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  • @ Cynthia Adina Kirkwood

Portugal’s COVID-19 Variant: A Wake-Up Call


Graça Freitas, director of DGS (General-Directorate of Health), by the internationally acclaimed political cartoonist Andre Carrilho

 

Portugal, once the most vaccinated country in the world against COVID-19, is now also the country with the highest incidence of the virus, reported SIC Noticias (May 20). It called for booster shots for young adults and the elderly as well as recommending the wearing of masks, according to RTP Noticias (May 20).


Graça Freitas, director of the General-Directorate of Health (DGS) confirmed that Portugal could reach 60,000 daily cases of COVID-19 in two weeks and more than 50 daily deaths, reported CNN Portugal (May 19). The number of cases already has skyrocketed to a median of 30,000 each day in the week of May 10 and May 16, reported SIC Noticias (May 20).


“This is a sixth wave of the pandemic, not only because of the number of cases but also because of Omicron’s new variant (BA.5),” which is more transmissible and has the ability to escape the immune system but “fortunately, it is not more serious than the others,” Graça Freitas told CNN Portugal.


Expresso (May 20) added that not using masks exacerbated the situation. The mask mandate, with exceptions, ended on April 21, reported Bloomberg (April 22).


The General-Directorate of Health (DGS) continued to advise -- not mandate -- the usage of masks in closed spaces and in crowded places, reported SIC Noticias (May 20), especially when around older and more vulnerable people, according to RTP Noticias (May 20).


However, the mask mandate remains in place for public transport, health establishments, pharmacies, nursing homes, dentist offices and spas, reported SIC Noticias (May 20).


COVID-19 vaccines will not prevent contraction or transmission of the virus, said Graça Freitas to CNN Portugal. However, they will reduce the incidence of hospitalization and death. Portuguese experts called for the development of new vaccines that address future variants, reported Expresso (May 20).


Those 80 and older and nursing home residents began to receive their second booster on May 16, according to SIC Noticias (May 16).


As happened in other phases of vaccination, patients will be summoned by local appointment, SMS or telephone call, according to ECO (March 12). A communication from the health agency said:


“The eligible population is around 750,000 people (in a population of 10.3 million), who must be vaccinated at least four months after the last dose or after a diagnosis of SARS-Co-V-2 infection. That is, this booster also covers people who recovered from the infection.


“Last week, the Minister of Health, Marta Temido, already had announced that the administering of the fourth dose of the COVID-19 vaccine was being considered for people between 60 and 80 years old.


“The DGS also announced that young people between the ages of 12 and 15 with immunosuppressive conditions will receive an additional dose of the COVID-19 vaccine, following a favorable opinion of the Technical Commission for Vaccination Against COVID-19 (CTVC)."


Graça Freitas, director of the General Directorate of Health, said that the DGS is also interested in inoculating “the young adults who, because they had the disease in December or January, did not have their first booster shot”, according to RTP Noticias (May 20).


“We are anticipating the autumn/winter vaccination, anticipating that this virus also may have a seasonal behavior.”


Instituto Nacional de Saude Doutor Ricardo Jorge (INSA) reported that the BA.5 variant of Omicron has been detected in 64 percent of cases, according to SIC Noticias (May 18). The number of cases has increased to a median of 30,000 each day in the week of May 10 to May 16, reported SIC Noticias (May 20).


Renascença (May 20) reported data from the DGS bulletin for the week of May 10 to May 16:


“Portugal recorded an increase in the number of cases, deaths and hospitalizations by COVID-19.


“A total of 191 people died from the new coronavirus, an increase of 47. The mortality rate is now 19 deaths per million inhabitants, up 33 percent in one week.


“A total of 157,502 new cases of COVID-19 were confirmed, an increase of almost 58,000 compared with the previous week. There were 1,450 patients in wards and intensive care, an increase of 243 compared with the previous week.


“Analyzing only the intensive care units, there were 84 admissions, 25 more when compared with the previous week.


“The transmissibility index (Rt) until May 16 was 1.23, which means that each patient infected, on average, more than one person. In that period, the incidence rate was 1,529 cases of COVID-19 per 100,000 inhabitants.


“According to Renascença calculations, the incidence on May 20 is even higher: 1,832 cases per 100,000 inhabitants.”


