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Three years later, are we facing the end of the pandemic?

2023-01-28T10:41:08.860Z


The World Health Organization debates whether to deactivate the international health emergency that it decreed after the confinement of Wuhan in 2020, while most of the restrictions in the world disappear


The World Health Organization never officially declared covid a pandemic.

Despite the fact that it has been expressed in this way very often, it is a mechanism that does not exist.

What he did now three years ago (on January 30, 2020) was to declare it an international emergency, something that is included in the health regulations.

And on March 11 of that year, in a speech, its director characterized the advance of the coronavirus throughout the world as a pandemic.

As to whether we are still immersed in it, there is no clear answer: it is a debate between technique and semantics.

To decide whether the health emergency continues, the WHO held a meeting this Friday, the results of which are not yet public.

Whatever the body decides, covid is no longer the emergency it was: neither in hospitals nor in the attitude of the population, which has mostly turned the page.

China, the last great country that remained to return to normality, is already beginning to do so.

The exit has been very abrupt, but it has already passed the peak of infections and large cities celebrate this lunar new year for the first time in three years.

Spain has been experiencing sustained transmission for months and the pressure on the health system has not suffered major fluctuations, as in the rest of the European Union.

Since the last wave, in summer, Spanish hospitals have remained stable and the Government has just announced the withdrawal (on February 7) of one of the last loopholes in the pandemic that still conditioned the daily life of citizens: the compulsory nature of mask on public transport.

It will only be maintained, for the moment, in health centers and establishments.

02:06

Darias announces the approval date to remove masks on public transport

The Minister of Health, Carolina Darias, during an act in Ibiza. Photo: SERGIO G. CAÑIZARES

Ignacio López-Goñi, a microbiologist and author of the book

Prepared for the Next Pandemic

, believes that things have changed a lot, that it no longer makes sense to talk about containing a virus that circulates freely throughout the world and that what it takes is to focus in protecting the vulnerable.

“The situation between countries is very different.

That of Spain has nothing to do with that of the United States or Japan.

For this reason, the WHO will probably be cautious and maintain the health emergency.

Another thing is that he insists on some issues, such as epidemiological surveillance;

vaccination and vaccination reminders, which is the most effective measure to prevent death and serious illness;

the reinforcement of health systems and, finally, that new vaccination strategies must continue to be investigated ”, he maintains.

To know how the virus evolves, today it makes little sense to observe the infections reported in the world.

Most countries are relaxing their surveillance, starting with Spain, which has been registering only those over 60 years of age for almost a year;

and only those who go to the doctor, because many already limit themselves to a home test that they do not officially communicate.

With these cautions in mind, the WHO has so far officially recorded more than 664 million diagnoses and 6.7 million deaths worldwide since the crisis began.

It is impossible to know how many infections there have really been, but it is certain that they multiply this figure several times.

Regarding deaths, a study published in

The

Lancet

in September suggested that the pandemic had actually caused some 17.1 million deaths.

What the WHO statistics panel makes clear is that the worst, both in terms of cases and mortality, is behind us.

Although thousands of people continue to die in the world every week with covid, the last great spike in global diagnoses was registered a year ago now.

Leaving aside the huge burst of infections and deaths that China has experienced between December and January, the situation is tending towards stability, with some small spikes in certain countries.

"Defining a pandemic is very complicated," says Rafael Toledo, professor of Immunoparasitology at the University of Valencia.

“It is understood as such an outbreak that affects several continents, but pointing out the moment in which it becomes endemic is not clear.

What we have to assume is that we are going to continue to have covid cases, which this winter are below flu cases.

We will have to see the evolution to see if the coronavirus returns in the form of cycles or peaks ”, he adds.

As there is no official definition, we may or may not be in a pandemic, depending on which one we attend to.

Adrián H. Aginagalde, a specialist in preventive medicine and public health, believes that this is not very important from an operational point of view, although he acknowledges that it influences from the point of view of public opinion.

And he considers that the covid meets the requirements to be called a pandemic: "A disease spread throughout the world, communicable, that affects a considerable number of people, and seriously some of them."

The criteria are established for a disease to be an international health emergency.

It must have a serious impact on public health and be unusual and unexpected, with a risk of international expansion, and have the capacity to generate restrictions on the movement of goods or people.

The WHO meeting this Friday evaluates precisely this and has been done every three months since the emergency was declared.

For practical purposes, it is more a tool for the WHO itself than for the countries.

Your decisions are not binding, you cannot prohibit or limit mobility, but being in an emergency helps you mobilize resources more quickly.

“Covid continues to need coordinated international action, both in monitoring cases, variants, new threats, and redistribution of vaccine stocks.

It is also true that these mechanisms could be maintained without the emergency being declared, as is done with HIV, malaria or tuberculosis”, reflects Aginagalde.

The future of covid and vaccines

Beyond definitions, what really affects citizens is the behavior of the virus, if the waves are part of the past or will return, what vaccines will be necessary.

Aginagalde recalls that no respiratory disease has been eliminated or become endemic (in his definition of maintaining a sustained and stable number of cases).

All have epidemic manifestations, that is, they occur in seasonal peaks with cases above expectations.

The covid is probably not an exception, but so far it has not acquired the seasonal pattern of others, such as the flu or the respiratory syncytial virus.

It hasn't been long before it does, and experts are watching it to determine its patterns, what are the thresholds above which it can be considered that it generates epidemics.

As Toledo mentioned, this winter the cases of flu have been much higher than those of covid, but the coronavirus continues to present itself on occasions as a serious disease that has kept around 3,000 hospitalized for months and more than 200 in the Emergency Units. Intensive Care, in addition to dozens of deaths per day: there were almost 21,000 in the first six months of 2022, according to the INE.

Most deaths occur among the very elderly or with comorbidities, which is why the health authorities insist that this vulnerable population receive vaccine boosters.

However, the fourth dose (second booster for the majority) is not taking hold like the previous ones, and only 58% of the population over 60 years of age have received it.

The committee of experts that advise the US health authority (the FDA) advise that the covid vaccine become an annual injection for the majority of the population, something similar to what already happens with the flu.

Possibly it is the guideline that sooner or later adopt the other western countries.

At least as long as the coronavirus continues to pose a health threat.



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Source: elparis

All life articles on 2023-01-28

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