Vaccination is not widespread enough to prevent hospital collapse, but the restrictions are more serious than before.

Liberation of three prisoners by Jesús El Rico.  Alex Zea / EP

The memory of previous vacation disconnections is too recent to ignore. We entered July with a national incidence of 8.47 cases per 100,000 inhabitants every 14 days and we left August with 205.53. We entered the December bridge with 231.11 and in mid-January we already exceeded 700. It is reasonable that we have doubts when dispersal dates come again, without schools, with family reunions and a pretense of normality, at least within the province.

To this must be added the uncertainty of the lack of information. The ministry closes today until Monday with a 14-day incidence of 152.3 … but with an incidence at 7 of 79.89, that is, the projection is upwards although not in a scandalous way. The rise in detection this week compared to the previous one is 24.5%, but it must be taken into account that up to seven autonomous communities had one less holiday, which obviously increases the number of tests and consequently the number of positives detected. .

What will we find on Monday, April 5, after so many days without more information than that of the regional reports of the different communities? Difficult to know. Even more important,how long it will take for the data, with so many holidays involved, to reflect the reality of virus transmission?

They are legitimate and concern questions. Until now, the authorities have legislated with one eye on the cumulative incidence and the other on the percentage of hospital occupancy. Now, perhaps, the sensible thing would be to look especially at the latter without losing sight of the positivity rate, which should give us an indication of where things are going.

In the worst case, we could repeat past mistakes and react late, but the truth is that the legislation is now quite strict or of course it is more so than at Christmas or in summer. The feeling is that, despite the hackneyed pandemic fatigue, we are more aware as a society of what to do to try to avoid this possible fourth wave than at other times.

ICU occupation by age range.

ICU occupation by age range.
@_jorgegd_

In any case, even if the transmission was triggered and we returned to a scenario that tripled or quadrupled the current incidence (and also discovered it late due to the notification delays), it is difficult to think of increments like the ones we have seen previously.

One might think that vaccination would also reduce the number of serious cases, but that is to some extent misleading: the very serious, that is, fatal, occur mostly among those over 80 years of age, which is the most vaccinated population now. same throughout the country. Now, those who require hospitalization and above all those who need ventilators and ICU beds belong mainly to the group between 60 and 79 years old, who represent more than 60% of cases.

These age groups are beginning to receive the first dose of their vaccines right now in several autonomous communities, which means that at the moment they are not protected and that, if there is an outbreak, hospitals may be affected and collapse.

There would not be as many deaths as in the previous twelve months but it could generate a problem of hospital care and occupation, especially in communities such as Catalonia or Madrid, which already live on the edge of the 400 ICU beds occupied with Covid cases since the beginning of the year. A rebound could greatly complicate the work of the already exhausted toilets who have not seen the end of all this.

Now, at the current rate (the data for this Wednesday already speak of almost 300,000 doses administered in just 24 hours), each day that passes without a radical increase is a day gained. Even if Easter leaves its mark, as long as it does so little by little, it will give us time to immunize more and more of the population and not just the elderly. In the short term, you could see these hospital upsurges, but in the medium-long, they would not be sustained, which is what really ends up collapsing a health system. This, I insist, in the worst case.

Vaccination by age.

Vaccination by age.

In the best scenario, Spain would continue to rise, yes, but without sudden jumps. A regular rise, never to exceed 50% week-on-week and that somehow staggered the number of new entrants. Something similar to what was the third wave in countries like France or Italy when they did not insist on “saving Christmas” and that may happen to us now that we have given up long in advance to “save Easter”.

Of course, the virus is unpredictable and half Europe is now in the midst of a new wave even by taking rather drastic measures, but in principle, Spain is following an epidemic rhythm very similar to that of the United Kingdom, Ireland and Portugal, where no significant variations are observed.

With restricted mobility and with the hotel industry closed or limited in almost all the autonomous communities -including Madrid, tourists aside, has legislated in this regard-, the doubt that we have is how will school holidays affect. We do not know if there is a direct relationship or not, but the fact is that when the kids leave the security circle of their schools, the transmission increases.

If it is coincidence or causality, it is still too early to tell, but it should be kept in mind. In this best scenario, we would have two or three weeks of increase in cases to a figure of around 300-400 nationals and with some community in serious trouble, but little else.

Of course, it is not a dream scenario, but it is that we are in a pandemic and it also touches a crisis. Insist that it’s the best scenario as far as possible: we would limit deaths by lowering the age of those affected and although we would not reduce the percentage of new admissions in relation to the cases detected, the total number would fall in comparison, especially with the third wave, due to the simple fact that transmission would be more short.

The problem, I already said, is that it will take us a while to find out, so all we can do is hold our breath and play with hypotheses. Would it be easier to pay someone to at least publish the daily report? Surely, yes, but that battle is already lost. Let’s try to win the rest.