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Basically, the virus is spreading in a predictable way, with good data, epidemiological processes can be predicted very well. The number of tests has reached the capacity limit, so from the numbers of daily cases that stabilize it does not follow that we can sit down and the virus reproduction rate is around (R) 1 because that is not the case . Epidemiological trends in Hungary are increasingly unfavorable, said epidemiologist Beatrix Oros in an interview with Porfolio.
In terms of mortality, although the new coronavirus is more dangerous than the usual seasonal flu, it is much less dangerous than the SARS coronavirus launched in 2002 or the MERS coronavirus, in which on average one in three infected people dies. The death rate for people infected with SARS-Cov-19 is about 0.6 percent, while that of symptomatic patients is about 1.5 percent, so overall, Covid -19 is not one of the most devastating diseases at all, it is an enemy that must be dealt with, epidemiologist Beatrice of Russia and a staff member of the Semmelweis University told the portal.
The problem is much more that it can spread quickly and easily, which is why it can make a lot of people sick in a short time, since almost everyone is susceptible.
220 times higher risk
Based on the current severe cases, it can be seen that the vast majority of the elderly and those with chronic diseases are actually at risk. The 75-year-old grandfather needs approx. She is 220 times more likely to have a severe course than her 27-year-old granddaughter. A risk factor, regardless of age, is an underlying chronic disease, eg. Eg cardiovascular disease, poorly managed diabetes, high blood pressure and obesity.
The test results of the first wave severe Covid-19 survivors have now been published, and half of those who were withdrawn to Lombardy hospitals for months of asymptomatic control even after discharge from hospital. Shortness of breath caused by chronic lesions in the lungs can persist for a long time. Such patients easily begin to choke, especially during physical activity. Late symptoms can include cardiovascular problems, a tendency to thrombosis, or neurological disorders. Chronic fatigue syndrome is a relatively common persistent syndrome. All of this degrades the quality of life.
Many of those involved were unable to return to work
said the epidemiologist.
The sequelae of the disease can occur not only after a severe but also milder course of the disease, but fortunately only less frequently.
Chronic conditions after SARS-CoV-2 infection are also new phenomena for medicine, about which we will have to learn much more in the future.
Caution doesn’t hurt because Covid-19 is not sure to be a disease that can be quickly and easily transmitted to everyone. Therefore, it is best to prevent infection, not get it, even in people at low risk of death.
Beatrix Oros emphasized.
With this virus, latent infection chains are known to dominate for a time before it spreads explosively. With a small outbreak, sometimes the virus shows up there, not gone. Such a warning sign was the papal core in early August.
If focal spread is not eradicated, explosive community spread will follow
If focal proliferation fails, the next stop will be a nationwide, explosive community spread out. This also happened in the last weeks of August, which, according to the epidemiologist, was mainly due to the young people in particular making more and more contacts at the end of the summer, meeting at freshman camps, weddings and other mass events, and the virus. in the population that when these two coincided in time, the epidemic broke out.
His epidemiological modeling and epidemiological research team indicated that the R-value is above 2 at the end of August, which is extremely risky. Back then, even in case numbers, this was not so obvious, but the change in trends and signs of spread were already visible. At the time, many still couldn’t believe that the professionals were just causing riots, but unfortunately a few days later the explosive spread occurred.
His team also indicated at the time that if the rise in prevalence among young people could not be curbed, this would unfortunately be followed by transmission to older age groups. Since then, this phenomenon has been supported by factual data, Beatrix Oroszi said. The spread to the elderly is followed in a few weeks by hospital admissions, an increase in the incidence of severe cases and, subsequently, an increase in mortality. Now, sadly, we also see it day by day.
The spread didn’t slow down, we didn’t hit the plateau
Testing has run into a capacity constraint, so stagnant case numbers do not indicate a slowdown in the epidemic. This is because the proportion of positive tests must be constant or decreasing, as opposed to the current constant increase. The positivity rate is already above 10 percent, while the WHO recommends a positivity rate above 5 percent indicates insufficient testing capabilities.
The epidemic curve is represented by the number of new cases per day confirmed by laboratory tests, but there are fewer of these tests than would be necessary to identify new cases. Then our surveillance system has reached its upper limit. We believe that the spread has not decelerated significantly and has not reached the plateau, but it continues to show an increasing trend, emphasized Beatrx Oroszi.
In Hungary, the epidemiological trends of Covid-19 are increasingly unfavorable. The wrong conclusion should not be drawn from the stabilization of daily case numbers that we can sit on, the epidemic has reached the plateau, the R-value is around 1, because this is not the case. Community outreach is still fast and needs to slow down
I would like to highlight the healthcare workers: today most of them still get the infection not in the hospital but in the community, but it may be they who bring the virus to the hospitals and transmit it there during the period asymptomatic of infection. So you shouldn’t relax on defense!
– said the head of the epidemiology working group of the Ministry of Innovation.
It is up to us to stop the epidemic. Good practices must be followed, I am thinking here of the use of masks, physical distance and personal hygiene. All are needed in defense, we can only reduce the spread together. And in addition to individual defense, it would be good if we did not abandon the investigation of contacts and evidence, since we do not have a good method based on other evidence in our hands, the expert warned.
In the absence of a vaccine and a truly effective specific antiviral drug, we don’t have many options. He believed that if we conducted contact tests and investigations, as well as individual defense, the trend could be reversed. If not, sooner or later only restrictive measures and the closure of the country remain.
When asked when they might hit another peak on the epidemic curve in their calculations, Beatrix Oros said it was very up to us. On how we will react and defend ourselves.
If we don’t fight back and can’t stop the spread, we may have a big wave of fall-winter epidemics that will be difficult to deal with.
The goal would be to flatten the curve with a low number of new cases per day that the epidemiology and health system can handle. According to him, the important question is not whether we know when the curve will peak, but whether we can flatten the epidemic curve. The R value, which better describes the rate of spread, is not yet reported because, with the positivity calculated from the current test data, it would not reflect the actual epidemiological situation and would be misleading.
What are the Austrians and Swedes doing right?
Referring to Austria, which has a similar population and number of nights, he mentioned as a significant difference in its epidemiological management that Austria performs more than twice as many tests per thousand inhabitants as Hungary and has continuously increased its testing capacity since the beginning of the epidemic. We have much less tests and the positivity rate is more than double that of Austria.
Behind an epidemic-like curve is that we can detect far fewer cases.
However, the tests form the basis for case identification, contact investigation, and interruption of infection chains. The big challenge in controlling the current epidemic is how well we get the public to know that asymptomatic people may already be infected. Therefore, close contacts of Covid-19 patients must be identified in a timely manner and quarantined before the infection is transmitted to others.
However, human behavior is key. Whether someone infects others does not depend on testing, the expert noted.
Three rules must be followed to keep propagation with individual defense at a level where both testing and contact investigation can begin. These include the use of masks, a physical distance of at least 1.5 meters, and a reduction in the number of physical contacts (eg groupings, restrictions on mass events).
For Wave 2, the Swedes also expanded testing and contact research. Beatrix Oroszi summarized the lessons of the Swedish model by saying that although milder measures have been taken, they will be sustained continuously for a long time, even as the spread of the epidemic slows down and new cases per day decrease, proving to be successful in treatment. of the second wave.
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