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Spain’s coronavirus incidence rate falls for the first time this year, but pressure on ICUs rises

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The third wave of the coronavirus has pushed Spain to the breaking point. According to the Spanish Health Ministry’s latest report, released on Thursday, the country has started to flatten the curve of new infections, but it has done so at crisis levels, with pressure on hospitals, especially in intensive care units (ICUs), close to unbearable. This pressure continues to rise across almost all of Spain.

The last 10 months of the pandemic have shown that there is not one but various peaks in a wave. The first is the number of new infections. The second is the spike in hospital admissions, which tends to happen a week later, and takes a little longer to be reflected in ICU figures. The final peak, which indicates a change in trend, is the number of deaths. The Health Ministry added 515 fatalities to the official count on Thursday, a terrible toll that is likely to remain at these levels for days to come while Spain transitions from peak to peak.

The latest data indicates that Spain is starting to see the other side of the peak of new infections in the third wave. A week ago, the Health Ministry reported a record-high 44,357 new coronavirus figures. On Thursday, that figure fell to 34,899. It is also the first day this year that the national incidence rate has fallen: the 14-day cumulative number of cases per 100,000 inhabitants now stands at 890, down from 900 on Wednesday.

Hospital admissions fell for the first time this year on Wednesday, with the percentage of Covid-19 patients in hospital wards dropping to 24.10%, down slightly from 24.03% on Tuesday. This data point fell again on Thursday, although the drop was again only marginal. But pressure continues to mount in Spain’s ICUs, which are the last line of defense of the healthcare system. If they are overwhelmed, authorities may be forced to introduce tougher restrictions, such as home confinement. Making matters worse, the pressure on ICUs is rising amid the uncertainty over how the emergence of new, more contagious strains of the coronavirus, such as the B.1.1.7 variant detected in the United Kingdom, will impact the pandemic in Spain.

“According to the data we have, we can expect that it [the B.1.1.7 variant] will be the dominant one in Spain by the end of February or the first fortnight of March. This has some implications because the strain is more transmittable,” said Fernando Simón, the director of the Health Ministry’s Coordination Center for Health Alerts (CCAES), at a government press conference on Thursday. The health official previously said this would not happen until a later date.

Simón admitted that there are small areas in Spain where the new strain already accounts for 20% of cases, but said nationally this figure was “around 8%.” With respect to restrictions, the health official said that “the measures that must be taken” are the same for the new and old variants of the coronavirus. “More measures can still be implemented without modifying the state of alarm,” he said, in reference to the emergency decree that gives regional governments – which are responsible for managing the health crisis – the power to introduce measures such as perimetral lockdowns, but not home confinement.

The figures released on Thursday also do not reflect how the coronavirus situation differs between each of Spain’s 17 regions. Indeed, the fall in hospitalizations over the past two weeks is mainly due to improvements in two regions: Valencia (which, despite this, remains in a “very critical situation,” said Simón) and Catalonia, which reported 466 fewer occupied beds on Thursday than on Tuesday. In Castilla y León, Galicia and Andalusia, there continue to be more hospital admissions than discharges.

“There are 11 regions where the situation is stabilizing or on a downward trend, but this is not the same as a fall in the hospital occupancy rate. The pressure on hospitals will continue over the coming days,” said Simón.

Andalusia and Galicia, as well as Murcia and Valencia, are some of the regions that are being hardest hit by the third wave of the pandemic, with the situation even worse than what it was during the first wave.

The big problem continues to be in ICUs. On Thursday, the Health Ministry reported 97 more ICU admissions than on Wednesday, and no region has managed to clearly reverse the upward trend. In other words, the peak of ICU pressure is still to come. In more than half of Spain, Covid-19 patients occupy more than 40% of all ICU beds – a similar figure to all other diseases combined. In the Balearic Islands, Castilla y León and Extremadura, the occupancy rate is more than 40%; in Castilla-La Mancha, Catalonia, Madrid and La Rioja, it is more than 50%; and in Valencia, it is 63%, a record high not seen since April last year, during the first wave.

As experts warned, the source of the problem is that Spain entered the third wave – which started after the December 6 long weekend – before the second wave was over. This meant that the ICU occupancy rate of Covid-19 patients, which was below 15% in October when the number of new cases began to rise, was already at around 30% in some regions when the third wave hit.

Read from source: https://english.elpais.com/spanish_news/2021-01-29/spains-coronavirus-incidence-rate-falls-for-the-first-time-this-year-but-pressure-on-icus-rises.html

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NSW COVID-19 hospitalisations pass 1,000 as cases continue to balloon across Australia

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sbs– New South Wales has recorded another 18,278 COVID-19 cases and two deaths as the state’s outbreak continues to surge.

