Meeting at Infarmed concerning evolution of Covid-19 -Live updates

Today, another meeting is taking place at Infarmed, in which the Government and political figures meet with experts to analyze the epidemiological situation in Portugal.

At Infarmed, in Lisbon, from 10 am, as has been happening since February, only the Minister of Health, Marta Temido, and most epidemiologists will be present.

The remaining participants, Marcelo Rebelo de Sousa, António Costa and Ferro Rodrigues, party representatives, members of the Council of State and social partners, will follow the meeting by videoconference.

This week the Assembly of the Republic is expected to debate and vote on the draft presidential decree for the renewal of the state of emergency for a new period of 15 days, with effect from April 1 and which will cover the Easter period.

The session begins with a presentation by André Peralta Santos, from the Directorate-General for Health, on the epidemiological situation , following the perspective of the evolution of the incidence and transmissibility of the SARS-CoV-2 virus, in charge of Baltazar Nunes and Ricardo Mexia, from the National Institute of Health Doutor Ricardo Jorge (INSA) .

João Paulo Gomes, also from INSA, will update the virus variants in the country, with Henrique de Barros, from the Public Health Institute of the University of Porto, giving a presentation on a year of learning from covid-19 in Portugal .

The meeting continues with the presentation of the social perceptions of the pandemic in the country, in charge of Carla Nunes, from the National School of Public Health of the Universidade Nova de Lisboa, and with the status of vaccination by the coordinator of the vice-admiral task force Henrique Gouveia e Melo .

The meeting starts 10.08 hrs

André Santos Peralta, the DGS, says there was a “downward trend of maintaining” the incidence of the virus, with an average of 79 cases per 100,000 inhabitants. However, in Greater Lisbon, “there are already some municipalities” with a growing trend. The active population became the population with the highest incidence, but there was a “very expressive” decrease in hospitalizations in the infirmary and ICU.

The active population became the population with the highest incidence, but there was a “very expressive” decrease in hospitalizations in the infirmary and ICU. “in a scenario of great incidence, only the population from 40 to 60 is enough to exceed the indicator of 245 beds of hospitalizations in ICU”. That is, “To be completely safe, the age group to be vaccinated will have to go up to these ages”.

Lisbon and Tagus Valley has the highest incidence (more cases per 100 thousand inhabitants every 14 days).

Regarding hospitalizations, there is a maintenance of the decline in the +60 group. In the ICUs, there is a “very significant drop” in the group of 50, 60 and 70 years old.

As for the variants, that of the United Kingdom increased, reaching 73% in Lisbon and Vale do Tejo and above 60% in the North.

The testing rate is “quite considerable” and the 4% positive ceiling is only found “in some municipalities”. There has been a greater speed in laboratory notification, revealed the expert.

English variant already represents more than 70% of the cases in the Lisbon and Tagus Valley region. “There has been an increase”

A new fact about lethality: “In the week of March 1st to 7th, there was a decrease in lethality in the more than 80 years,” he says.

Regarding the virus variants, especially in the United Kingdom, there was an increase, with a prevalence of new variants in the order of 73.3% in the Lisbon region, and 60% / 65% in the North and Center, and in the rest of the country the estimate is more uncertain but it will be around 30% in the Alentejo and 70% in the Algarve.

10.38 hrs
Transmission Rate R (t)
 
Baltazar Nunes, from the Ricardo Jorge National Institute, first highlights the growing trend of the transmissibility index, the R (t). “It is natural to slow down the decrease in new cases,” says the expert. But, currently, all regions of the Continent are in the green zone of the risk matrix .Although the R is approaching 1, “it is important to evaluate the two indicators – the incidence at 14 days and the R – together”, says Baltazar Nunes. Only when the R rises above 1 will the number of cases begin to rise. Much of Central and Eastern Europe has incidence rates above 120 and R above 1. For Baltazar Nunes, this “may be a risk for Portugal”.

At the end of March, the incidence is expected to stabilize at the line of 60 cases at the end of March. “We no longer predict that the incidence will drop from that level,” explained the expert.

The next steps, concluded Baltazar Nunes, must be aware that R and mobility are increasing, and that the incidence in European countries is also rising.

Therefore, Ricardo Jorge recommends increasing testing, maintaining preventive measures and increasing vaccination.

Ricardo Mexia, from INSA, said that a “pressing need” in the vaccination strategy is to have an “agile” notification of the test results. In the last few days, there has been an “important increase” in testing, especially rapid testing. PCR tests have known “stabilization”.

In schools, in more than 80 thousand tests, the rate of positivity is currently 0.1%. On March 19, the positivity rate was 1.2% – below, therefore, the recommended 4% threshold.

10.44 hrs

Variants

João Paulo Gomes, also from the Ricardo Jorge Institute, now takes stock of the incidence of the covid-19 variant. Almost 100% of covid cases in England are from the United Kingdom variant and this should be the trend in the rest of the countries, being just “a matter of time”, says João Paulo Gomes, director of the Department of Infectious Diseases of the National Institute of Health Dr. Ricardo Jorge (INSA). “The UK variant is expected to be in more than 80% of cases in our country.” “Almost all countries are expected to have a near 100% prevalence of the UK variant.” In Portugal, we have a prevalence of 70%, although, says the specialist, it is expected to reach 80% of cases shortly.

