Avalanche of contagion saturates primary care

GironaRampant incidence caused by the increased transmissibility of the Omicron variant, responsible for most of the new coronavirus infections in Catalonia. The number of weekly cases has almost doubled in the last seven days (from 39,578 to 78,586) and, therefore, has taken much momentum growth 15 days ago, when there were four times fewer weekly infections (22,717). In fact, in seven days, it has come to infect almost 1% of the population, a record never achieved so far in the whole pandemic, according to the researcher of the Biocomcs group of the UPC Enric Álvarez. "And it will surely rise more, between 100,000 or 150,000 cases per week, that is, between 1 and 1.5% of the population will be infected in a week," predicts the expert. This Tuesday the number of cases registered passed 24,000 for the first time since the pandemic broke out, although it is not yet known whether they correspond to a single day or have been caused by a backlog in inserting the data.

Whatever the case, what is undeniable is that all indicators show a very negative evolution, and this is overwhelming primary care: 15-day cumulative incidence has more than tripled, from 291 to 1,006 cases per 100,000 inhabitants. The reproduction rate (Rt) continues to rise and stands at 1.73, which means that for every 100 new infections, 173 more people are infected. And the number of positive tests continues to grow: 15%, when it should be below 5% according to the WHO (above this threshold it means not all cases are being detected). On the other hand, the only figure that shows a slight improvement is the number of deaths: two weeks ago 124 were reported; last week they dropped to 118.

Álvarez indicates that it will be necessary to wait for the first week of January to find out whether the restrictions applied in Catalonia stop the increase in contagions.

More than double the number of tests done

The health area most affected by the exponential growth in the incidence of the Omicron variant is primary care. In a single day, on 27 December, 59,420 visits were made by covid, which is more than double those recorded two weeks earlier (27,740). More data that reflects the enormous effort made by health workers is the number of PCR and antigen tests performed: in 15 days have doubled and has exceeded half a million tests a week (from 252,528 to 580,407).

"Health centres are really saturated by the increase in visits, but we do not believe that they will be overrun," says the president of the Catalan Society of Family and Community Medicine (CAMFiC), Antoni Sisó. To relieve the pressure of primary care, the doctor demands the Generalitat hire administrative staff to "free [doctors] of bureaucratic tasks", given the impossibility of hiring new doctors and nurses because there are none.

Effect on hospitals

As for the number of people in hospital, it also continues to grow. There are 1,516 covid patients in regular wards (200 more than a week ago) and 404 patients in ICUs (60 more than seven days ago). However, it should be borne in mind that most of those hospitalised are Delta variant patients, since Omicron patients are not yet in hospital (there is a 12-15 day delay between infection and hospitalisation). For example, in the Hospital de la Vall d'Hebron, out of the 32 covid patients now in ICU, 3 have the Omicron variant. And, of the 76 in hospital, 6 are omicron, according to the deputy director of care, Maria José Abadías.

Although the latest published studies point to a lesser severity of the Omicron, Álvarez stresses that "it is not clear" that the new variant is significantly less severe in unvaccinated people or who have not recovered from the virus. In this sense, he considers that at least in Catalonia we will have to wait a few days to verify this conclusion. "We don't know what percentage of people infected with the virus will end up on the ward, how many will end up in critical care or how many will unfortunately die. And, depending on this value, there may be some very different scenarios" in the new year, he says

The head of the Department of Intensive Care Medicine at the Hospital Josep Trueta, Josep Maria Sirvent, launched a similar warning on Twitter: "I ask politicians, experts and talking heads to be more cautious and not claim the Omicron variant will not strain the health system and be dealt with as a common cold. At the moment, the impact on hospitals caused by covid (mainly Delta) in some regions is very high. Let's talk about it on January 15!"