The Spanish Health Ministry and regional authorities on Wednesday approved a traffic light system to determine coronavirus restrictions based on an area’s epidemiological situation. This set of common criteria is to be applied until 70% of the population and all over-50s are vaccinated against Covid-19.
The traffic light system categorizes risk as extreme, high, medium, low and new normality based on data points such as the seven-day and 14-day incidence rate, and the percentage of hospital and intensive care unit (ICU) beds occupied by Covid-19 patients. The system, which applies to areas with more than 10,000 inhabitants, then recommends different restrictions based on the level of risk. Up until now, this has been used just as a guide. But on Wednesday, the Inter-Territorial Council of the National Health System (CISNS), which brings together health chiefs from the central and regional governments, voted to make it legally binding.
This means that the regions – which are in charge of controlling the pandemic as well as the Covid-19 vaccination drive – must follow the rules set out by the system. For example, even in a low-risk scenario, nighttime venues must close at 3am and only a maximum of 10 people are allowed to a table in sidewalk cafés. Catalonia, Madrid, Andalusia, Galicia, Murcia and the Basque Country have opposed the mandatory condition of the measures, which will come into force soon, once they are published in the Official State Gazette (BOE). These regions are home to 29.5 million people – more than half Spain’s population of 47.5 million. Castilla y León and the North African exclave city of Melilla also abstained from the vote.
According to the latest figures from the Health Ministry, 18,426,204 people in Spain have received their first dose of a Covid-19 vaccine – 38.8% of the population. Meanwhile, 9,679,187 people have got the full protection offered by the immunization – 20.4%. The government has set the target of vaccinating 70% of the population by the end of the summer, a target that is on track assuming there are no setbacks such as interruptions to supply. The Health Ministry on Wednesday reported 4,984 new coronavirus infections and added 66 fatalities to the overall death toll. The 14-day cumulative number of coronavirus cases per 100,000 inhabitants, meanwhile, fell a further two points to 118.
The new rules agreed on Wednesday, and which will be approved via a Declaration of Coordinated Action (DAC), may lead to legal conflicts between the Health Ministry and some regional governments. Madrid has already announced that it will follow its own measures – not those outlined by the traffic light system. In a message posted on Twitter, Madrid premier Isabel Díaz Ayuso said: “Hospitality establishments are safe spaces and our allies to overcoming this crisis. They cannot pay for the inefficiency of the Sánchez government,” in reference to Prime Minister Pedro Sánchez who leads a coalition government made up of the Socialist Party (PSOE) and junior partner Unidas Podemos.
Madrid has been at loggerheads with the central government over the reach of coronavirus restrictions since the health crisis began. When the CISNS agreed last October that areas at certain risk levels should be placed under perimetral lockdown – a decision that affected 10 municipalities in Madrid – the Ayuso government applied the restrictions, but challenged them in court. When a judge ruled in the region’s favor, the central government was forced to declare a state of alarm in the region to ensure the coronavirus restrictions were followed. Madrid also opposed the coronavirus restrictions approved by CISNS for the Christmas vacations and Easter break, such as limits on travel and social gatherings, but did eventually adhere to them.
At the end of the CISNS meeting on Wednesday, Health Minister Carolina Darias reiterated that it was mandatory for the regions to follow the measures approved by the council. “It is very important to be at a low [risk] level, not only so that we are safer and the virus is spread less, but also so that we can start entering the new normality,” she said. “We have to learn from the lessons learned. We know what happened last summer [when increased social activity led to a second wave of the virus]. What’s important is finishing off what we are achieving and reaching incidence rates below 50 [cases per 100,000 inhabitants, the threshold for low risk].”
The measures approved will affect Spain’s 17 regions differently, depending on what restrictions are already in place in each territory and their contagion rates. While some regions will be able to ease restrictions, others will have to toughen them. In Madrid, for example, the 14-day cumulative number of coronavirus cases per 100,000 inhabitants is 165, a data point, among others, that places it in the high-risk category. Despite this, the restrictions in the region correspond to those in the “new normality” category, i.e. regions where the incidence rate is 25 cases.
Andalusia allowed nighttime venues to reopen until 2am after the state of alarm came to an end on May 9. But these venues will have to close once the new rules are published in the BOE, given that the 14-day cumulative number of cases per 100,000 inhabitants in the region now stands at 177 and is continuing to rise. On the other hand, Valencia, which is in a low-risk scenario, could already allow nighttime venues to open until 3am. Hospitality establishments, however, will still need to shut by 10pm until next week.
