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The European Medicines Agency (EMA) assured this Friday that any authorization for vaccines against COVID-19 will have “all safeguards and controls” in place and that the assessment will continue after it is put into use.

In a public internet panel, several experts from the agency reinforced the idea that the speed with which the various vaccines under analysis were developed did not compromise neither the guarantees of efficacy or safety that would be possible in a normal vaccine development process.

According to Lusa, the director of the Vaccination Strategy and Biological Sanitary Threats department, Marco Cavaleri, said that the process of creating, clinical trials and approving the use of a vaccine takes an average of five to ten years, but that “unprecedented” novelty in relation to vaccines for COVID-19 was that the steps “were taken with the same rigor, with everything more compressed, in parallel and without intervals”.

That is what allowed “to see a vaccine developed in months instead of years, without cutting steps, with the same amount of information available and the same regulatory standards”.

The head of the Clinical Studies department, Fergus Sweeney, said that the evaluation process by the agency was done “in less time, but without generally reducing the size or rigor of the scientific evaluation and data” provided by the manufacturers to the EMA.

This also contributed to the unprecedented number of experts gathered in evaluation committees, which were divided to carry out, on the one hand, the medical evaluation of the candidate vaccines and, on the other, to assess their risks and safety.

Fergus Sweeney said the format of conditional marketing authorization that the European agency could grant guarantees that “all safeguards and controls are working” and that manufacturing companies are “legally obliged” to continue studies on the application of the vaccine .

This authorization is foreseen for emergency public health situations and can be withdrawn if manufacturers do not meet any of the requirements or if there are problems with the vaccine.

The control mechanisms that will continue to be applied even after the mass vaccination of the population begins include “a robust monitoring plan”, recurrent controls of several vaccine batches as they become available, specific vaccination plans for children, specific studies covering the most vulnerable populations such as pregnant women or heart patients.

The director of the data analysis department, Peter Arlett, indicated that even after vaccination begins, there will be “a strong pharmacological surveillance mechanism” in place and that “safety will not be compromised” in the event of adverse effects.

“Vaccines will only be approved if the benefits outweigh the risks”, he guaranteed, at the same time that at European level and national regulators “additional resources” are being added to closely monitor the application of the vaccines and evaluate any new data.

Under special attention will be the adverse effects of vaccines, the totality of which will only be known with time and application, and Arlett said that there is a network that includes doctors, regulators, manufacturers to share information, as well as the citizens themselves, which he encouraged to report. any adverse effects to health authorities.

He stressed that “since millions of people will be vaccinated in a short period of time, many will have symptoms of illness” close to the vaccine intake, so they may be reported as adverse effects, but they will only be a temporal coincidence.

Currently, the EMA has two mRNA vaccines (those from Pfizer / BioNtech and Moderna), which give the human body a genetic instruction to create an immune response to the new coronavirus and two viral vector (AstraZeneca). / University of Oxford and Jannsen), which use inert viruses to stimulate the body to develop immunity.

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Many Portuguese are scheduling tests with Covid-19 for the days before Christmas to be able to reunite with the family, according to Unilabs Portugal, which only on December 22 has 1,500 appointments.

“Since the communication [on December 5th] of the Prime Minister regarding how Christmas will be, namely from Monday and Tuesday, we have had a very large increase in testing requests, namely PCR tests and also antigen tests, for the 21st, 22nd and 23rd of December, ”the president of the clinical diagnosis network told Lusa.

For Luís Menezes, this situation demonstrates that “people see testing as a way to create an additional safeguard”, in addition to the measures indicated by the Government.

The director-general of Health, Graça Freitas, called, in a recent press conference on covid-19, that the population does not take tests on their own initiative, and should wait for a request or for medical advice.

A position supported by Luís Menezes, affirming that the diagnostic centers “are available to support public authorities and individuals individually in this request, but it is necessary to remember that everything that is being said by public health authorities must be taken into account. in count”.

“Testing can be seen as another safeguard”, but the Christmas dinner should be held with a small number of people, with physical distance and with the use of masks whenever possible.

Luís Menezes said that this situation was not surprising because there were already some questions in this regard, but he said that it was “nothing normal” for people to schedule tests two weeks in advance and ask if they have the results until December 22 or 24.

Detection tests for covid-19 (PCR) are the most sought after, do not require a medical prescription, unlike rapid tests, which are “clearly contraindicated” because they have very low sensitivity for asymptomatic individuals, he said, stressing that “it is It is important for people to be aware that the test is not an absolute certainty that they are negative ”.

The president of the National Association of Public Health Doctors, Ricardo Mexia, told Lusa that “it is important that people realize that the various measures and precautions they can take in order to prevent the spread of the disease are complementary” and considered “a interesting strategy ”the use of tests to identify people who may be infected but are asymptomatic.

“It is a measure that seems interesting to me and that can also help to reduce the risk of an exposure that is expected to happen during the festivities”, said Ricardo Mexia, noting that the test “is not to allow to reduce the other measures” that contribute to the reduction of risk, but to complement them.

