Misc 21/01/2021

Antoni Trilla: "We are normalizing covid mortality, which is ten times higher than that of the flu"

Interview with the head of preventive medicine and epidemiology of the Hospital Clínic

Gemma Garrido Granger
3 min
Antoni Trilla: “Estem normalitzant la mortalitat del covid, que multiplica per deu la de la grip”

Santa Coloma de GramenetEpidemiologist Antoni Trilla (Barcelona, 1956) is positive about the extension of the restrictions to avoid saturating hospitals and believes that the possible impact of the British variant of the coronavirus - which he believes has been circulating in the country for some time - cannot yet be seen in the Catalan curve. He also regrets that the population has normalized the high daily figures of deaths and is hopeful with the vaccination campaign among the elderly and health professionals.

Do you see the extension of the restrictions for two more weeks as appropriate?

It is a wise and prudent measure in view of the current state of the health system. The restrictions are being deployed because hospitals are very full and it is known that the peak in admissions is between 15 and 20 days after the acceleration of the epidemic. We know that it is possible that we will have even more pressure on healthcare, so all the contagions that can be avoided will help us.

Are you confident that the situation will be straightened out before 7 February?

The indicators are very fragile, they can go off at any time, and at very high values. Everything is very uncertain and we do not know if the epidemic will stop growing or if it will accelerate again.

There are already voices that advocate declaring total lockdown.

There are fewer and fewer tools left, but I believe that deciding on home lockdown, which is the last step, only depends on whether the health system can withstand the onslaught. It is logical that we think that a closure can be useful, because it would decisively reduce both infections and mortality, and furthermore, if it is made very short and strict, of a fortnight, the rise in the curve would be slowed down and the economy would have an easier time getting back on track. But we know that the current restrictions work.

Do you think the population has normalized that 400 new deaths are reported every week?

Unfortunately, normalizing such a pervasive data is a human reaction after such a long time. But the reality is that the death toll is very high. Covid mortality is 1%. It may not sound like much, but it is: it's ten times higher than that of the flu.

The death pyramid widens from the age of 70 onwards.

That's right. Mortality is concentrated in higher age groups. Luckily, young people are practically non-existent in the death pyramid, unlike the 1918 flu.

Dr. Cabezas explained yesterday that there are some cases of infection in people who have already received the vaccine.

The transmission is very strong and it is normal that in the period of 21 days between doses there can be contagion. As it cannot take more than 42 days to administer the second dose, the person should be allowed to recover, and then the vaccine should be given.

The Health Department says that the risk of getting infected is reduced after twelve days from the administration of the first dose.

Within a week of the first dose the person would already have some immunity, which could be of 50%. The second injection would act as a stimulus to confer maximum protection. If we are lucky, in the next few weeks we will have a good portion of care homes and health professionals protected.

Are you worried about the advance of the British variant?

It would be bad business if a more transmissible variant became strong. Now it is very difficult to say or deny that the mutation is behind the contagion, it would have to be sequenced, but it could have been in place without us noticing. Surely there are more cases than we detect and logic suggests that we will find them in areas of greater density and mobility.