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Ómicron tests immunity and health systems in Latin America

2022-01-12T03:18:48.765Z


Argentina, Colombia, Peru or Mexico are already immersed in peaks of cases that will exceed all the previous ones. Although less serious is expected, the risk is in the accumulation on unequal protection and immunity systems


Flight cancellations and chaos at the Mexico City airport due to contagions from pilots and flight personnel and the collapse of the test centers of the main tourist destinations in Argentina in the middle of the summer season. A new wave of coronavirus linked to the omicron variant threatens Latin America and is beginning to be felt in the most unequal region of the planet, which is evaluating how to cope with this new stage of the pandemic that, due to the accumulation of cases, can put in check to their health systems and various sectors.

The new peak is marked by a paradox: although the probability of developing a serious disease has decreased case by case thanks to acquired immunity - by vaccines, but also by previous infection - the more accelerated contagion of the new strain maintains its challenge to global health systems, especially the most vulnerable.

Argentina and Puerto Rico were the first in Latin America to notice a much faster increase in cases than the previous peaks.

They were followed by Colombia, Mexico, Peru, Panama, Bolivia and now, also, Chile.

Epidemiologists and politicians agree this time: the cause is omicron, the new variant of SARS-CoV-2 that marks the passage of the new phase of this pandemic, which is almost in its second year of life.

In Argentina, the number of cases has already far exceeded the previous record for the pandemic.

It has also done it in Mexico.

In Colombia and Peru, the daily data has also set highs, and the average of the last seven days will do so at any time.

In Chile, growth is lagging, but there is nothing to suggest that the curve does not follow a similar path, as it has already done in other corners of the world and quite possibly it will throughout the Latin American continent.

Of these countries, those that, as is the case of Colombia, maintain powerful genomic surveillance systems and are up to date already observing how omicron is effectively becoming the dominant variant within the samples they collect.

These unusual growths coexist with the increasingly abundant evidence that, case by case, omicron produces a less severe disease than delta, the variant until now dominant in the world. Some of this evidence refers to the intrinsic characteristics of the new mutation of the virus: at least seven preclinical studies in the laboratory and in mice have confirmed that the infection is now concentrated in the upper part of the respiratory system, which would reduce the risk of pathologies severe respiratory problems. This or other characteristics would translate into a 50% or 60% decrease in the risk of hospitalization (and up to 84% lower risk of requiring mechanical ventilation).

On the other hand, there is the factor of acquired immunity.

Early studies from the UK or South Africa indicate that a normal vaccination schedule with Pfizer, Moderna, Jannsen or Astrazeneca reduces the risk of hospitalization by between 50% and 80%, depending on how recent it was.

A reinforcement on any of them seems to significantly increase this protection: up to between 85% and 88%.

Past infection is also protective: up to a 60% reduced risk of ending up in hospital, as seen in the UK.

These data are promising, especially for vaccinated individuals, or vaccinated and with previous infection and especially for those who do not belong to risk groups: because they are mean values ​​applied individually.

Its population translation is not exact.

What governments, experts and citizens hope to see at the aggregate level can be summed up in two words: decoupling and moderation. Decoupling in growth as a function of gravity: that the mildest grow more pronounced than the most severe. That is, a moderation in the sum total of serious cases to avoid saturation or even the collapse of health systems.

The peaks in South Africa and the UK have shown clear decouples. The volume of cases in the latter, however, has been high enough to put parts of the British public health system under strain. This tension has been aggravated by the impact of omicron on the health personnel themselves: medical leave: the day after Christmas, up to 1 in 20 workers in the system were on sick leave. More worrying is the US experience, still underway: omicron peaks in various areas of the country are showing less decoupling and, therefore, little aggregate moderation.

The learning that Latin America can draw from the countries that have suffered the omicron wave in advance is that the peaks in process will be more or less disruptive depending on the quality of the immune wall built in each country, the capacity of its health system , and the distribution of both in the population.

The immune wall is made up of many bricks. The most robust are vaccines and their population distribution. A country with high initial vaccination rates and reinforcements applied, especially to vulnerable segments, will have part of the job done. The difference in protection against serious disease between vaccines still needs to be better understood, and better data is needed for those of Chinese, Russian or Cuban origin, widely used in the region. Ómicron will be a test for all of them, as it is already assuming for the others.

To this must be added the past infection: countries with an assumed high impact are, paradoxically, in a better position today. This does not mean that the previous contagion was a success: hundreds of thousands of lives were lost, and it would have been much better to obtain it via vaccination. But it is undeniable that it may now pay off in light of the data in South Africa, a country with high past seroprevalence.

The starting position also matters: populations that are aged, impoverished or with a high incidence of certain relevant comorbidities are always more exposed to serious developments. Latin America is a young continent, but at the same time it has high poverty rates in several countries. In others, chronic health problems (such as obesity and diabetes in Mexico) have placed them in a more delicate position from the beginning. You can't expect it to be any different with omicron.

The quality of this immune wall will filter more or fewer cases into the hospital system, and where less they are filtered, the more their capacity will be put to the test. Ómicron sends far fewer people to intensive care than delta, but not so fewer to less severe hospital stays. That is to say: while in the first waves of 2020 the focus was on the lack of physical capacity (mechanical ventilators, other intensive care equipment), now it may be on the lack of human capacity to manage a greater number of moderately severe cases. In Mexico City, for example, you are already seeing long lines at hospitals and health centers. There are also interruptions in airports and basic services, such as transport or education due to the increase in the number of infections.

It is still too early to measure decoupling and moderation in Latin America, but in some countries the first is already glimpsed: graphing in parallel the accumulated cases of the last 14 days and the number of people admitted, in Argentina there is a clear separation for now when This data is compared with the previous great peak, in mid-2021. Its magnitude, however, remains to be seen, since the wave has not yet reached its peak in the country.

In Colombia, where the wave began to grow somewhat later, the trend is the same.

There, in addition, it is possible to separate between normal and intensive care hospitalizations, which allows us to confirm that, indeed, it is the latter that have fallen the most compared to past peaks.

The crucial thing remains: to follow this trend in all countries to confirm that the decoupling is large enough for moderation to take loads off the shoulders of the health systems, and also of some societies that as a whole have been dragging them for almost two years. economic, social and emotional burdens for the pandemic never suffered before.

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Source: elparis

All life articles on 2022-01-12

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