One of the mandatory rules that must be applied regardless of the risk level is the ban on smoking when a two-meter distance from other people cannot be respected. This ban also applies to water pipes, hookahs and other ways of inhaling tobacco.
Here is an overview of the main coronavirus restrictions set down by the traffic-light system.
Low risk and new normality. Indoors, the maximum capacity is 50%. Outdoor areas will be allowed to operate at full capacity, provided that the seats between different tables are 1.5 meters apart. The consumption of food and drinks, both inside and outside, will have to take place while seated at tables, with the same safe distance. The tables will have a limit of six people inside and 10 outside. Closing time will be 3am at the latest, and registers will be introduced to ensure that patrons can be traced should a coronavirus case be detected.
Medium risk. If the progress of the health crisis is favorable, closing time will be at 2am and the same measures for the lower risk scenario will be adopted, apart from a limit of a third of capacity inside.
Bars and restaurants
New normality. The permitted capacity will be 50% inside with the option of an extra 10% if risk-control measures are introduced that guarantee high levels of ventilation and air-quality control. Tables in outdoor areas can be fully occupied provided that the distance between chairs at different tables is at least 1.5 meters. Service and consumption at the bar are allowed, provided the aforementioned distance is respected. Six people can share a table inside, and 10 outside. Closing time will be 1am and service will cease one hour previously.
Low risk. The same measures as in the new normality, but with a distance of two meters between tables.
Medium risk. Inside, the same measures as low risk, but with a limit of a third of capacity. Outside, a maximum of 75% and six people per table.
High risk. Indoor areas will be closed and the same measures will be applied outside as for medium risk.
Very high risk. Outdoor capacity limited to 50% and limits on opening times, with groups of patrons separated and a maximum of four people per table. If the trend is rising and exceeds 500 cases per 100,000 inhabitants over 14 days, establishments must close, only offering takeaway or delivery for consumption at home.
New normality. A maximum of 10,000 people. Independent sectors of no more than 1,000 people must be established, with safety measures being observed at all times. Transit areas between these sectors will be at least two meters wide. Smoking will not be permitted, nor the use of electronic cigarettes, in areas dedicated to the public. Maximum capacity of 50%, guaranteeing a useable area of 1.5 square meters per person, and eating and drinking will not be allowed in the public areas.
Low risk. The same measures as previously described, but with a maximum of 5,000 people and space of 2.25 square meters.
High risk. A maximum of 2,500 people. If possible, independent sectors of no more than 500 people will be established. Capacity will be limited to 30% and the area per person will be three square meters. Consumption of food and drink will be prohibited.
Very high risk. No events with large crowds will be allowed.
Primary and secondary school, vocational training. These centers will remain open during the entire school year, “ensuring there are canteen services as well as out-of-hours study support for minors with special needs or who belong to socially vulnerable people,” according to the document, to which EL PAÍS had access on Tuesday. If there are outbreaks or the transmission of the virus runs out of control, “mixed in-person and remote education will be considered” before the center is closed, or “changes to the timetable that will allow for greater limits on contacts.”
Universities. The agreement only stipulates “distance learning as far as possible” for university teaching under alert level 4, and for the rest of the levels the same recommendations will be in place as for 2020 to 2021 – i.e. the use of masks, a Covid coordinator, contact tracing, quarantines for those with symptoms and ventilation of closed spaces, among other measures.
For all centers. All of the prevention measures set out by the ministry will be applied in all schools and universities. These include limiting contacts, maintaining social distancing, creating bubbles, handwashing and mask use, regular ventilation of indoor areas and students with symptoms staying at home.
Omicron: Everything we know about the new Covid variant
independent– The World Health Organisation (WHO) has named the new B.1.1529 coronavirus variant omicron and designated it a variant of concern just weeks after it was first detected in southern Africa.
Scientists believe it could take months before we have a more complete understanding of the scale of the threat it poses.
What is known is that the variant, which descends from the B.1.1 lineage, is “unprecedented” and “very unusual” in the number of its mutations as it has 32 in its spike protein.
Where did omicron emerge?
The variant was first detected in Botswana on 11 November, where 19 new infections of the omicron variant have been found, as of Friday.