João Paulo Gomes also explains that the rapid tests will not allow the search for new variants. Mass testing is positive, but it has this problem, says the expert. To solve it, he proposes to increase the sampling of PCR tests, which are the ones that allow the analysis and surveillance of variants, by increasing the network of laboratories – private and the Academy.

There are 24 cases of the South African variant identified in Portugal (250 in the United Kingdom, 300 in Belgium). João Paulo Gomes stresses the importance of flight control and travel history, as this variant is spread across European countries that have many flight connections with Portugal. “The last thing you want is for the same thing to happen to the UK variant, which is widespread.”

As for the Manaus variant, 16 cases are identified in Portugal, within the average and very distant from countries like Italy, which already have almost 160 cases.

Ricardo Jorge will also increase the installed capacity for the sequencing of the samples.

1100 hrs

INSA proposes solution for the “continuous decrease” in the number of PCR tests

With the increase in testing with rapid tests, there is a “continuous decrease” in the number of PCR tests, “the only ones that allow the search for SARS-CoV-2 variants”. To resolve the issue, INSA researcher João Paulo Gomes proposes an extension of the laboratory network to select positive PCR samples to perform their genomic sequencing, inviting more laboratories to participate, and also suggests that whoever has a positive rapid test can be again tested with PCR.

Of the approximately 50 countries that do genomic sequencing, Portugal is in 12th place, with 4332 sequenced genomes, a far cry from countries such as the United Kingdom (287 thousand) or Denmark (50 thousand). Taking into account the size of the population of each country, Portugal manages to sequence 43 genomes per 100 thousand inhabitants, which puts us higher on the list.

“We do not do a week-by-week surveillance, but we focus on one week of each month to have more geographic representation”, says João Paulo Gomes, from INSA.

Death rates

Henrique de Barros takes stock of a year of pandemic. 

Henrique de Barros, from the Public Health Institute of the University of Porto, now talks about the balance of a year of pandemic in Portugal.

He begins by saying that the deaths were the first major concern of the specialists, but “at the end of this year it will be time to think about the weight of other adverse consequences of the infection, such as the continuity of the signs of illness after recovery”. The effects on children should also be studied. “It is at school ages that we will start to find infections, even because of the choice we made to vaccinate the most advanced ages, leaving the younger ones more susceptible to the encounter with the virus”.

“About 2% of people are dying” due to the disease, the expert said, with the risk being “significantly higher” in men than in women. “There is a big difference between the regions”, with Alentejo presenting the highest risk of death due to the virus.

There is a big difference between the regions and the lower risk of dying in the Madeira region is notorious compared to other regions in the country. In the center, LVT, Alentejo and Algarve the values ​​are higher.

In the months of December and January, the values ​​recorded were higher. The burden on the NHS had an effect on the greater probability of dying, he says.

Have the variants are at increased risk of death, especially the so – called Spanish variant. Both the English variant and the Brazilian variant will become important when the estimates are more stable – hence greater vigilance is needed in patients infected with these variants in view of the risk of dying.

Number of cases in health professionals “decreased a lot” with the start of vaccination

Regarding the effectiveness of vaccination, the infection decreased a lot in health professionals from the moment that vaccines started to be administered, notes Henrique de Barros. This is compared to the risk of infection in the general population.

Effectiveness of Vaccinations

Vaccine effectiveness is 98%, equal to that recorded in the trials. “It is an extraordinary security”

Regarding the effectiveness of vaccination, the infection decreased a lot in health professionals from the moment vaccines started to be administered, notes Henrique de Barros (the data are based on health professionals from the Centro Hospitalar de São João, in Porto). This is compared to the risk of infection in the general population.

Health workers had more cases than the general population, because they were more tested, but from the moment they started being vaccinated (they were the first to be vaccinated), the infection decreases faster and earlier than in the generality of the population. “From that moment on, there were half of the expected cases due to vaccination”, he says.

Even so, there was an average of 7 cases of infection for every 100 cases in the vaccinated population (0.07%). There is 98% vaccine effectiveness, he says. That is, it is equal to the efficacy verified in the vaccine trials. “It is an extraordinary security”, he says.

People who leave home are the most difficult to avoid visiting family and friends

There are some measures that are easier to take, such as wearing a mask, but others that are more difficult, such as keeping your distance or teleworking. However, there were “critical indicators” that were analyzed such as “avoiding visiting family or friends” and “staying at home”

In these two indicators, there were 36.9% of people who admitted that it was difficult or very difficult not to visit family or friends and 35.2% to stay at home.

In a finer analysis, Carla Nunes says that “it is the people who naturally leave home, the ones who most report having more difficulty in avoiding visiting family members with friends”

Carla Nunes, from the National School of Public Health, presents the barometer data on the various public health indicators and notes that there are “slight” changes both in behaviour and in the perception of the global health status.

“46.3% of people saying they had reasonable, bad or very bad or overall health status” and “1 in 5 of people – felt agitated, anxious or sad” in the past few days.

In addition, says the professor at the National School of Public Health, there was a “slight increase in worse behaviors”.

Vaccinations

The coordinator of the vaccination plan against covid-19, Henrique Gouveia e Melo, revealed that, in April, “about 1.8 million vaccines” will arrive in Portugal. The 70% vaccinees are still expected “by the end of the summer” and, in the second quarter, the number of inoculations will reach between 95 thousand and 100 thousand per day.

1.8 million vaccines have already arrived in the country, 95,000 of which went to the archipelagos. Until Saturday 1.3 million vaccines had been administered and, this week, another 177 thousand will be administered.


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