself surprised due to the proximity between Portugal and Brazil.
The South African variant currently represents 53 cases in the country. The expert stressed the importance of border control “to try to understand if there is a lack of control” of the spread of this variant, which he said was being introduced, mainly, from Mozambique.
João Paulo Gomes recalled that there are signs that this variant may be more resistant to vaccines, but clarified that the situation is not a cause for alarm.
The Brazilian variant is “very controlled”, said João Paulo Gomes. The South African variant, on the other hand, deserves “some concern” and requires attention to border control.
Óscar Felgueiras, from the Regional Health Administration of the North and Faculty of Sciences of the University of Porto, talks about local risk indicators. He proposes to combine two indicators – the neighbouring incidence and the municipal incidence – in order to obtain the adjusted incidence indicator . The objective is to correct the low specificity of the neighbouring incidence.
The specialist points out problems in taking into account the incidence by municipalities as a “single indicator”. One of them is the fact that small counties where the number of cases is not very high have a very high incidence, as in Vimioso. The municipality has an incidence of 249 cases for a population of 4 thousand inhabitants, but, taking into account the four neighbouring municipalities, there are 36 cases in the region for 67 thousand inhabitants. If the region is considered in its entirety, the incidence would be 53, far below that recorded in Vimioso. “We can think about defining an incidence indicator next to the municipality in question”, but in this case there is the disadvantage of “mitigating the risk” in some places.
Thus, the specialist proposes to combine two indicators – the neighbouring incidence and the municipal incidence. Thus, the adjusted incidence indicator is obtained , whose objective is to correct the weaknesses of the previous ones, reflecting the risk of proximity and mobility expected between municipalities and promising to be a tool to implement health measures at the local level.
“There is no clear relationship” between incidence and population density
Carla Nunes, from the Escola Superior de Saúde Pública at Universidade Nova de Lisboa, said that, between February and the beginning of April, the areas of greatest risk in the country were “the whole coast” and also the South of the country.
With regard to the spread of the virus, there has been a greater concentration of cases. “There is no clear relationship” between incidence and population density, said the expert.
As for the Portuguese’s perception of the disease, Carla Nunes revealed that there has been a “change in behavior” in the last two weeks. On 2 April, 7.5% of respondents in a study coordinated by the specialist stated that they had been in groups of 10 or more people , against 4.9% on 19 March.
Of the respondents, 87.7% said they considered vaccination to be safe or very safe, against 8.4% who considered it to be little or not at all safe. 87.5% believe that vaccines are effective or very effective, against 14.6% who think they are not.
One in four people say they feel agitated or sad due to the rules of social detachment. One in two rated their health status as very poor and reasonable.
There are still 22.4% of respondents with little or no confidence in health care related to covid-19, a figure that rises to 51.7% with respect to other diseases. In this parameter, there were no major changes compared to the previous period, the same occurring in relation to the assessment of Government measures : currently, 31.7% of respondents say that they are little or not adequate.
Greater difficulties were also reported in complying with measures , namely the use of a mask (increase from 7.5% to 14.5%), teleworking (from 34.7% to 42.4%), the duty to stay at home (from 27.5% to 33.3%) and precautions regarding visits to friends or family (from 34.4% to 41.5%).
Schools show safety
Henrique Barros, from the Public Health Institute of the University of Porto (ISPUP), reinforces that “the rate of infection reduction has changed”, with the incidence now increasing in most age groups, with the exception of older ages, where vaccination has an effect. “The vaccine encirclement that is coming from the oldest to the youngest, makes these ages more susceptible to the circulation of the virus”, says the expert.
Stressing the increase in incidence among children, the specialist spoke of schools as “surveillance structures” and presented data on specific school groups. Henrique Barros concludes that, “contrary to what is seen in employees, who are adults, in proportion of infection marker is much lower ”. That is, although there is an increase in cases at these ages, this is very small, summarizes the expert. In addition, there is an “enormous variability” in the infection rate depending on the classes, which places the risk outside the school and not on the school grounds.
Henrique Gouveia e Melo, coordinator of the task force for vaccination against covid-19, confirms the forecast of receiving 1.9 million vaccines in April and a total of 11 million over the second quarter.
Until last Sunday, Portugal received 2.6 million vaccines and administered about 2.1 million doses: first doses were 1.5 million people, that is, more than 15% of the population has one dose taken, and 6% took two doses.
With the priority groups for phase 1 of the vaccination plan with high rates of vaccination coverage (values between 80% and 99%), the process has now moved on to phase 2, which includes people over 65 who were not been vaccinated before. And so far 400,000 people in this group have been vaccinated, equivalent to 27% of this group, announced Henrique Gouveia e Melo.
The main criterion for this phase is that of age, that is, advancing from the oldest to the youngest.
Portugal will vaccinate the entire population over 60 “between the last week of May and the first week of June, which gives us some hope”. The 70% vaccinated with the first dose – which implies vaccination for all over 30 years of age – “between July and August”. In terms of serious illness, hospitalizations and deaths, this advance will provide “quite high protection”.
In update from live news