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In recent days the debate has been on the table about the closure (or not) of schools, as well as the factors that may justify it. On Tuesday, in the Assembly of the Republic, the Prime Minister, António Costa, threw some more pieces into the fire by stating: “If we know for the week, if we know tomorrow, if the day after tomorrow we know, if in 15 days we know, for example , that the English strain has become dominant in our country, it is most likely that we will have to close schools ”. But can one variant, even though it is more transmissible than others, be a factor that in itself can lead to the closure of schools? For now, the experts heard by the PUBLIC affirm that it is a factor that worsens the transmission capacity of the virus, but the pressure on health services and the adherence of the population to the measures must also be taken into account.
Viruses are constantly changing, and SARS-CoV-2 is no exception. Variants (grouping multiple mutations) are expected to emerge over time. There will already be thousands of this coronavirus and if some disappear, others persist. Initially identified in the UK, the B.1.1.7 strain has already been reported in some 60 countries and has already reached a high prevalence in London and the south-east of England. In Portugal, so far, 72 cases associated with B.1.1.7 have been detected, according to a January 12 report from the National Institute of Health Doutor Ricardo Jorge, in Lisbon.
Although it has been suggested that it does not cause more serious disease, it has been found to be more transmissible than other circulating variants, which can increase hospitalizations and mortality. There are studies that indicate that it is transmitted more quickly in the population, becoming between 50% and 56% more transmissible than others.
And can this variant, if it becomes apparent that it has become dominant in Portugal, lead to the closure of schools?
Paulo Santos, a researcher at the Center for Research in Health Technologies and Services, adds that the decision to close schools depends on epidemiological evolution. What really is at the moment is the pressure on health services. “It has to do with the organization and access to health services,” he says. And he says of the Prime Minister’s statement on the SARS-CoV-2 variant identified in the United Kingdom: “At a time when the new strain does not have more importance in terms of penetration than the others, we are doing hypothetical scenarios of its evolution is to be preparing a speech for a decision to be taken and it needs a justification ”.
The doctor and researcher emphasizes that we must be aware of its rate of spread and its importance in terms of severity. However, given the data that are available and considering that it is still early for certain evaluations of its effects and prevalence in the country, Paulo Santos reiterates: “Right now, it is not the most prevalent and we continue to have a problem with others. . To use the new strain to justify the measures is to find an excuse not to have any of this last week, and so we did what we had to do. It is a political speech ”.
In turn, Elisabete Ramos, professor at the Faculty of Medicine of the University of Porto, responds that the question is not specifically about the variant: “If it turns out that the increase in the proportion of cases is explained by this variant – which has a greater ease of transmission: it means that measures to limit contact between people and transmissions must be stricter. “He adds:” It is not necessarily because of a variant, but because of the characteristics associated with it, which may explain why it is It is necessary to take more restrictive measures to try to minimize the impact. “
The scientist says that, apparently, it will not cause more severity of the disease, and the risk of the need for hospitalization does not seem to be different, but it can more easily infect other people. Therefore, there must be a booster to prevent someone infected with this variant from contacting other people. After all, that individual is more likely to infect the people he contacts.
Specifically on whether school closures are justified, he says he doesn’t know if he justifies it, because this whole discussion is difficult and encompasses everything that involves the school. The researcher points out that, within schools, there is a set of measures that make people there have a low risk of being infected, but the question is also about what the school “cannot control”, such as meetings outside the school. school. establishment and roads there. “In the first period, schools were not places where the disease was transmitted because there were no known outbreaks. It does not mean that there are no patients, because they will always reflect what is happening in the community, ”he clarifies, referring to the fact that the more cases in the community, the more there will be in the schools.
Therefore, in addition to the variant, there are other determining factors in the evaluation of the pandemic situation in the country, such as people’s adherence to the measures, says Elisabete Ramos.
The virologist Maria João Amorim, for her part, considers that B.1.1.7 is “a factor that brutally worsens the transmission capacity of the virus”, but that, “taking into account the debacle in which we find ourselves, it is not in himself a justification ”. . The researcher at the Gulbenkian Institute of Sciences, in Oeiras, confesses that she has been a staunch defender that even nurseries should be kept open, but that, having knowledge of the latest data on the pandemic in the country, she has no doubts: “We really have to stop the chains of transmission. “
The scientist says that there are several levels in the question of schools and that one of them is that an age division must be made. “Clearly, in university and secondary education, students are capable of transmitting the disease a lot, even asymptomatically, increasing the transmissibility in the population,” he explains, considering that it will be necessary to have a stricter control. So at this point, it is not yet known whether the variant increases transmission in younger children, as their ACE2 receptor levels are known to be lower.
Maria João Amorim says that she has always been very careful in her evaluation of the genetic variants and mutations of the virus, but considers that it can be said that this strain increases transmission. “We need to be able to stop the transmission because otherwise we will have a very high death toll.” The scientist reinforces that the assessment of the current situation is “very complex and multifactorial”, but warns that it is necessary to gather teams of specialists who can advise the Government. There is also the contribution of each one: “Each action is fundamental. We have to stop this transmission if we don’t want to have 200 deaths a day. We have to do it individually. “
