January 25, 2022 6:08 pm

Comparison: what is the health impact of the third wave of Covid-19 and why is it milder than previous outbreaks

In just over two months, two years will have passed since the Covid-19 pandemic began in Argentina. During that time, different scenarios took place, some more dramatic than others, and society got used to it. to live differently, with restrictions, requirements, new customs and habits. In the last week the explosion of cases certified the march of the third wave with figures that were breaking historical records and days that widely exceeded the barrier of 100,000 infected. The regrowth, however, so far it is not more serious that the two similar situations that have occurred so far, according to the specialists consulted by THE NATION.

Vaccination and the protection barrier it generated against the threat of Covid-19 is the great difference from one year to the next. With seven out of ten Argentines with complete schemes and the administration of the third booster dose on the rise, the infection levels trigger alerts, but no concern because it does not yet impact intensive care care. The unvaccinated, in this context, are the most exposed to develop serious pictures that cause death with the circulation of delta and omicrom and it is a moment considered as a break for many experts because it could mean the transition to endemic, a hypothesis that is also closely followed by the Minister of Health of the Nation, Carla Vizzotti.

“The vaccine finds us better off because at the beginning of the pandemic a virus with an unstoppable and totally unknown destructive capacity broke out. Now health care for the unvaccinated is on the rise: those who die in Argentina are the unvaccinated or the poorly vaccinated, without completing the schemes “, says the infectologist Hugo pizzi, from the National University of Córdoba.

“Intensive therapies have unvaccinated patients, the same happens in Italy and in other European countries. Doctors in France are in a dilemma because they do not want to treat the unvaccinated. The fence is closing towards the unvaccinated, who lack empathy, judgment and solidarity ”, adds the expert. The city’s Health Minister, Fernán Quiros, today provided conclusive data by revealing that 65% of the beds occupied in intensive care have patients not vaccinated against Covid-19.

At the worst moment of the pandemic, during the second wave and in the middle of last year, combined the high number of infections with the high number of deaths and the Intensive Care Units (ICU) to the limit, with occupations that exceeded 90% of the availability of beds. The health systems of the main cities were saturated and on the verge of collapse, with referrals between provinces and readjustments of the facilities to generate new critical care spaces.

It was the second major outbreak that Argentina experienced, in the middle of the vaccination campaign, which began in March 2021 after a long plateau after the summer season. At the end of that month, the steepest slope in the number of cases began, going from a daily average of 7,000 cases to 24,000 in April and 32,000 in July, with days of up to 41,000 infected. The weekly average of deaths per day reached 620.

After the peak of the second wave, the curve began to decline steadily until October and after more than 20 weeks down, there was a break and the trend was reversed to begin to rise again. Although it was foreseeable that the expansion of the delta variant would cause a greater number of cases no one expected the December explosion when all the records of the pandemic in the country were broken with days that exceeded 110,000 new infections. Unlike what happened last year, the mortality rate remains low (the peak was a weekly average of 42 deaths per day) and also hospitalizations in ICUs with a 37.5% occupancy throughout the country and 38.7% in the metropolitan area. In the city, the public sector occupancy is 10.5% (63 beds out of 600 available) and in the private sector it is 16.2% (199 out of 1,222).

“The tremendous contagion of omicron caused it to spread with unusual speed. In Argentina there is a much less harmful scenario than the previous waves because we are in the presence of a large vaccinated population; It wouldn’t be the same if there weren’t so many people vaccinated, that’s why we are seeing that the rate of intensive care hospitalization increased, but not at such a great rate ”, he explains. Luis Camera, secretary of the Argentine Society of Medicine.

“This wave is mobilized by omicron and delta, mostly, both with different biological behavior: delta is the most aggressive of all those that arose (more than gamma and lambda) and omicron is the least aggressive and harmful because it is very minor. the possibility of generating pneumonia. Somehow it is a more benign virus”Adds Camera. And anticipates: “In this third wave the lethality will be much lower, there will be ten times less loss of life. It is an analysis that is already being done so the vaccine is the big difference ”.

The difference between the different waves is not only in the occupation of intensive care beds, in deaths and cases, but also in different situations of daily life. In the first major outbreak, the strict quarantine changed all social behaviors with empty, desolate cities, like never before. The saturation of hospitals, in critical care areas, became the most recurrent image of that moment. Today shows test centers collapsed, doctors attacked by patients and the very high positivity in the most important tourist cities, such as Mar del Plata or Córdoba.

“The third wave is different: having 85% of the population with one dose and 73.6% with two, omicron causes a mild to moderate disease without such a high rate of complications or mortality [además hay un 16% con una tercera dosis]. However, omicron, in unvaccinated patients, behaves the same as other variants. The unvaccinated are more likely to become seriously ill and they are transmitters of the disease. There are studies that show that every 200 people who are admitted to intensive care in the world between 190 and 195 are not vaccinated “, reports the infectologist Roberto Debbag.

“This wave, being so explosive and highly transmissible, causes social and health disruption. The problem of tests that are not enough and the occupation of emergencies that blocks the attention of other patients, suspended flights, absenteeism from work and suspended meetings. The difference in favor is the drop in hospitalization and hospitalization ”, he adds.

On March 20, 2020, the start of the quarantine in Argentina, there were 31 active cases of Covid-19 that were increasing progressively day by day. In June the curve began to rise (with 564 cases per day and a weekly daily average of 684) and can be taken as the start of the first great wave. The most vertiginous rise took place from August, with between 7,000 and 10,000 new patients per day, until the maximum peak that would arrive two months later.

The 18,326 cases on October 21 marked the roof of that first regrowth when there were still no vaccines available, to then enter a setback that lasted until mid-December with a new rebound. However, the peak did not exceed 14,000 daily cases in January, against expectations that predicted a complicated summer due to the stampede of infections and the possible saturation of the health system. The deaths reached a weekly average of 419 deaths per day.

In that first wave, deaths began to rise in July and from mid-September they had an abrupt jump when they went from a daily average of 240 to 400, to then go down gradually until the end of the year and maintain an intermittent evolution during the first quarter of 2021. From that moment, in April, growth did not stop and went through the worst moment of the pandemic with figures higher than 700 daily deaths and more than 600 on a weekly average per day between May and July.

Leaving that moment behind and despite the escalation of cases in recent weeks, it remains to wait until when infections can rise and the pandemic begin to retract. “It is possible that omicron is a transition towards endemic. In March or April it would be exhausted in a significant way worldwide, although it depends on individual and collective behavior ”, risks Camera. For his part, Debbag argues: “If a new variant does not appear in the current semester the end of the pandemic is near because there are populations that have many asymptomatic patients, which makes the planet become immunized ”.


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