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Coronavirus: few vaccines in sight and younger people in therapy, the uncertain scenario of the sub-60s

2021-04-13T17:40:47.820Z


Compared to the first wave, health experts see a drop of 8 to 10 years in the profile of adults hospitalized for Covid. Why the 'breadwinners' are more exposed than before.


Irene Hartmann

04/13/2021 1:48 PM

  • Clarín.com

  • Society

Updated 04/13/2021 1:48 PM

Daily cases of coronavirus, weekly average, grew

70%

in the last week, a sharp jump that had not been seen in the entire pandemic.

Intensive therapies are filling up and there is no longer any doubt that the 

second wave is much worse than the first

, with the pending question of what will happen to the fatality rate.

As older adults are being immunized, all eyes are on a very large population that seems to be in a

gray area

, in the absence of massive access to vaccination: the

under-60s

.

Without counting children and adolescents, that is, taking those between 20 and 60 years old, we are talking about almost

65% of the accumulated infected

.

In CABA, they reach

75%

.

Now, to what extent does this group end up having to be hospitalized?

The numbers are so dynamic that it's hard to keep up.

10 days ago, the Ministry of Health of the Nation informed

Clarín

that in February and March, patients between

20 and 60

 years old had represented 20% of hospitalizations due to Covid.

This Wednesday, from the Argentine Union of Health Entities (UAS) they reported that it is more than double: the patients of that strip in the AMBA represent

47% of those hospitalized for SARS-CoV-2

.

The conclusion they reached

updates the profile of the pandemic in Argentina

: the average age of hospitalization for coronavirus

fell from 8 to 10 years

, if the first and second waves are compared.

Attention to an intensive care patient hospitalized for Covid-19 in Buenos Aires.

/ Reuters

A few days ago, the coordinator of the Intensive Care of the Sanatorio Güemes,

Diego Pereyra

, pointed out to this chronicler an uncomfortable matter, linked to these data: “

We are receiving younger patients

.

The average age was 70, but it seems to be dropping a little to fifty-something or sixty years. "

"A priori, in this segment, the mortality rate from Covid falls, but if we take into account that this patient often brings

comorbidities

(obesity, hypertension, diabetes or some immune or rheumatological suppression) his risk is equal to the elderly patient" , he pointed.

Then?

What is uncomfortable is the question of whether immunization of this segment should not be a priority.

According to Pereyra, “it must be considered that it is an

economically active population

, people who in many cases are breadwinners.

It is a difficult debate, but many doctors ask it ”.

On the elusive path of community transmission, Covid is known to circulate "where it can."

As many activities that promote contagion are enabled (beyond the new restrictions, whose fulfillment depends on the philanthropic call to good individual action), this population, which to a large extent takes children to school and attends their workplace, it was more 

exposed

.

One more variable is added.

Last year there was a sub-60 segment for which the virus was at ease:

health personnel

.

As this segment is mostly vaccinated, the spectrum of those under 60 who are liable to be infected gradually narrowed.

However, as long as there is no true "herd immunity", the pressure on susceptibles of these ages is proportionally increasing.

Current photo

Doctors from the city and province of Buenos Aires contributed their views on the profile of the infected and hospitalized that they see every day.

According to

Cristina Freuler

, head of Infectology at the German Hospital, “all the diagnoses in recent days were in people between

25 and 45 years old

.

This means that there are many more patients at home than before, but, anyway, hospitalizations are increasing compared to a month ago because there are many more infections ”.

Lines to enter businesses in the commercial area of ​​Avellaneda.

Photo: Luciano Thieberger

In fact, he evaluated, “this wave already has

levels similar to the peak of last time

, only that the increase occurred much more abruptly.

We assume that it will have larger dimensions ”.

Ten days ago 

Ricardo Teijeiro

, infectologist at the Pirovano Hospital, warned that what was to come was going to be “

two or three times the size of the 2020 wave

.” The current figures are beginning to prove him right.

Of the ages, he explained that he observed "a very high attack rate in younger people. Average, from

17 to 40.

They take few precautions, have mild or moderate symptoms and most do not go into hospital. As for those between

50 and 60 years old. with comorbidities

, they are seen, and many end up hospitalized ".

The doctor clarified that "the percentage of this segment still does not exceed older adults, who have the comorbidity of age, but as the vaccination rate of this other segment is very low, it could change."

In charge of the Infectology service of the Santojanni Hospital,

Pablo Scapellato

 contributed ("without accurate statistics in hand") his impression of these days: "The people who come for Covid are more and also

younger

."

"I do not know if hospitalized patients have more comorbidities, but it would seem reasonable to me because, in my interpretation, we have learned to manage outpatients better and we

hospitalized less

. Those with comorbidities remain hospitalized," he explained.

His outlook for the weeks to come is not encouraging: “We started from a higher floor and we already have many cases.

Of the lethality, I do not dare to give an answer.

But I want to say that the health system is

exhausted

.

Although we are vaccinated, we work in the same or worse conditions than last year.

In these months more personnel could have been trained ”.

Vaccination campaign for older adults at the Julián Centeya Cultural Space, CABA.

Photo Guillermo Rodríguez Adami

Also

Pablo Pratesi

, head of Intensive Care at the Austral Hospital, gave his vision: “We see younger patients, between 20 and 60 years old.

And you see more pneumonia than before.

But we also learned more about the disease and we are attentive to things that we did not attend to before ”.

Scenarios


Jorge Aliaga

, physicist, director of Planning at the National University of Hurlingham and a dedicated analyst of the pandemic figures, explained that “at the beginning, in March 2020, the average age of those infected by Covid was older than now because those infected were, to a large extent, people who had gone abroad on vacation.

And there were few cases ”.


“Then, in May, the average was linked to the explosion of infections in popular neighborhoods, where many young people live.

Excluding these events, the average age of those infected remained more or less stable throughout these months, but

in the last weeks it dropped a bit

. "

The curves that this expert disseminates daily are eloquent: at last year's peak, the average age of those infected was 41.3 years.

Now

38.2

.

"75% of the newly infected are under 50 years of age and as only about 5% are over 70 -both as a first effect of the vaccination or because they continue to take great care of themselves-, that exerts changes in the number of deaths" , remarked

The glass half full?

The doctors consulted agreed that in this avalanche of cases a "dedicated" behavior dominates, compared to last year.

The youngest consult at the slightest symptom and 

quickly

According to Teijeiro, “the people are warned.

Last year he was afraid to admit that he might have coronavirus, and if he had a fever, he would wait a day or two to see if it would pass.

Now they go to one and stand in line to swab themselves ”.

However, he concluded, “this apparent awareness does not translate into prevention.

Everything that comes from here on will depend on how we advance with the sanitary rules ”.

$

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Source: clarin

All life articles on 2021-04-13

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