British variant penetrates homes and affects entire families

Primary health care observes more outbreaks within families and warns of the difficulties in ensuring isolations are done well

3 min
A woman undergoes an antigen test at the Barcelona Conservatory as part of a study on activities with a high risk of infection

Santa Coloma de GramenetThe majority of covid infections are occurring in family environments. The outbreaks that originate in homes or in sporadic meetings between members of the same family and close acquaintances account for 51.5% of the outbreaks reported by the Public Health Agency. In fact, according to the latest report of this agency, the number of outbreaks in the family far exceeds those identified in schools (15.8%), nursing homes (10.2%) and the workplace (9.3%), both in frequency and number of people affected. "Everything suggests that this responds to the increased circulation of the British variant", explains the head of microbiology at the Hospital de la Vall d'Hebron in Barcelona, Tomàs Pumarola. The variant, he notes, "is rising strongly in Catalonia. Before, when the virus entered a home, it affected a percentage of the members, but now the variant is transmitted better and it affects everyone".

The main hypothesis behind this increase in intrafamilial infections is that the effect of the mutation identified in the United Kingdom is already being observed, which is transmitted more easily, and that in Barcelona it already represents 30% of the cases detected "and it is rising", according to Pumarola. "Some primary health care centers (CAP) call us and ask us if we can analyze some samples to see if the British variant is behind a large outbreak in an area, because they suddenly see many positive cases", the microbiologist explains, who insists that they are not more serious but more frequent.

Primary health care already began to notice in December an upturn in intrafamilial infections that were attributed to increased social interaction during Christmas meals, but now the feeling - especially in Barcelona and the metropolitan area - is that there are more and more cases of whole families who come out positive, with members of all ages affected. "Covid managers are finding more cases concentrated in the nuclear family", the director of the EAP Sant Andreu de la Barca (Baix Llobregat), Glòria Jodar, says. Maria Jose Gordillo, nurse at the CAP Comte Borrell Barcelona, agrees with her: "We do not know if it is due to the new variants, which are more contagious, but yes, now there are more entire families infected".

Other health professionals consulted by the ARA, such as the director of primary health care teams in Gornal and Bellvitge, Xavier Bayona, ruled out today a change in the pattern of infection. "We continue as in recent months, with an incidence rate relatively lower than the environment. We are not observing more families infected internally than before", he says. However, from the Catalan Society of Family and Community Medicine (Camfic) they point out that their professionals do see it: "We note that infections are occurring mainly in very closed groups, such as families".

Problems with isolations and quarantines

"We also think that prevention measures at home have been relaxed", Jodar points out. And this is the second hypothesis that, combined with the rise of the British variant, could be facilitating the path to the virus. The doctor of the CAP Bon Pastor Nani Vall-llosera highlights a certain trivialization of the symptoms among the population a year after the outbreak of the pandemic. "It seems that people have not understood that at the first symptoms you should always consult the health care centre (CAP). If you wait three days because you think it is a normal cold, a normal gastroenteritis or a normal sore throat, and you make an appointment after three days with these symptoms, you will already have been contagious for five days", he says.

Many do not even do preventive isolation in a room to avoid chains of contagion. "It is clear that the message 'If you are a close contact you have to lock yourself in a room' has not yet got through. And these contacts who, during what should be their quarantine, end up being positive cases, have already infected the whole family or a large part of it", he explains. When children are positive, families have to plan to protect the rest of the family, for example, one parent is isolated with the child and the other stays with the siblings. However, not all family models are the same and do not have the same possibilities.

Vall-llosera also denounces the fact that there are many people who live in substandard housing conditions that make isolation impossible or who cannot access sick leave. "It is striking how little is said about how difficult it is for a positive person to isolate or quarantine in isolation or in close contact. And this lack of information does not help to avoid intrafamilial contagion".

Pumarola agrees that the population has to be more careful than ever with prevention measures within the bubbles and family nuclei, although a certain relaxation at times after so many months of tension is qualified as "human". "In any case, we have to be very aware that neither being young nor having no previous pathologies means that you will not have any complications in case of infection or that you can not transmit it to vulnerable people who may end up hospitalized or even die", he says.