Sunday’s case numbers are slightly lower than Saturday’s 22,577.

The state recorded two deaths from the virus, while 1,066 people are hospitalised, up from 901 on Saturday. There are 83 in intensive care.

At the peak of the Delta outbreak, on 21 September, there were 1,266 people hospitalised with infections, and 244 in intensive care.

Testing numbers to 8pm on the first day of 2022 were down to 90,019, a drop from 119,278 on New Year’s Eve.

The high case numbers come as Premier Dominic Perrottet continues to focus on hospitalisation and intensive care numbers rather than the daily case total.

Despite comprising about six per cent of the population, unvaccinated people make up the majority of those in intensive care, Health Minister Brad Hazzard says.

To ensure hospital systems can cope, asymptomatic health workers who are in isolation due to being a close contact of a positive case will be permitted to leave isolation in “exceptional circumstances”, NSW Health announced on Friday night.

Victoria posts 7,172 cases, extreme heat closes testing sites

The first day of 2022 hasn’t been kind to 7,172 Victorians, the state’s latest residents to contract COVID-19.

A further three virus-related deaths have also been recorded for 1 January.

However the number of Victorian coronavirus patients in hospital care remains relatively stable at 472, up 19 on Saturday’s figure and 48 beyond the seven-day average.

Of them, 52 are classified as active ICU cases and 22 are in need of ventilation.

Chief Health Officer Brett Sutton’s daily update said on Sunday community sampling had revealed 76 per cent of all samples collected over the Christmas period were the Omicron variant. Further testing to confirm this is being undertaken over the next week.

In total, Victoria is managing 31,461 active COVID-19 cases.

Health authorities says virus testers managed to process 48,252 results in the 24 hours to Saturday evening.

The state is 93 per cent fully vaccinated for everyone aged 12 and over.

Some 7,442 infections were reported on Saturday, another pandemic record. There were 51 actively infectious patients in intensive care and 21 ventilated.

Extreme heat caused the closure of eight of the state’s testing sites on Saturday.

Queensland records 3,587 new cases

Queensland has added 3,587 infections to its COVID-19 caseload as a new indoor mask mandate comes into effect across the state.

Some 16,688 Queenslanders now have the virus. However, hospital numbers remain low with 112 patients in care, five of them in ICUs and none requiring ventilation.

Health authorities say testers processed almost 34,000 results in the 24 hours to 7pm on Saturday.

Queensland is 86.60 per cent fully vaccinated for everyone 16 and over.

Chief Health Officer John Gerrard says despite a jump of more than 1,300 cases in a day, he’s not surprised. In part, the increase is related to a change in reporting protocols which saw case figures taken from a 12-hour window on Friday.

“This number is probably a bit smaller than we had expected,” he said in Brisbane on Sunday of the latest figures.

“It probably (also) relates to testing over the holiday period and so it will not be a surprise at all that in the next couple of days we see a significant increase in cases as more samples are tested and more people come forward.”

Dr Gerrard said what experts were now seeing with the virus was that it was “a vastly different disease” to that which was spreading in the community last year and prior to vaccination.

“With a degree of contagiousness of this virus, we are going to be seeing very large numbers of cases, even though the severity is clearly going to be less,” he said.

“We are going to see very large numbers of cases and a small proportion of a very large number (who fall ill) is still a large number.”

Masks were declared compulsory in “virtually all indoor spaces” in Queensland from 1am on Sunday.

Previously masks were only required indoors at supermarkets, shops, on public transport and ride share as well as airports and planes, cinemas and theatres in Queensland.

They now need to be worn at workplaces unless unsafe to do so, pubs, clubs and cafes unless when seated, indoor stadiums and sport arenas, libraries, hair dressers and nail salons, and medical centre waiting areas.

Queenslanders were also urged to return to work-from-home arrangements where possible.

SA hospitalisations ‘very much within capacity’

South Australia, meanwhile, recorded 2,298 COVID-19 cases on New Years Day from 21,140 tests.

The newest caseload is up from 2,108, while hospitalisations have also risen by 11.

There are currently 82 people in hospital, Premier Steven Marshall said on Sunday, a number which he said was “still very much within our current capacity”.

Seven people are in ICU.

“We see a lot of admissions but also a lot of people are leaving hospital on a daily basis after their conditions have stabilised,” Mr Marshall told reporters on Sunday.

