[ad_1]
The uncertainty around the next few months remains, but now two models are known that show how the covid-19 epidemic could evolve. Behaviors are decisive, but the projections of the University of Washington do not exclude the need for a new confinement. In Portugal, they point to December as the critical month.
The recipe has been rejected by several countries and António Costa reiterated this week that the country cannot stop again as in March. The focus is now on getting back to school and working without crowds. The team of epidemiologist Manuel Carmo Gomes, a researcher at the Faculty of Sciences of the University of Lisbon, presented to the Government a model based on the network of contacts of the population and the dynamics of the epidemic in the country, that is, the results of the serological survey that showed there were six times more infections than those that have been diagnosed. The team predicts that the reduction of contacts will be vital to flatten or even avoid a second wave, which requires a reduction of contacts in schools and that contacts in general in society are at least half of those that existed before the covid. -19. “The second wave is not a fatality”, Carmo Gomes stressed at the meeting of experts at the Faculty of Medicine of the University of Porto, explaining that the advantage of the model is to show how the increase in hospitalizations can be stopped. For example, if schools reopen with contact between pre-covid students, the second space could be larger than the first.
Ali Mokdad, one of the authors of the projections from the University of Washington, which point to 2.7 million deaths worldwide in early 2021 – which could be reduced by a third with the massive use of masks – underlines the importance of all behaviors, but keeps measures such as school closings and non-essential services on the horizon. For Portugal, the model developed by the University of Washington, which is based on mobility reports from cell phone operators and a survey on the use of a mask carried out worldwide on Facebook, shows an increase in cases especially from November . To define when countries would replace containment measures, they use the level of 8 deaths per million inhabitants, which in the current projection is reached in early December. With the extensive use of masks, if the population always wears them, it can happen at the end of the year. “We didn’t call it a second wave, because that meant we went down to zero cases and started over, which didn’t happen. We are still in the first wave. If it is preventable [a evolução]? When mobility is reduced, you always wear a mask, keep your distance, wash your hands often, if people don’t let their guard down we can prevent many of the cases, ”said Mokdad. SUNHowever, drawing attention to the effect of seasonality with greater circulation of viruses and bad weather will condition solutions such as terraces and outdoor alternatives. At the same time, the increase in cases can also lead the population to adopt safer behaviors.
The model, based on current mobility, foresees 4,000 deaths from covid-19 by the end of the year in the most favorable scenario, with massive use of a mask, and 8,000 with current use, representing 65%. In both scenarios, which will be updated with the evolution of mobility in the coming weeks, it is estimated at this point that it will reach the critical level of confinement in December. They calculate 11,000 deaths if this does not happen and an exponential increase in cases, which in December could be between 15,000 and 20,000 infections a day, without other measures. “We can postpone confinement, if people wear masks and if mobility is reduced, the curve flattens out. The problem is that we cannot imagine a country that reaches eight deaths per million inhabitants per day and not emergency shutdown, to prevent the virus from spreading exponentially. We see Indonesia, where it was said that the confinement would not return and today [quarta-feira] It was announced in Jakarta. If Portugal reaches a point where hospitals are at 80% capacity, there is no other way than to enact a lockdown so as not to overload the hospitals and be able to admit other patients. When that happens, only a lockdown can stop the epidemic.
Mokdad says that most countries followed the criterion of eight deaths per million population to enact the first lockdown. In Portugal, it was far from that – when the country entered a state of emergency, due to the collapse of the health system in Italy and Spain, there were around 100 new cases / day in the country and RT was growing, having reached the maximum 2.07, the value when the country borders. The epidemic had claimed the first two victims.
The red lines
António Costa considered this week that the confinement is a non-scenario, but pointed out red lines. The first will be the evolution of deaths. “There is no greater good than life and this is fundamental,” he said. Second, our intensive care capacity. We have never been in a borderline situation, there has been a constant reinforcement of our intensive care capacity. But if suddenly we all need intensive care, this is an important indicator. The third is the need for hospitalizations in the hospital system and taking into account that the hospital system and the NHS cannot be exclusively dedicated to covid-19 ”, he continued, reiterating at the same time that the objective is not to close schools or stop again. the economy.
HE SUN He asked the Ministry of Health if levels are defined from which measures can be toughened, either in terms of the evolution of deaths or hospitalizations, but did not have an answer until the end of the edition. At the Covid-19 press conference, the Minister of Health stressed that the current epidemiological situation requires redoubling everyone’s efforts and admitted that the result will be decisive for the functioning of the country: “The measures adopted sought the best balance between values present, as is evident, we seek to offer a safe return to schools, protect the most vulnerable, that is, the elderly and institutional residents, and we seek to keep jobs and the economy going. This will only be possible if we balance the contacts. The number of contacts and also the protection used in those contacts are decisive ”.
Although government regulations follow the logic of reducing contacts, measures such as reducing crowds to 10 people, limits of four people in establishments less than 300 meters from schools or shifts, and mandatory rotating equipment in mirror have not been made public. companies in the metropolitan areas of Lisbon and Porto aim to achieve the objectives of some of the scenarios proposed by the Carmo Gomes team.
In the presentation to the Government and parties, the researcher presented four scenarios for the evolution of hospitalizations, without detailing global figures. If schools were to reopen on September 14 with the same contact between students as before covid-19, and assuming that society is reduced by half, the second wave of increases in hospitalization would be greater than at the beginning. the epidemic, in which there was a peak of 1302 hospitalized patients on April 16, which then began to decline (schools closed on March 15 and a state of emergency was declared on March 18). In a scenario of reducing contacts in schools to 70%, Carmo Gomes’ team points to an average of hospitalizations identical to that of the first wave, and a reduction of contacts to 50% would allow the curve to flatten to levels lower than those of the first wave wave. And the reduction to 30% would more surely avoid a second wave. _ “It is demanding but it is possible,” said the specialist.
During the week, the researcher said that the increase in cases currently registered in the country was only expected for the end of September. “We have not seen a corresponding increase in hospitals and I hope it continues, but now there is no doubt that it is a shame that we start classes on September 14 in this situation,” he told Renascença. “My recommendation is to strengthen the public health teams now,” she said.
Epidemic accelerates
The week closed with a marked increase in cases compared to last week. The RT stood at 1.14 in the first week of September and now the growing trend of the epidemic is accentuated. From Monday until yesterday, 3,356 new cases of covid-19 were registered in the country, which compares with 2383 the previous week. The number of active cases now exceeds 17,000 infected people in follow-up, of which 404 are hospitalized.
When the country entered a state of emergency there were 637 active cases in the country. At that time, fewer tests were done, so the comparisons are not linear. The peak of active cases was on May 15, when there were 24,000 infected patients. More than half of the infections with a known link have occurred in a family context, but at the moment, the link is known only in 60% of cases, said the Minister of Health. A new stage begins, in which the objective is once again to “flatten the curve.” , an expression that was not heard for some time, and that Marta Temido used again yesterday.
Click on the image for a better view
