The omicron variant of the coronavirus contains in itself a great benefit and at the same time a great obstacle. Although on the one hand it causes a essentially mild disease, for another generates a poor immune response in the individual. It means that this can be easily reinfect.
Says the Head of the Infectious Diseases Service of the Germans Trias i Pujol Hospital (Can Ruti) and director of the IrsiCaixa AIDS Research Institute, Bonaventura Clotet. Clotet believes that Spain is “at the beginning of the seventh wave”, something that will be “confirmed in the coming days”. Y the little protection acquired with the omicron will facilitate its arrival.
“It seems that the virus [con la ómicron] has found a way to infect a lot and, at the same time, causes mild sickness. However, it does not arouse a great immune response against it and that is why the person becomes reinfected,” he points out. According to Clotet, to be protected against the omicron variant (and its sublineages, BA.1 and BA.2) are needed “10 times more” of neutralizing antibodies than with other variants. That is why he does not rule out that many of the people who have been infected during the sixth wave, which was record in infections due to omicron, get infected again now on the seventh.
47% more infections
Between April 1 and 29, the cumulative incidence in the last 14 days rose in Spain 47%. If at the beginning of the month it was 459 cases per 100,000 inhabitants, yesterday, according to the latest data from the Ministry of Health, it was 676 cases per 100,000 inhabitants.
The considerable increase in infections is not compromising, for the moment, the hospital activity. But that does not mean that it is not rising, on the contrary: throughout this month the admitted by covid in hospitals throughout Spain have increased by 53%, going from the 4,150 that there were at the beginning of April to the 6,362 that there were yesterday. It is also on the rise coronavirus mortality: in the last seven days there has been in Spain a total of 252 deaths, 18% more than the previous week. The indicators reflect that, in general, the virus is rapidly retransmitting.
“Ómicron has found the mechanism to survive because it infects without doing too much damage and without triggering a great protection of antibodies”, says Dr. Clotet
As Clotet explains, “mild” infections do not generate large antibodies. The serious ones, yes. “Omicron has found the survival mechanism because it infects without doing too much damage and without triggering great antibody protection. We will see new omicron infections,” advances the researcher, who recalls that covid-19 can be a complicated disease for vulnerable people or people with risk factors. Clotet calls avoid closed spaces already make use of the mask, which is no longer mandatory, when you are in them.
In addition, like other experts, he believes that it is important to advance in the third doses. In Spain, only 52% of citizens have the third dose and this is because in the sixth wave so many people were infected that it was not necessary to administer a new vaccine. “We should move forward with the third dose. It is very necessary because it is what allows us to recover the amount of neutralizing antibodies that decreased after the second vaccine,” says Clotet, who recommends starting to put the fourth doses to those over 65 years (Health plans to start putting them on the over 80 soon).
The ucis, the last step
the epidemiologist Joan Cayla, member of the Spanish Society of Epidemiology (SEE), he fears an increase in admissions to the ucis in the coming weeks. Right now, in communities like Catalonia, income from covid-19 in ucis are very low: this Friday there was 31 people, the historical low of the entire pandemic. However, Caylà clarifies, admission to the ICU is the last step of “natural history” of the infection. In other words, if infections increase a lot, the ICUs will inevitably rise.
Epidemiologists fear that ICU admissions will rise if infections run amok again
The SEE, concerned about the increase in the incidence of the virus and the Spain’s new surveillance system (which no longer counts on a case-by-case basis, in which confinement is not mandatory for mild positives, who are also not tested) recently published a guide to protect yourself from covid-19.
Ask asymptomatic or mildly ill patients to “telework” to cut transmission chains. Also, to rethink the communication strategy on the masks. “You have to take it on transport and in open places where there are crowds,” insists Caylà. And, finally, like Clotet, the SEE asks advance without further delay in the third doses.
However, around the administration of the third doses there is conflicting positions. The pediatrician and vice president of the Spanish Association of Vaccinology (AEV), Fernando Moraga-Llop, thinks it could “wait” to put them because, in the coming months, they will appear new vaccines that will improve the previous ones and will be more effective before the omicron. The epidemiologist at the Vall d’Hebron Hospital positioned herself a few days ago along the same line Magda Campins in an interview with EL PERIÓDICO.
Vaccinologists bet on waiting to give the third doses, if the situation allows it, because in summer there will be better vaccines
“You could wait to give the third dose to those people who had covid in January and who would have to put it on in the next five or six months, if the epidemiological situation does not change much. If a new vaccine comes out in August, maybe it’s worth the wait” highlights Moraga-Llop, who recalls that the vaccines that are used now were manufactured to deal with the Wuhan variant, that of the first wave.
Pfizer and Moderna they are doing clinical trials of new vaccines that, in principle, will be effective against the omicron. For Moraga-Llop, the “ideal” thing would be for them to be ready in the next seasonal season, that is, from October. This pediatrician also has his hopes pinned on the recombinant Protein Vaccines, What Novavax, although the latter was manufactured at the end of 2021, when the alpha and beta variants were still circulating.
“The vaccine in which we have the most hope is Hipra, the Spanish one. It carries the S protein of the alpha and beta variants, but previous data indicates that it also has a good response against omicron”, he points out. By 2023, the “biggest novelty,” she notes, will be intranasal vaccines. “They will be the third generation. They would prevent the infection and the transmission of the infection,” he concludes.