Letter from the infectologist: the isolation rate now loses its logical meaning

At that time, the figure was 38.8 in Italy, 41.6 in Poland and 17.6 in Latvia. It is true that Estonia does not have a good situation either: the neighbor indicator is currently 46.4.

Across Europe, including Lithuania, as the coronavirus pandemic deteriorated, the list of countries considered affected was increased on September 14. Before that, isolation was mandatory upon arrival in countries that exceeded 16 patients per 100,000 inhabitants. After the increase in the indicator, isolation was required only for those countries that exceeded the threshold of 25 cases.

Following this innovation, several European countries have been “removed” from the affected list, making travel easier. However, Lithuanians could not rejoice about that for a long time. In a short time, most European countries exceeded the rate of 25 cases per 100,000 inhabitants.

Not only European countries, but also Lithuania itself crossed the red threshold very quickly. At present we have almost doubled the figure of 25 cases per 100,000 inhabitants, but it is still necessary to isolate ourselves from the so-called affected countries (where there are more than 25/100 thousand inhabitants).

Teacher: The indicator loses its meaning

We asked Alvydas Laiškonis, professor and infectologist at the Lithuanian University of Health Sciences, if this indicator is still significant if the limit has already been exceeded in Lithuania.

“Isolating ourselves from countries with lower morbidity no longer makes sense. When we go from 16 to 25, we try to protect ourselves from those countries with high morbidity. At the moment, morbidity is high, so we must look for another indicator, because this no longer has sense, ”said the professor.

In this case, however, there is a risk that we will face an even greater number of tipping points when accepting compatriots returning from abroad without mandatory isolation.

“It is very difficult to answer if there would not be more chimneys. In France, for example, in some places the incidence has reached 130 people per 100 thousand inhabitants. This is a very high morbidity. Maybe you should take the weekly average. In Europe, morbidity still varies widely. I think that the European Union should adopt a single indicator ”, said the infectologist.

Prof. Mr. Laiškonis also recalled that due to the high morbidity in the French regions of Marseille and Guadeloupe, quarantine was adopted.

“There has been great opposition from the people to the biggest demonstrations against the quarantine and all measures, because the French cannot in any way accept that their freedom is restricted. There is an increase in the coronavirus in Europe. It can probably be said that it is beginning the second wave, which will continue to rise, warned the interlocutor.

– Also, the flu season is already beginning. Morbidity will increase and now it will be the most difficult period to distinguish between flu and coronavirus. Hospitals face a very big task in separating the flows, as they will need 3 flows: flu, coronavirus, and healthy people. Not all hospitals have the capacity to run out of staff. There is already a shortage of infectologists. “

By the way, the professor notes that in Lithuania we only observe one indicator: morbidity. At that time, the French counted 3 key indicators: general morbidity, morbidity over 65 years and people in resuscitation.

“They found that although the morbidity is high, so far there are not many serious forms and the hospitals are not overcrowded. It should probably also be counted. It is observed that now the highest morbidity occurs among people aged 20 to 50 years, many asymptomatic forms. When hospitals were expected to be clogged due to very serious forms, this did not happen ”, said prof. A. Laiškonis.

So researchers have turned their attention to this fact: why are young people sick now? There are several hypotheses.

“The first wave has hit older people, now some of them have died, so the number of older people has decreased. Another thing, people from 20 to 50 years old are the busiest who work a lot, they commute daily. Older people are now very protective of themselves and avoid trips, events. Perhaps that is one of the reasons, “said the infectologist.

An interesting fact is that currently there is talk that differences in morbidity between countries may be due to genetics. Perhaps this would partly explain the lower incidence in Latvia.

“As much as I had to communicate with Latvian colleagues, their test volumes are lower. Genetic problems arose. For example, it is strange that diphtheria is present only in Latvia, and not in Lithuania. They may also have a lower susceptibility to the coronavirus. However, they cannot say for themselves why they have a lower incidence ”, said the interlocutor.

The current situation is particularly bad in France, with an incidence rate of 236.7, and even higher in some regions.

“They couldn’t comply at all, there were no major restrictions. There is currently a great “battle” between the government and the people as the government tries to tighten the restrictions. There were even demonstrations in France against the wearing of masks. Bar hours are limited to 10 pm, and the French are used to spending all night in bars, causing outrage. Compliance with his measures was very poor. It is said that the true joy of a Frenchman is having many types of wine, cheese and going on strike ”, the professor briefly reviewed the situation in France.

So far, no increase is promised

Health Minister Aurelijus Veryga, who spoke by phone on Thursday on Delfi Day, said there are several reasons why the indicator remains the same.

“It is not very easy to answer why this is so, but I will try to explain the logic, it will not be correct for all countries, but sometimes it really can work, especially when we do not have some uniform criteria to compare countries in detail. The logic of isolating yourself from a country where rates may be even lower is that perhaps there is little evidence in that country or we do not trust the research from that country because perhaps the actual situation there is not known. Another option is when the spread in the country is not focal but spreads in society or in the community. So it means that even if that indicator is relatively low, the risk of a person getting infected and still bringing us the virus is high ”, explained A. Veryga.

The minister also expressed the need for a European consensus.

“It would really be ideal for Europe to agree on some kind of common list of indicators, according to which countries would evaluate and we would have a common methodology. But as long as they don’t exist, there are really big differences, “said the director of SAM.

According to the minister, the issues of self-isolation and who should be paid for the investigation upon arrival from Latvia will be discussed in a general meeting on Monday.

During the last day 91 cases of coronavirus infection (COVID-19) were confirmed in Lithuania. Of these, 46 were registered in Kaunas, 19 in Šiauliai, 16 in Vilnius, 8 in Panevėžys and 1 in Telšiai and Tauragė counties.