The country’s president Mokgweetsi Masisi said on Thursday that some of these first cases were in diplomats who had travelled to Botswana from Europe and elsewhere, without detailing which countries.
South Africa’s first case was spotted on 14 November, and the country reported the variant to the WHO on 24 November.
Professor Francois Balloux, the director of the Genetics Institute at University College London, said that the variant’s mutations are in “an unusual constellation” that “accumulated apparently in a single burst”.
He suggested that the variant might have emerged from an immunocompromised person who harboured the virus for a long period of time, “possibly in an untreated HIV/AIDS patient”.
How prevalent is omicron in the UK?
In the week after the first omicron cases were detected in England, the UK has discovered 150 infections in total.
Twenty-nine of the cases are in Scotland, where first minister Nicola Sturgeon said on Saturday that cases are no longer linked to a single event, but to several different sources including a Steps concert in Glasgow.
“This confirms our view that there is now community transmission of this variant within Scotland,” Ms Sturgeon said, warning that cases are expected to rise in the days ahead, “perhaps significantly”.
The first-known case in Wales was discovered on Friday, and Northern Ireland has said it expects to discover an instance of the variant in a matter of days.
How did omicron reach the UK?
According to health secretary Sajid Javid, the two cases initially found in England – in Brentwood, Essex, and in Nottingham – were “linked” and were traced to southern Africa.
While targeted sequence testing of other cases was launched in those areas, Mr Javid admitted that air passengers from South Africa who arrived in the UK last Friday were not tested, despite fears they could be carrying the omicron variant.
The travellers left airports in normal ways – including on public transport – and were only then asked to take Covid tests and to go into isolation if they tested positive, the health secretary said.
It means the UK does not know how many arrivals from South Africa were infected – after a staggering 10 per cent of people on one flight into the Netherlands tested positive for the omicron variant.
Where else are omicron cases being detected?
New infections linked to the omicron variant have been confirmed in at least 38 countries, including Belgium, Canada, Australia, the Netherlands, Denmark, Germany, Israel, Italy, the Czech Republic and Hong Kong.
How transmissible and dangerous is omicron?
Urging countries on Friday not to panic, but rather to prepare for the likely spread of omicron worldwide, the World Health Organisation (WHO) said it would likely take another fortnight to establish how transmissible and dangerous the variant is.
While scientists believe it may be considerably more infectious than the delta variant, the UN health agency stressed that the data is still only preliminary.
The variant’s 32 mutations include E484A, K417N and N440K, which are associated with helping the virus to escape detection from antibodies.
Another mutation, N501Y, appears to increase the ability of the virus to gain entry to our cells, making it more transmissible.
In South Africa, where approximately 42 vaccine doses have been administered per 100 people, the WHO said there had been a 311 per cent surge in coronavirus cases in the last seven days of November, compared to the previous week.
South Africa is seeing more cases of re-infection than with previous variants, the health agency said, citing a microbiologist from the country’s National Institute for Communicable Diseases.
But despite cases of the new variant emerging in dozens of countries around the world, not a single death has yet been attributed to it, the WHO said.
Of the 150 cases identified in the UK, none are reported to have been hospitalised, although the UK Health Security Agency noted that the infections are recent and there tends to be “a lag between onset of infection and hospitalisation and death”.
“We need to be prepared and cautious, not panic, because we’re in a different situation to a year ago,” top WHO scientist Soumya Swaminathan said, suggesting that omicron could become the globally dominant variant, in the same way that delta now accounts for 99 per cent of cases.
Is omicron resistant to vaccines?
The spike proteins coating the Covid virus allow it to attach and gain entry to human cells. Vaccines train the body to recognise these spikes and neutralise them.
The 32 mutations in the omicron variant’s spike protein will change the shape of this defence structure and make the spike protein less recognisable to antibodies.
Antibodies then won’t be as strong in attacking the virus, which would then be able to slip past immune defences and cause infection.
However, WHO emergencies director Michael Ryan said on Friday that there was no evidence to back changing existing vaccines to tailor them to the new omicron variant, suggesting that the focus should be on distributing jabs more widely.
What are scientists saying about omicron?
Scientists have mixed opinions over whether or not we should be worried about the latest variant.
Dr Tom Peacock, a virologist at Imperial College London, warned that the variant could be “of real concern” due to its 32 mutations.
He wrote on Twitter that the variant “very, very much should be monitored due to that horrific spike profile” which could mean that it is more contagious than any other variant so far.
