Covid: Spain turns the page on pandemic: goodbye to testing and isolation

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admin March 27, 2022 19 Views
Updated 2022/03/27 at 12:42 PM
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Covid: Spain turns the page on pandemic: goodbye to testing and isolation
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The pandemic isn’t over, but Spain this week has taken a decisive step to turn the page: starting Monday, testing only people over the age of 60, vulnerable people and people from the health and social health environment for COVID Will happen. The rest will be able to live a normal life, even if they are infected and have mild symptoms. Prudence is recommended in social interactions and a mask, which is still mandatory indoors and remains the ultimate symbol of COVID. The rules change radically after each case is counted after two years, emphasizing testing at the slightest sign, isolating oneself if positive, no contact with cohabitants. In comparison, the rest of the decisions made so far (capacity, covid passport, schedule, extent of meetings) are almost trivial at the epidemiological level.

The Ministry of Health and the community thus eschew governments that have treated the coronavirus with more laxity for two years. Spain is on the same level as the United Kingdom, the only large country in its surroundings to have taken a similar step. Not even Denmark, which has relaxed measures as far as possible, has decided to allow people with symptoms to lead normal lives. There he will have to isolate himself for four days. Of course, they don’t wear masks indoors. Spain keeps them. for now

The decision is by no means without its objections. Many public health experts have expressed skepticism, if not outright disapproval. Joan Guiques, former secretary of public health for the Generalitat of Catalonia, is one of those who believes it will be necessary to wait: “It is too soon. We are not in a flu like situation right now and Covid has given us a huge surprise. I’ll be more careful.” Salvador Piro, an epidemiologist at Fisabio (Foundation for the Promotion of Health and Biomedical Research of the Valencian Community), does not see the new system as bad, but questions the resources and timing of implementing it: “It has sufficient immunity.” is to stop testing the population at risk and allow primary care to do other things. But if you do, it means you have to mediate measures to make contagion difficult in sensitive environments, and now the transmission is high so that the infection is not passed on.

This time, for better or worse, it has been a move directed by technicians, with politicians limiting themselves to accepting their recommendations. Despite how much rulers insist on this, it has not always been so, especially in recent months.

It all started in the sixth wave. Health officials felt there was no way to accurately measure cases. And, at the same time, the obligation to do so completely overwhelmed the system. Technicians then began to study how they would manage the following waves, if any. But they knew it couldn’t happen that way.

This belief came with the realization that the coronavirus is far less lethal than the first waves, thanks to the vaccines, mutations and natural immunity that has arisen at the base of millions of infections. The hospital system has suffered, with many more cases, but it is far from collapsing. The medium-term horizon will be to measure COVID with a sentinel network such as that used for the flu. But the system takes months to be ready, so a transition system had to be installed.

The team from the Coordination Center for Health Alerts and Emergencies worked on and shared the first draft with the rest of the Alert Panel members (from all communities) in January. Sources in this body tell that when he proposed to leave isolation and diagnose mild cases, many saw it as “madness”.

But, gradually he got convinced. Not without reservation. No one knows what the experiment will be like. But they justify the decision to choose: resources are limited and the focus on COVID is cut short by other diseases. This is clearly seen in the primary. If family doctors spend days diagnosing the coronavirus and signing off on sick leave, they can’t see older patients, they have little time to make their first appointment, there’s a greater tendency to make mistakes in diagnoses . And there is a less obvious face for citizens: of public health teams, of epidemiologists who work in administration and who have been weary for two years. “If we wanted a new sentinel system, we could not continue to measure each case”, justifies one of them.

This progress is not irreversible. Now the reference will be to the hospitals. As long as they install COVID traffic lights as “low risk” (less than 10% in ICU and less than 5% in ward), the scheme will continue. If it goes up from there, it will be necessary to take a step back and re-count cases and resume isolation of people with symptoms.

The only reference is to the United Kingdom. There, cases have increased since isolation ended in early March. But the same thing has happened in other European countries that have not taken this measure: France, Germany, Italy … it will not be possible to measure here as a whole, because they will not be diagnosed. People over 60 will serve as thermometers. And the key will be in the hospitals. They will not test everyone who enters, only if the cause is respiratory disease. The dilemma of whether the people admitted to the hospital were due to Kovid or not. If they tolerate the pressure without significantly increasing and the virus does not undergo a mutation that makes it more lethal, then the coronavirus is officially considered the same as a cold.

Although COVID is still technically a notifiable disease, officials have advised citizens to act as with any other common and present disease. Anyone who has minor symptoms (some cough, temper, runny nose…) can lead a normal life. Of course, we now use equipment that would have been foreign before the pandemic: in these cases, masks would be more than recommended and, whenever possible, teleworking. In addition to being extremely cautious of vulnerable people. Personal responsibility is appealed: if someone has symptoms, it is unwise for them to go to their grandmother, for example.

If the symptoms of the disease worsen, the next step, as in the case of the flu, would be to go to the doctor. This will determine the course of treatment and action: if sick leave is necessary or tests to check for pneumonia.

voices of dissent

The health minister, Carolina Darías, defended that the advance puts Spain “at the fore” in the fight against Covid. He wants to lead the change in the surveillance system and join the plan for other European countries. There are several experts before him who look at the decision with a whiff. Antoni Trilla, epidemiologist and dean of the Faculty of Medicine at the University of Barcelona, ​​appeals to discretion: “First the sentinel system will have to be strengthened in number and capacity, which I consider appropriate, and then the general shutdown will have to be abolished. , Not the other way around, because the sentinel network is small”.

Experts also acknowledge the “paradoxes” that the latest guidelines from health officials may mean for citizens: Although the active search for cases and isolation are left out, the mask is kept indoors. “There may be a certain paradox: the mask thing is a matter of occasion when they want to remove it, taking into account that the flu is also on the rise to some extent now. But it can be explained”, says Trilla.

Guikes describes both decisions as “slightly consistent”, and warns that “the perception of risk among citizens is disappearing because the message they are sending is that it is over”. Peiró urges a communication campaign: “Measures [de pasar a una red centinela] I don’t think the situation will get worse, but (…) it is very complex and requires social communication and specific policies in some places.

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