The sixth wave of Covid-19 in Spain: when will it come, how it will be and who will it affect

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Like the artists, in the promotional interviews of their album or film, they end up being asked about their next projects, People are already beginning to question what form the sixth wave of Covid-19 will take although we continue on the downward slope of the fifth. Because one thing seems clear: there will be, there will be.

Or that is at least what the CSIC researcher pointed out this week Margarita del Val. “The waves are going to continue,” he pointed out in a television program, and even dared to predict a date: end of september, “As soon as it gets a little cool at night, we are going to start going indoors.” And there, if there are no masks or good ventilation, SARS-CoV-2 is unbeatable.

There are barely 20 days until the premonition of the popular scientist is fulfilled, although not everyone agrees with her predictions. “I admire Margarita del Val for her work, whether or not it agrees with her opinions,” says the Public Health expert Antonio Cabrera de Leon before analyzing when that presumable sixth wave will arrive.

“More than in the cold, I would be attentive to probable outbreaks a few days after the bridge of October 12, the celebrations of November 1 or the bridge of the Constitution“That is to say, a little later. The experience of the second and third waves of the coronavirus – which began after festive periods – is clear.

Cabrera de León, professor of Preventive Medicine and Public Health at the University of La Laguna, considers that, if a new wave arrives at the end of September, “it would be more for the teaching activity“. In this it coincides with the words of the coordinator of Pediatric Emergencies of the Gregorio Marañón hospital, Paula Vazquez, which already pointed out to this newspaper in August that the return to classes this year would be different from last.

“We will have another peak [de contagios] with the return to school, those under 12 years old without vaccination and those under 6 years old without a mask; there will be a lot of transmission, “he explained, also indicating that the myth that the child was not contagious is history: this is how it has been seen in the fifth wave.

Something similar has also pointed out Joan Carles March, a professor at the Andalusian School of Public Health, who has indicated to this medium that “with the situation we are in, with the beginning of school and the population under 12 years of age without vaccinating, with those between 12 and 19 years of age being vaccinated and starting a period of more frequent colds and flu, it is clear that the sixth wave may be feasible. “

However, Cabrera de León is more optimistic and does not believe that there is to fear the return to the classroom. “In 2020 the second wave arrived from the summer and we started the course in full wave. We were very, very worried.” With the good teaching organization and prevention measures such as masks and bubble groups, “there was no wave attributable to schooling.”

He is skeptical of the inevitability of the sixth wave. “I don’t know if there will be one or when it will arrive.” However, we have a very powerful weapon against it. “We have come a long way in vaccination and, if a new strain more virulent than the current Delta spreads, we may not reach new waves anymore although there are still numerous outbreaks. “

The new Lambda and Mu variants

Delta has made health administrations sweat. When the fourth wave gave us an idea that perfect storms were a thing of the past and reflected a calm sea perspective until the vaccination was completed, this variant raised the waters again, leaving us with a clear warning signal: there is no than to trust everything solely to vaccines.

The C.37, Lambda, and B.1.621, Mu variants aren’t exactly new. They have known each other since the beginning of this year. However, it has been in recent weeks when the World Health Organization classified them as ‘of interest’ (that is, they must be closely monitored).

Both have wreaked havoc in Latin America. Lambda lived its expansion period in Peru in the months of May and June, and is also present in other South American countries. Has six relevant mutations in the S protein of the virus (Delta has two). Mu, which is predominant in Colombia, has three.

Cases, especially of the Mu variant, have already been described in some communities, albeit in isolation. The Ministry of Health indicates that the mutations of the two strains are related or compatible “with increased transmissibility and escape from the immune response against the previous variants”.

However, the importance of the variants in the evolution of the pandemic in Spain has been uneven. While Alpha and Delta have been imposed in successive periods, others like Beta, very feared for its alleged vaccine escape, has always been well controlled.

The contribution of Lambda and Mu to a possible sixth wave is uncertain, although Cabrera de León goes further and points out that, “as long as the population of all countries is not massively vaccinated, we run the risk of a strain appearing that roll back the control of the pandemic. “

Who will be affected the most by the sixth wave

Regarding the characteristics of this hypothetical wave, Margarita del Val indicated that it would have more asymptomatic patients because the vaccines are not sterilizing but largely avoid the symptoms. This fact would serve to continue spreading the infection, since the wearer is not aware that he is wearing it.

The virologist also pointed out that relative mortality will be lower than this summer, although with an indeterminate number of cases, something in which the experts in Public Health agree, which no longer link the increase in infections to a proportional increase in the rest of the indicators. Serious cases, hospitalizations and deaths will be the indicators to take into account when taking measures.

Cabrera de León points out that, “whether it’s a wave, it’s just outbreaks,” the main affected will be the unvaccinated. Several specialists have already warned EL ESPAÑOL that group immunity is a concept that has been left behind with this pandemic and that those who are not vaccinated will always have a greater risk of contracting the virus and developing serious disease.

The next to whom it will affect the most, explains the Canarian epidemiologist, are “those in which the vaccine has failed.” As their effectiveness is around 90%, they will remain (with the current numbers) around 3.5 million people with insufficient protection.

Furthermore, “if we take into account the 12 million people that we have not yet vaccinated (children and others), maybe we are close to 20 million exposed“He says crudely.” In them lies the risk that there may be waves. “

Cabrera de León does not forget who are the most vulnerable in the sixth wave or in any of the previous or following: the elderly. In them, the percentage of vaccine failure “may have been greater than 10%”.

The professor of Preventive Medicine at the University of La Laguna points out that, as was done with the different waves of the study on seroprevalence of the virus in the population throughout 2020, the Carlos III Health Institute should promote “a rapid study to find out the degree of immunization that these people have“.

Until then, and although vaccines have done an excellent job, Cabrera de León is inclined to implement protection policies in residences. Which? “Masks, distances and control of visits”.

Wave after wave, the same restrictions. They are the ones that have helped to manage the pandemic and time has proved them right. Even when? For now, and until the pandemic subsides, they will continue to be present.

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