Meanwhile, Prof Balloux of UCL said that at the moment there is “no reason to get overly concerned”, and also said that “it is difficult to predict how transmissible it may be at this stage.”
Professor Andrew Pollard, of the Oxford Vaccine Group, said it is “extremely unlikely” to trigger a new wave in the pandemic in the UK.
Professor Calum Semple, who sits on the Sage advisory group, said: “The headlines from some of my colleagues saying ‘this is horrendous’ I think are hugely overstating the situation.
“Immunity from the vaccination is still likely to protect you from severe disease,” he said.
“You might get a snuffle or a headache or a filthy cold but your chance of coming into hospital or intensive care or sadly dying are greatly diminished by the vaccine and still will be going into the future.”
Dr Meera Chand, the Covid-19 incident director at the UK Health Security Agency, said that the status of new Covid variants worldwide is constantly being monitored at random and that a small number of cases with “new sets of mutations” were “not unusual.”
She explained: “As it is in the nature of viruses to mutate often and at random, it is not unusual for small numbers of cases to arise featuring new sets of mutations. Any variants showing evidence of spread are rapidly assessed.”
What is the UK doing to curb the spread?
Boris Johnson announced on Saturday evening that people will be ordered to wear masks in shops and on public transport in England from 30 November in response to the omicron variant.
The prime minister also said that contacts of omicron cases must isolate for 10 days. All international arrivals must also take a day 2 PCR test and isolate until they receive a negative result.
Mr Johnson told the press conference that the rules will be reviewed before Christmas in three weeks’ time.
Meanwhile, southern African nations have also been added to the UK’s red list for international travel.
South Africa’s health minister, Joe Phaahla, said travel restrictions placed on his country were “uncalled for”.
He claimed they would not prevent the virus’ spread and suggested regular testing and mask-wearing to prevent surges of infections.
Which countries are closing their borders?
While the WHO has repeatedly warned against implementing blanket travel bans except in nations whose health systems are unable to withstand a surge in infections, Japan, Morocco, and Israel have decided to shut their borders to all overseas citizens.
A number of nations, including the UK, US and some in the European Union, have placed restrictions on travel from nations in southern Africa.
The UK has added Botswana, Angola, Eswatini, Namibia, Lesotho, South Africa, Mozambique, Malawi, Zambia and Zimbabwe to its travel red list.
Australia announced a two-week delay to its plans to reopen borders to skilled migrants and students from 1 December.
In response to the various travel bans, the president of South Africa Cyril Ramaphosa urged nations to “urgently reverse” these decisions as they could spook economies.
The emergence of omicron is a wake-up call for the world to realise the impact of “vaccine inequality”, Mr Ramaphosa said, warning that further variants are inevitable until everyone is vaccinated.
First image of omicron coronavirus variant shows many more mutations in area that interacts with human cells
independent– Researchers have revealed the first image of omicron, the new coronavirus variant first detected in South Africa and Botswana, which shows that it has more mutations than the currently predominant Delta variant.
The 3D image of omicron, produced and published by the Bambino Gesu hospital in Rome, reveals that the variant has many mutations concentrated in the spike (S) protein — the part of the novel coronavirus that enables it to enter human cells.
“We can clearly see that the omicron variant presents many more mutations than the delta variant, concentrated above all in one area of the protein that interacts with human cells,” the researchers said in a statement on Sunday. “This does not automatically mean that these variations are more dangerous, simply that the virus has further adapted to the human species by generating another variant.”
The scientists called for further studies to unravel if the adaptation seen in the variant is “neutral, less dangerous, or more dangerous”.
Scientists have found about 50 mutations in omicron, 30 of which are on the S protein, and half of those in the receptor-binding domain – the part that binds to the ACE2 receptor on human cells through which the virus enters tissues.
The red dots in the image, researchers said, indicate areas with “very high variability,” while the orange ones are those with “high variability”, and the yellow ones with “medium variability.” Green dots are parts of the S protein showing low difference between the two variants, while the gray area shows portions that do not vary.
“Case numbers tripled in 3 days in South Africa to 2,828, but this is perhaps partly because of intensive monitoring, although it is possible that the transmission rate is double that of delta (R=2) and the doubling time is about 4.8 days,” Peter Openshaw, professor of experimental medicine, Imperial College London, said in a statement on Saturday.
