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The reopening of the country is part of this second stage, which starts on the Monday after Easter, in order to have different speeds in the country. The Government evaluates and decides this Thursday in the Council of Ministers the measures for the next fortnight and if it is necessary to make the first adjustments to the misconfiguration plan presented on March 11. And despite the fact that throughout the country the terraces are preparing to open and the Lisbon City Council and even the General Directorate of Cultural Heritage (DGPC) have announced before any official announcement from the Government that the museums, monuments and national palaces will reopen from On April 5, with free weekend tickets, the country will not be able to advance to the new stage at the same pace.
The red lines were announced by the Government three weeks ago and, in general terms, the country is within the comfortable zone, with an incidence at the national level below 120 cases per 100,000 inhabitants and an RT that, according to the National calculations. Instituto de Salud Dr. Ricardo Jorge, converges to 1 but has not yet reached that value. Therefore, in the risk matrix presented by the Prime Minister, the country is in the green zone. However, the Ministry of Health confirmed to the Sunrise that the Government has adopted a model in which deflation is unlocked in municipalities with a more favorable epidemiological situation, and it can be suspended if it is in the orange zone (an accumulated incidence in 14 days greater than 120 cases per 100,000 inhabitants) or going backwards if it reaches the red zone (more than 240 cases per 100,000 inhabitants), it will be applied at the municipal level.
If in the last year the risk analysis system by municipality already existed, now there is another novelty: the incidence calculation begins to be carried out with which decisions are made in order to weigh the risk of neighboring municipalities and at the same time to correct for affecting population density in this indicator – in a municipality with few inhabitants, relatively few cases could immediately put the municipality in the red. In practice, to correct this effect, the 14-day incidence, calculated strictly based on the new cases and the population of each municipality, is no longer used, and a calculation is made that includes neighboring municipalities.
The idea was suggested by the team from the Northern Regional Health Directorate that presented the proposed deconfinition plan at the request of the Ministry of Health, led by Óscar Felgueiras and Raquel Duarte. In Nascer do SOL, the Ministry of Health advanced the general lines of how decisions will be made from now on and sent the decisions and announcements to this Thursday: «The risk matrix, combining two criteria (incidence and transmissibility), allows monitoring the evolution of the epidemiological situation at the continent level. If we move into the yellow zone, it is possible that the deflation process will not progress according to the planned timelines. If we go into the red zone, there may even have to be a pullback in deflationary measures. In case it is necessary to make such decisions – stoppage or setback – they will apply only to the municipalities with the highest risk, depending on the respective municipal incidence corrected by the incidence of neighboring municipalities ”.
The incidents of the bulletin do not allow the forecast of brakes
In the update of the accumulated incidence to 14 days per municipality that the DGS made available this Monday, there were 32 municipalities above the threshold of 120 cases per 100,000 inhabitants, in this orange area, nine of which with more than 240 cases for every 100,000 inhabitants. .
However, these data will no longer be the data analyzed this Thursday by the Government. The DGS has maintained the methodology for updating the calculation of the accumulated incidence to 14 days per municipality on Mondays, but with reference to the cases notified until the beginning of the previous week. And last year, the decisions were made by the Government with the most up-to-date calculations of the current week. Thus, this list that places 32 municipalities above the level of 120 cases per 100,000 inhabitants refers to the epidemiological situation of the country on March 23. However, the incidence of new cases of covid-19 at 14 days has continued to fall throughout the country, although an increase in diagnoses has been observed in recent days.
On the other hand, with the use of an adjusted incidence calculation, the fact that a municipality appears with more than 120 or more than 240 cases per 100 thousand inhabitants in the DGS bulletins may not mean that there will be a brake on the deflation because it may be the case that, considering neighboring counties, this effect is diluted. Above this level you can see a municipality apparently below the risk threshold that is surrounded by others with a strong epidemic activity. With the current epidemiological situation, there will be few municipalities in this situation and especially in the south of the country, which is also the only one in the country where INSA calculates a RT greater than 1. The team from the Faculty of Sciences of the University of Lisbon calculates an RT greater than 1 at the national level since last week and there is some apprehension among the experts heard by Nascer do SOL about the fact that it is an atypical week and in which, despite the regulations, there may be greater mobility. In the last edition, the epidemiologist Manuel Carmo Gomes also admitted apprehension with the conclusions of a modeling of hospitalizations for the coming months, taking into account the evolution of vaccination coverage and the dominant English variant, more transmissible, which suggests that a deflation level Starting in the fall of this spring, with the full opening of schools, it would not prevent a fourth place in May. The Ministry of Health did not clarify if this study was analyzed, the first modeling of the impact that deflation can have in the country by the percentage of people vaccinated and if it can motivate any change in the vaccination plan or in the deflation plan. .
Nascer do SOL also sought to understand if all the indicators defined as red lines will be published on a regular basis by the working group that brought together experts from FCUL, INSA and DGS: in addition to the incidence and RT, the positivity rate, the percentage of isolated and traced cases and contacts within the first 24 hours after notification and percentage of confirmed cases reported late. The Ministry of Health indicated that daily, through the covid-19 bulletin, the main indicators are revealed, without clarifying whether the rest will also be publicized.
If there is a brake on decofinancing already at this stage, one of the decisions will have to transfer if it is total or if some activities are reopened in it, and the Government has so far indicated the resumption of school activity as a priority. For next week, it is the turn of the 2nd and 3rd cycle students and 15 days later, in the third stage of deflation, the secondary and higher education students.
Massive testing has yet to take off
The first days of the week were marked by an increase in diagnoses compared to last week, and yesterday there was still no data available on the number of tests carried out in recent days. With schools closed and holidays on Friday, they may be smaller and the effect of Easter on both testing and increased contagion can only be measured after the start of the second stage of deflation.
Last week the tests came down and, with the exception of the first week of deflation, there has yet to be a significant jump in testing. Portugal maintains the lowest incidence rate of new cases at the European level and a positivity also below 2%, but there are countries with less positivity and more tests.
According to the latest weekly report from the European Center for Disease Prevention and Control, referring to the week of March 15-21, the first to reopen, the country was the seventeenth in the EU to do more tests per 100,000 inhabitants and last week will have regressed. In the last week, with comparable data at the European level, Portugal carried out some 2,500 tests per 100,000 inhabitants. In Denmark, one of the countries given as a reference in massive tests, more than 30 thousand tests are carried out for every 100 thousand inhabitants in a week. In Austria more than 20 thousand.
In both countries, access to periodic tests is free for the population. In Portugal, there is still no news about the reimbursement of tests beyond the regular projections foreseen in sectors such as home and school. This Wednesday they began to sell the tests to sell at home in the Pingo Doce parapharmacies and should soon arrive at the pharmacies. One of the alerts of the ECDC was already due to the need to have mechanisms to report positive and negative results, since access to tests without a medical prescription can interfere with the calculation of positivity, one of the indicators that allows monitoring the epidemiological situation ( results of the total positives in the total of tests carried out in the country). Another concern is equitable access. DGS, Infarmed and INSA, in joint response to Nascer do SOL, indicated yesterday that the platform for online notification of results, provided for in the ordinance that regulated the use of self-tests, will be available “in due course.” At this time, the procedure to follow for those who buy a test to do at home and have a positive or inclusive result is to call the SNS24 line.
