"We have had to reinforce anticovid measures due to the British variant"

Girona/BarcelonaIt was the night of December 31 when the medical director of the Hospital de Olot, Jaume Heredia, received an urgent call from those responsible for the center. They had detected that two professionals working in the covid unit had tested positive and that there were two non-covid patients with symptoms. "All the alarms went off: in six months we had had virtually no cases of transmission and, suddenly, two workers and two patients had been infected", Heredia recalls, who explains that they followed the protocol and made a screening throughout the hospital. The result: ten patients and three professionals infected, which increased the following days to seventeen patients and eleven workers.

"We did not understand how, doing the same things as before, we had been able to have this explosion of cases among staff and patients", Heredia admits, who met with the rest of those responsible for the center to try to find out what could have caused the outbreak. "We put forward several hypotheses: had we relaxed regarding some measure, were we not cleaning well enough, or we might have the British variant", they wondered.

After checking that all the protocols had been followed, on 11 January they decided to send a sample from one of the infected people for sequencing to see if it was the British variant. And, the following week, they confirmed their suspicions: one of those infected had the new mutation. "We alerted Epidemiological Surveillance and investigated other cases: with a single sample you can't draw any conclusions", the medical director says, adding: "And yes, we found a certain number of cases, but we still have to determine to what degree it is running free", he points out.

FFP2 masks for all staff

Parallel to the outbreak in the hospital, the health authorities detected that the contagions in the Garrotxa region were increasing exponentially, especially from January 9. "In three or four weeks the number of cases increased tenfold, it was clear that something was happening". Faced with this situation, the management team of the hospital decided to rethink all protective measures.

"We know that the variant has a higher transmission of 50-70% and that it is much more highly concentrated in the air. We had to increase all the measures to a higher level of safety", Heredia stresses. Until January, all professionals working in the unit covid wore FFP2 face masks, and the rest of the hospital workers wore surgical face masks. "Now in the covid unit we wear FFP3 masks, waterproof goggles and a waterproof gown. And, in the rest of the center, everyone goes with FFP2", the medical director says, who also explains how they reviewed all ventilation circuits and installed purifiers and air filters in the different units to try to reduce the levels of concentration of the virus in the environment.

Heredia also stresses that now we must analyze the ages of those infected by the British variant to try to predict the hospital pressure they will suffer in the near future. "If most are under 40 years of age, there will be a lesser impact on the hospital, but if this increases to over 50 years, I am much more concerned", the director admits, who recalls that the Hospital de Olot has no ICU but does have beds for acute patients, and they have to be moved to a different hospital when they get worse.

More transmission

Olot Hospital is not the only center where they have detected the presence of the British variant. It has also been located in the Monstacopa care home in the capital of the Garrotxa. As explained by the coordinator of care homes in the Girona region, Xavier Arrebola, on December 31 they found that a worker was positive. They tested all residents and employees and detected seventeen residents and five more workers infected.

"From the first moment protocols were applied: the positive cases were isolated and the center was sectorized", certifies Arrebola, who also reports that, despite the anticovid measures, positive cases did not stop surfacing. "The direction of the center could not understand, they had another outbreak in September and they were able to control it very well. But now, applying the same protocol, we saw that the numbers continued to grow and that positive results were coming out of everywhere".

With the advice of the Public Health technicians, they analyzed all the circuits and protocols, but they found no errors and decided to send a sample of a positive sample to be sequenced. "They confirmed that it was the British variant", the residency coordinator says, who, from his experience, confirms the greater contagious capacity of the mutation. "My feeling and perception after dealing with many outbreaks in care homes is that the British is more contagious". In the care home of Olot the outbreak caused a total of 14 deaths and it infected 114 people: 59 residents and around forty workers.

Screening in schools

To try to cut the chains of contagion and to reduce the incidence of the virus, the Department of Health will begin a screening in six schools in the Garrotxa tomorrow, where a higher rate of cases has been detected. The first will be the IES Garrotxa and, during the following days, it will be followed by the schools of Pia, Pla de Dalt, Sant Roc, the Institut Bosc de la Coma and Escola Joan Maragall in Santa Pau. In addition, the Education Department is considering whether to put in place other measures to stop infections in the Garrotxa, which seems to not stop after weeks of exponential growth.