“South Africa is going into summer and rates of delta are very low, so hard to say if omicron competes over delta,” Dr Openshaw added.
On Friday, the World Health Organisation noted that there could be an increased risk of reinfection with the new B.1.1529 coronavirus variant, named omicron, compared to other variants of concern.
“The number of cases of this variant appears to be increasing in almost all provinces in South Africa,” the WHO noted in a statement on Friday. “In recent weeks, infections have increased steeply, coinciding with the detection of B.1.1.529 variant.”
While the number of people testing positive has risen in areas of South Africa affected by this variant, the WHO says further studies are underway to understand if the surge in cases is because of omicron or other factors.
The WHO’s Technical Advisory Group on Virus Evolution also highlighted that it is still unclear whether infection with omicron causes more severe disease compared to infections with other variants.
“While preliminary data suggests that there are increasing rates of hospitalisation in South Africa, this may be due to increasing overall numbers of people becoming infected, rather than a result of a specific infection with omicron,” the experts noted in a statement on Sunday.
They urged all countries to enhance surveillance and sequencing efforts to better understand circulating variants of the novel coronavirus, and submit complete genome sequences and associated metadata to a publicly available database, such as GISAID.
The WHO and several health experts across the world have called for increasing global vaccine equity to ensure that new variants of concern do not emerge.
“It is very likely that current vaccines will protect against severe disease with omicron as they do for all the previously identified virus variants. But this does highlight the need to remain vigilant – the pandemic is not over,” Lawrence Young, virologist and professor of molecular oncology at Warwick Medical School, said.
Spanish researchers pave way for fair play in global Covid testing and research
thelocal– The World Health Organisation described the accord as the first transparent, global, non-exclusive licence for a Covid-19 health tool, that should help towards correcting the “devastating global inequity” in access.
The deal brings the Spanish National Research Council CSIC together with the global Medicines Patent Pool (MPP) and the WHO’s Covid-19 Technology Access Pool (C-TAP) knowledge-sharing platform.
“The aim of the licence is to facilitate the rapid manufacture and commercialisation of CSIC’s Covid-19 serological test worldwide,” the WHO said.
The test effectively detects anti-SARS-CoV-2 antibodies developed in response to either a Covid-19 infection or a vaccine.
CSIC, one of Europe’s main public research institutions, will provide the MPP or prospective licencees with know-how and training.
WHO chief Tedros Adhanom Ghebreyesus described the licence, which will be royalty-free for low and middle-income countries, as “the kind of open and transparent licence we need to move the needle on access during and after the pandemic”.
He added: “I urge developers of Covid-19 vaccines, treatments and diagnostics to follow this example and turn the tide… on the devastating
global inequity this pandemic has spotlighted.”
C-TAP was founded in May 2020 as a platform for developers of Covid-19 tools to share knowledge and intellectual property.
Set up during the scramble for Covid vaccines and treatments, the health technology repository was first suggested by Costa Rican President Carlos Alvarado.
The information pool was intended as a voluntary global bank for IP and open-sourced data as part of a common front against the new coronavirus.
However, as it turned out, rival pharmaceutical companies have largely kept their findings to themselves rather than sharing them as global public goods.
Tuesday’s deal “shows that solidarity and equitable access can be achieved”, said Alvarado.
CSIC president Rosa Menéndez said she hoped the move would serve as an example for other research organisations.
‘Preposterous’ tests hoarding
The medical charity Doctors Without Borders (MSF) said the test could quantify three different types of antibodies — and crucially, differentiate vaccinated people from those with natural Covid infection.
“This feature will become very important for measuring the number of Covid-19 cases in countries and the impact of control measures,” it said.
In welcoming CSIC’s move, MSF diagnostics adviser Stijn Deborggraeve said it was “preposterous” in a global pandemic that tests were being monopolised by “a handful of privileged people and countries”.
The Geneva-based MPP is a UN-backed international organisation that works to facilitate the development of medicines for low- and middle-income nations.
The antibody test licensing accord is the third Covid-related deal that the global pool has struck in a month.
Last week, the MPP reached an agreement with US pharmaceutical giant Pfizer to make its prospective antiviral Covid-19 pill available more cheaply in 95 low- and middle-income countries via sub-licensing to generic drug manufacturers.
The MPP signed a similar deal last month with Pfizer’s US rival Merck for its prospective oral antiviral medicine molnupiravir.
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