Emilia vexler
08/28/2021 6:01 AM
Clarín.com
Society
Updated 08/28/2021 6:01 AM
The
Delta variant
has shown a high level of contagion. Infected people have around 1,000 times more viral particles in their upper respiratory systems than people infected with other strains of Covid. Patients are more than twice as likely to be admitted to hospital, nearly four times as likely to go to therapy, and twice as likely to die. Says the CDC of the United States.
Why would it be different in Argentina?
The scenario, the experts interviewed by
Clarín
warn
,
would be traced to our lands. The difference would be that the new version of the virus will already be hitting very hard by the time the health authorities can
confirm its community circulation
. It is that Argentina is among the countries with the
least sequence of tests
. Little was tested since the first outbreak. Now less is genotyped.
The government's justification for why the pandemic is "measured" so slowly is Argentina, facing the third wave.
The idea is that "Delta is one more variant".
However, for some scientists this variant is the
evolutionary convergence paradigm of the virus
, since it has managed to select the worst of each of its predecessors.
According to the number of tests carried out in the country -about 100,000 per day-,
what is the percentage of samples on which genomic surveillance is done?
Analia Reardon, director of Epidemiology and Information Strategic and most authoritative person to talk about how is genotyped in Argentina, detailed
Clarin
the official strategy for measuring the pandemic.
Search operation for the Delta variant in Monserrat, at the end of July.
Photo: Emmanuel Fernández
"There are some jurisdictions that do their surveillance, I do not have the data, with some special type of PCR there is. We, from Malbrán, do it on travelers (from abroad), we also analyze samples where there is an unusual increase in cases, in people who have a serious illness or die, also in people who have complete vaccination (both doses) and die, and then each of the provinces send us to Malbrán between 15 and 20 weekly samples for a random analysis In addition, the inter-institutional Consortium for Genome Sequencing and genomic studies of SARS-COV-2 (or PAIS Project) analyzes between 20% and 50% of the positive samples ", says Rearte.
The data provided by Rearte contradict the figures provided by epidemiological reports: from January to the beginning of August
only 0.1 percent
of the total positive cases in the country
were sequenced
.
3,394,241 new positive cases of Covid were reported and 3,632 sequences were carried out
- Why does genomic surveillance not scale?
- Genomic surveillance is indistinct from the number of cases you have.
You put strategies of who you are going to sequence, we take the WHO guidelines.
There is no country in the world that sequences 100% of the samples.
Then, with the population samples (not by individuals but by population) what we are monitoring is the samples that are isolated, what is the proportion of each of the new variants.
We are doing what the international recommendations say.
- There are more and more cases of Delta unrelated to travelers. From genomic surveillance, what is done to find and detect the eventual community circulation?
- So far the jurisdictions are giving us other variants (not Delta).
What is being done is delaying
(the circulation of this variant), and with the low number of cases that we are having, the jurisdictions are greatly increasing the control of all cases.
Because it is not only 'Delta variant', When Delta is found, the indications
are exactly the same
as with Manaus: isolate, search for close contacts.
The Malbrán Institute deals with part of genomic surveillance.
Photo: Mario Quinteros
- Argentina is one of the countries with the most deaths and where there is less genomic surveillance since the beginning of the pandemic. Why?
- Mortality ... depends on how you measure it.
If you measure 100,000 inhabitants mortality, there is a problem there, because the data is measured from surveillance records.
And the records across countries are wildly disparate.
When you measure excess mortality (the number of deaths in a crisis or pandemic), which includes not only deaths from Covid but also from saturation of the health system, there are countries in the region that do not register those deaths from heart attacks for example because they could not be attended to.
We include them.
We have very very little underreporting of deaths.
In excess of mortality, we are not among the first.
To the contrary.
- So genomic surveillance is not relevant? Is it not useful to evaluate reopening or restrictions?
- It does not change the way you control the pandemic.
The sanitary measures are the same for Alpha, Delta, Gamma or the next ones to come
. It's not that if I don't have Delta, I stay calm. Although he does not have Delta, and now more with the boys in the schools, we must immediately isolate the case and all its contacts. Regardless of what the sequence is. Today Delta is the concern, tomorrow it will be another and the day after another.
As with influenza, do we sequence all flu cases? No.
It is done to serious cases. Because one defines as politics what is necessary to have an impact on public health. Covid variant sequencing is done for isolation. Sequencing is used to see the severity of a variant and get an idea of what the percentage of circulation is.
- Isn't the coronavirus with its variants different from influenza?
- Tell me what measures you would take with a person, individual, non-population, who has a Delta variant and what measures would you take with someone infected with Gamma.
It is not that if it has a Delta variant, for example, you hospitalize it and give it some treatment.
Regardless of the variant, you isolate it to the person.
It is not like, another example added to the flu, it is important to determine the germ,
meningo
or
pneumo
, which has one treatment or another, with contacts and others.
In the coronavirus, individually, it does not change.
Expert warning
For Roberto Debbag, vice president of the Latin American Society of Pediatric Infectology, the Delta variant
is not just another
.
"First there is the period of calm, when you are with the previous variants, then it takes a certain circulation (Delta), and it is from the third or fourth week that it begins as a community and makes a
spiraling effect of ascent
. This is detected with genomic surveillance. When it produces chaos or health stress, the probability of complications increases, "he says.
Along the same lines, the renowned infectologist Eduardo López also marks
Clarín
something that should happen and does not happen in Argentina.
"The Delta puts those over 60 in check, I do not tell you with comorbidities, in general, that they do not have the second dose. And to stop community circulation, which is almost a fact, you have to
test more and sequence more
. Knowing which the variant helps decision-making, without a doubt. Here little is tested and much less is sequenced. All the variants always showed some delay to be identified as predominant. It was not like that until they were very evident, "he closes. .
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