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The beginning of the epidemic in Portugal was marked by the “massive dissemination” of a variant of SARS-CoV-2 with a specific mutation, which began to circulate in the North and Center regions more than a week before the diagnosis of the first cases .
This conclusion is part of the “Study of the genetic diversity of the new SARS-CoV-2 coronavirus in Portugal”, published today at the DGS periodic press conference to update information on the pandemic in Portugal, a research project coordinated by the Dr. Ricardo Jorge National Institute of Health (INSA), to analyze the genetic diversity of the new coronavirus, which causes the covid-19 disease, especially during the first months of the epidemic.
The first results of the study, which has already analyzed 1,785 sequences of the new coronavirus genome, reveal that “the beginning of the pandemic in Portugal was characterized by the massive spread of a variant of SARS-CoV-2 with a specific mutation in the protein ‘Spike’ ”, which has been the subject of research and the main focus of the vaccine because it is responsible for binding the virus to human cells, allowing infection.
This variant “D839Y” of the SARS-CoV-2 will have entered Portugal, in the North and Center, “around February 20, associated with trips to Italy, specifically to the Lombardy region”, the research coordinator, João Paulo Gomes.
“It will have circulated in a somewhat uncontrolled way, or at least undetected in these areas of the country, and will have caused a massive spread and a series of transmission chains before the first cases were reported in Portugal,” said the coordinator of the study.
The first cases of covid-19 were reported on March 2, one associated with the Santo António Hospital and the other with the São João Hospital, in Porto, but they are not linked to “D839Y”.
“So this started much earlier, we have no doubts,” said the INSA researcher.
The most notorious example of its spread was the outbreak in the municipality of Ovar, where the implementation of a sanitary fence would have prevented its spread to other areas of the country.
Despite the identification of this genetic variant in 11 districts, “it simply did not spread” to the south of the country due to “the very strong, very strict” public health measures adopted, “including the health fence in Ovar, which it generated a kind of strangulation to its original diffusion ”, he explained.
“During the exponential phase of the pandemic in Portugal, which was basically in March and in the first days of April, [a variante] reached 33% of cases on certain days, 3% of all cases had this mutation, and in accumulated data, we estimate that on April 9 or 10, this mutation was present in approximately 4,000 people with covid-19 ”, he is stressed.
For the researcher, this can be “a great model” to understand how it all started, how the infection spreads and “how important are some measures taken at the right time”.
He also considered that if the measures had been “a little early, they would have worked even better”, but at that time there is no data to justify them.
“Now, with these models and with these results, we know that, in fact, a few days earlier, many chains of transmission, many hospitalizations, many infections in general would have been avoided.”
For the researcher, “this type of retrospective analysis, carried out on an unprecedented scale in Portugal, can be used as a combat ‘asset’ in future situations, either in a second wave of covid-19, or in other possible epidemics”.
“Their conclusions will serve us above all as a lesson to prepare for the near or distant future, it does not mean that they are of immediate application”, said João Paulo Gomes at the press conference.
“It will be very important for all of us to understand exactly how we got where we got and to what extent public health measures were timely and effective,” he said.
The study, financed within the framework of the first edition of the Research4Covid support program, has the participation of more than 60 hospitals / laboratories throughout the country.