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US follows UK’s lead and shortens isolation for healthcare workers who test positive for Covid-19

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independent– Healthcare workers who test positive for Covid-19 and are asymptomatic only need to isolate for seven days, the Centers for Disease Control and Prevention (CDC) has said.

The CDC reduced the recommended isolation time from 10 days in part due to concerns that the highly transmissible Omicron variant could cause even greater staffing shortages at hospitals.

In new guidance released on Thursday, the CDC said infected healthcare workers could return to work after a week as long as they were asymptomatic and produced a negative test.

The US recorded 261,339 new cases on Thursday, according to data from Johns Hopkins University.

Earlier this week, the UK Health Security Agency announced that essential workers would be allowed to return after a seven-day isolation period amid a worsening staffing crisis in hospitals.

In a statement, CDC Director Rochelle Walensky said it was updating guidelines in response to an “anticipated surge” in patients due to the Omicron variant.

“Our priority, remains prevention—and I strongly encourage all healthcare personnel to get vaccinated and boosted.”

Dr Walensky added that health care workers who were fully vaccinated, including with a booster shot, did not need to isolate after a high-risk exposure.

On Friday, New York Governor Kathy Hochul announced that essential workers who tested positive could return to their jobs after five days if they were fully vaccinated and asymptomatic, and had not had a fever within the past 72 hours.

“This is not Delta, or the first variant,” Ms Hochul said during a live address.

“This is Omicron, and thus far it has demonstrated it’s not as severe in its impact, and therefore we want to make sure that our critical workforce, who we’ve relied on from the beginning, can get back to work.”

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Covid booster jab triggers immune response in days, not weeks, say scientists

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independent– Those who receive a Covid booster jab can expect to mount an immune response in a matter of days – not weeks, scientists say.

The boosters have been shown to restore the body’s immunological defences against Omicron, which appears capable of infecting those who are double-jabbed.

While it takes up to two weeks to prime the immune system against Covid after a first dose, the effects of a booster jab start to be felt within two to three days, experts believe.

“The immunity generated after a booster jab will rise much quicker than the first immune response,” said Gary McLean, a professor in molecular immunology at London Metropolitan University.

That’s because crucial memory cells activated after the first dose will still be present in the body, Prof McLean explained, and therefore “do not require the two-week activation and instruction phase they initially go through”.

These memory cells – T and B – are responsible for hunting down infected cells and producing antibodies that stop the virus from gaining entry in the first place.

Their continuing presence means the immune system is on high alert and ready to spring back into action at the earliest sight of the virus, or anything that mimics it.

“That can then translate into boosted antibody levels and other increases in active T cells within days of the booster,” said Prof McLean. “It is likely that maximal immune activity is reached seven days after the booster.”

Professor Charles Bangham, an immunologist and co-director of the institute of infection at Imperial College London, said that in a secondary or subsequent immune response, T cells and antibodies should start to be detectable within “two to three days” of a booster.

The boosters appear to be 70 per cent effective against omicron infection – and are thought to offer even higher protection from hospitalisation and death – but scientists are concerned that the UK rollout won’t be able to keep up with the spread of the variant.

Doubling at a rate of every two days, Omicron has fuelled a sudden lift in national cases. On Thursday, 88,376 new Covid cases were reported, setting a new pandemic record for the second day running.

However, infections are thought to be running at far higher levels. The UK Health Security Agency said it expects there to be more than one million infections a day by the end of the month.

The government, meanwhile, has set the ambitious target of rolling out one million boosters a day to counter Omicron, and intends to have offered all eligible adults one by the close of the year. Some 745,183 third doses were given on Thursday, bringing the national total to 25.4 million.

Recent research from Israel suggests that rates of infection, severe disease and death from Delta were reduced after three to seven days post-boost – but reduced more after 12 days post-boost – when using the Pfizer vaccine for all three jabs.

The UK’s Cov-Boost study, which investigated the benefits of a booster jab among people who had received doses of the Pfizer or AstraZeneca vaccine, also pointed to an increased immune response by day seven.

“This ‘secondary immune response’ is more rapid than observed following the ‘priming’ course of vaccination, when the body takes 14 days or longer to ‘prime’ the antibody-producing B cells to produce antibody against the virus,” said Penny Ward, a visiting professor in pharmaceutical medicine at King’s College London.

“However when virus antigens [an immune-triggering structure] are ‘re-encountered’ – either by a boosting shot of vaccine or by exposure to infection – these cells react very rapidly to produce antibody more quickly.”

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