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It is the portrait of a country with enormous regional asymmetries that results from the dissemination, by the General Directorate of Health (DGS), of the list of municipalities with a rate of new cases accumulated in 14 days per 100,000 inhabitants. Looking at the map, which leaves almost two-thirds of the country “painted” in red (high risk of transmitting the new coronavirus infection), there are 90 municipalities with more than double the rate that implies curfew, which is above 240 new cases of covid-19.
There are even two – Paços de Ferreira and Lousada – with more than three thousand new cases at 14 days per 100 thousand inhabitants, this in the period between October 28 and November 10, because the DGS released the data almost a week late. . And 27 municipalities are above the threshold of a thousand, four times more than the level defined by the European Center for Disease Prevention and Control (ECDC) as a high risk of transmission (240).
Whatever the indicator considered, these figures unequivocally demonstrate that Portugal has “an intense epidemic activity”, as emphasized by the Director General of Health in the usual press conference to assess the situation, in which she also highlighted that Portugal now occupies the tenth position in this map of countries considered by the ECDC – in addition to the Member States, United Kingdom, Norway, Iceland and Liechtenstein. Above Portugal – which has a growing trend and appeared this Monday with an accumulated incidence of 710 cases – emerged Luxembourg, the Czech Republic, Austria, France, Croatia, Slovenia, Poland, Italy and Belgium. In the last two weeks, we are worse than Spain and close to Italy.
Looking at the Portuguese map that can be re-analyzed in detail – DGS stopped updating the list at the end of October – most of the 27 counties above the 1,000 threshold are in the north, the worst affected area in this region. second wave of the epidemic, but it is also possible to discover some municipalities in the central part of the country with very high cumulative incidence rates, such as Manteigas, with more than two thousand, Belmonte and Guarda (more than one thousand).
In the North, Paços de Ferreira and Lousada remain at the top, with more than three thousand cases per 100 thousand inhabitants in that period, figures that, even so, indicate an improvement in the situation compared to previous weeks.
The disclosure of this indicator will finally allow citizens to follow the evolution of the epidemic in their municipalities, as affirmed by some experts and mayors. Will this disclosure help people in any way change some risky behaviors? “I can’t get a black and white perspective. On the one hand, it is interesting that the population knows the intensity of transmission in the municipality in which they live, because they can still take more precautions, such as staying at home or reducing contacts. But, on the other hand, it can also bring a false sense of security to people who live in municipalities with less accumulated incidence ”, reflects Teresa Leão, researcher at the Institute of Public Health of the University of Porto (ISPUP). “Borders are theoretical, they are not walls designed by politicians,” observes the public health doctor.
But Teresa Leão admits that this indicator is also important to identify the needs of health and social support services. “There are confined people who need someone to bring them food, medicine,” he recalls.
Regarding the differentiation and scheduling of measures announced by António Costa last week, taking into account the high incidence discrepancy between municipalities, Teresa Leão is cautious. “It is difficult to define a threshold and there may also be difficulties in communicating with the population.” Thus, it proposes that, instead of evaluating only the cumulative incidence, the transmissibility index (Rt) should be taken into account, which allows perceiving the evolution of the situation. If considered in isolation, he warns, the incidence indicator “can cause some fear and agitation in the population, which may feel uncomfortable because it is labeled as high risk.”
Is the dissemination of this indicator important for municipalities? For the presidents of the two most affected municipalities, Paços de Ferreira and Lousada, it is necessary to be careful in the way the situation is presented. “At first, some people felt discriminated against when they went to hospitals, to universities. I even took one position at that time, ”recalls the mayor of Lousada, Pedro Machado. With the spread of the infection in the community, this problem will be overcome, he believes. “What worries me now is whether the measures will be sufficient.”
But both Pedro Machado and Humberto Brito, mayor of Paços de Ferreira, argue that this indicator gives a distorted idea of reality, because both municipalities have considerably less than 100,000 inhabitants. “Lousada has 45 thousand,” says Pedro Machado.
What both consider relevant is that the situation has been improving in recent days in their municipalities, a possible reflection of the restrictive measures enacted three weeks ago. In Paços de Ferreira, the municipality decided, on its own initiative, to put psychologists and social work technicians to help public health teams trace contacts more quickly, with a computer platform created for this purpose. “We found more than 700 people who had never been contacted. We are smoothing the curve, but that takes time ”, emphasizes Humberto Brito.