North is at Epicenter


In its review of DGS weekly data, Renascença reported that the North had 588 hospital admissions.


“The North is now at the epicenter of the epidemic. In the last week, it recorded more than 63,000 new cases, 50 deaths and 588 hospitalizations, 40 of which were in intensive care.


“Lisbon and Vale de Tejo have almost 47,000 more infections, 57 deaths and 502 hospitalizations, 23 in intensive care.”


Central, North Region


“The Central Region accounted for 28,232 cases (a weekly increase of 7,303) and 54 deaths (an increase of 18), and the North totaled 63,487 cases of infection (a weekly increase of 27,553) and 50 deaths (a weekly decrease of 5).


Alentejo, Algarve


In Alentejo, 7,744 COVID-19 cases were recorded (a weekly increase of 1,992) and 16 deaths (a weekly increase of 4) and, in the Algarve, there were 5,405 infections (an increase of 1,878) and seven deaths (a decrease of 2).


The Azores, Madeira


“As for the autonomous regions, the Azores had 4,320 infections (a weekly increase of 952) and four deaths (the same number as the previous week), while Madeira recorded 1,490 cases (a weekly increase of 312) and three deaths (a weekly increase of 3),” reported Renascença.


40-49 Most Infected Age Group


“According to the DGS, the age group between 40 and 49 years old was the one with the highest number of cases within seven days (27,434) followed by people between 50 and 59 years old (24,407), while children up to nine years old were the group with the fewest infections (7,229).”


Elderly Top Hospital Admissions


Of the total admissions, 625 were elderly people older than 80, followed by the age group from 70 to 79 (329) and then the group aged 60 to 69 (185).


The DGS also recorded:


1. 18 admissions of children up to nine years old,;

2. 6 between 10 and 19 years old;

3. 22 between 20 and 29 years old;

4. 35 between 30 and 39 years old;

5. 43 between 40 and 49 years old, and;

6. 95 between 50 and 59 years old.


Who Died


1. 146 people over 80 died;

2. 33 between 70 and 79;

3. 8 between 60 and 69;

4. 1 between 50 and 59, and;

5. 3 between 40 and 49.


Vaccination


The DGS bulletin stated that 100 percent of those over 80, between 65 and 79 and between 50 and 64 years old are fully vaccinated against COVID-19, according to Renascença.


As for the first vaccine booster dose,


1. 95 percent of those older than 80 have received it;

2. 97 percent of those between 65 and 79;

3. 84 percent between 50 and 64;

4. 60 percent between 25 and 49, and:

5. 46 percent between 18 and 24.


INSA researcher, Joao Paulo Gomes, said that the BA5 variant is increasing in Portugal as it is in South Africa, where it was first detected, according to SIC Noticias (May 13). Joao Paulo Gomes, who is responsible for monitoring the genetic diversity of SARS-Co V-2 and other infectious diseases in Portugal, said that it is “a virus with an incredible ability to adapt to the evolution of the immune system.


“By being able to pass through vaccine and natural immunity, “the vaccines currently distributed, still developed with the original strain, are very ineffective against the infection but continue to show very high efficacy in terms of the hospitalization process.


“We all know friends and colleagues who had the infection a few months ago and are now infected again. This is happening with these strains.


“We think it will be almost inevitable that (COVID-19) almost will turn into flu. We will have to live with this coronavirus, and it is thought that the vaccination process will have to continue, even if it is for the most vulnerable groups.”


INSA monitors samples of COVID-19 collected weekly across the country and identifies genetic codes.


In Expresso, Filipe Froes, pulmonologist and consultant at the DGS said:


“(The current) vaccines are at the end of their lives. We already have five variants, several strains, and we should already be going on the fifth different vaccine. But what we have is a vaccine for the ancestral variant, which is almost two years old.


“We are in a transitional phase between the end of the pandemic and the beginning of the epidemic season, between the pandemic vaccine and a seasonal vaccine that will have to be made suited to the variants in circulation, as is made annually for the flu.”


Experts are unanimous, according to Expresso: the current COVID-19 vaccines are starting to serve less and less. Admittedly, they give some immediate defensive reinforcement against the serious evolution of the disease in the most fragile, but they will be of no use next winter.


The surprise of the BA.5 variant, which is the leader of COVID-19 transmission in Portugal, is a serious alert, reported Expresso.


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