He pointed out the cost of carrying out tests as a condition and said that eventually there may be a supply problem, questioning “to what extent will there be capacity for so many people to be able to take the test in a very short period of time”.

For Ricardo Mexia, this is “one more example” that people are concerned and want to protect themselves and those they like.

The SYNLAB laboratory network has also been recording many RT-PCR test schedules for this period, but associated with travel.

“Customers started contacting very early (since the beginning of December) to make appointments also for December 24th, in order to be able to make their trips on December 26th”, he advanced, without specifying the number of appointments have been made.

The Germano de Sousa laboratories have been contacted by some people asking if they are open around Christmas, but as they are working until the 24th and there is no need to make an appointment, they have not yet seen an increase.

“Probably people who are interested in taking the test will arrive on the 22nd, which is what matters in order to be able to rest,” said pathologist Germano de Sousa, predicting an increase in demand at that time.

 

 

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The coordinator of the National Vaccination Plan foresaw today that, in principle, the first vaccines against covid-19 will begin to be administered to the population at risk in early January, a day or two after arriving in Portugal.

Speaking on RTP’s “Big Interview” program, Francisco Ramos was convinced that on December 29 the European Union will give a positive opinion for the distribution of vaccines to member countries, admitting that the “big doubt is the quantity” of vaccines that will arrive in Portugal, with the national access of 1.5 million vaccines from Pfizer pharmacy in the first quarter of 2021.

As he explained, it is predicted that one batch will arrive in January and another batch in February (all from Pzifer), and it is estimated that only in mid-January should a decision be made by the health authorities on the final evaluation and acceptance of Moderna’s vaccine. .

If all goes well, Francisco Ramos admitted that in January it will also be possible to have access to vaccines from these pharmaceutical companies, warning however that there is some “uncertainty” citing that, for example, there is still no date for appreciation of the AstraZeneca vaccine, although there is still “hope” that there will be a decision in January or February.

“It is the best scenario, but there is still uncertainty, namely regarding the quantity” of vaccines available “, he said, reiterating his confidence that in February it is expected to have the Oxford / AstraZeneca vaccine.

In view of the anxiety associated with the arrival of vaccines, Francisco Ramos stressed that it is important to first obtain “safety guarantees” in all vaccines and reiterated that “it is not yet known what quantities (of vaccine) will arrive in the first batches”, pointing out how priorities to prevent mortality, namely of elderly people in homes, health and risk professionals and those who suffer from “severe disease”, associated with pathologies such as chronic kidney disease.

The coordinator for the National Vaccination Plan against covid-19 mentioned that 50% of deaths affect people “over 50 years of age”, mainly those with associated pathologies.

According to Francisco Ramos, if everything goes as planned, 950 thousand people will be vaccinated in this first priority until February and indicated that the elderly in the homes “will not be vaccinated on the same day”, that is, simultaneously, but as the vaccines are distributed to homes and hospitals, where people at risk will be marked “with location, date and time”.

It will also be the Health Centers that call for the vaccination of people with a medical declaration attesting to the clinical condition that allows vaccination in the first phase of the plan.

“What is the routine capacity is 50 thousand inoculations a day without jeopardizing the other normal activities of the Health Centers”, guaranteed Francisco Ramos, admitting that in the most populous cities other spaces could be defined to vaccinate people with right to inoculation against the coronavirus.

“In large cities it will be possible to find other spaces where the teams of the Health Centers operate” the vaccination, he said.

As for the Pfizer vaccine, he said that there will be only one delivery point on the continent, with distribution to the rest of the national territory, with the exception of the Azores and Madeira where the delivery logistics will be specific because they are islands.

Francisco Ramos was confident in the plan and pointed out that “in the best scenario” the experts admit that 50 to 70% of the population may be vaccinated by the end of spring, noting however that vaccination is not mandatory.

However, he warned that “we have to wait a few more months to see if vaccines do what they promise”, in an allusion to effectiveness.

The former Secretary of State for Health welcomed the support and articulation of the Directorate-General for Health (DGS), INFARMED, Shared Services of the Ministry of Health and the Armed Forces (FA), saying that the latter’s support gives him ” an enormous tranquility “taking into account the joint work that he had in the past with the FA when he was at the Portuguese Institute of Oncology (IPO)

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Unemployment and death of elderly people by covid justify the growth of this crime. PSP and GNR investigated 667 complaints between January and August this year.

Abandonment of pets has skyrocketed in major cities across the country. The growth of cases investigated by the PSP and the GNR is mainly due to the death of the elderly by covid-19 and the increase in unemployment caused by the pandemic. Most of the crimes occurred in Lisbon, Porto, Setúbal and Leiria.

Maria Quaresma dos Reis points out those two justifications for the growth of crimes of abandonment in recent months, namely in the capital. “Many elderly people who died by covid lived alone with cats. The family members, due to financial incapacity, did not welcome the cats, who end up going to the street”, declares the animal provider in Lisbon. In some cases, covid victims no longer had a family and animals eased loneliness.

SOS Animal recognizes the phenomenon of abandonment fuelled by the pandemic, but does not risk saying that the increase was due to deaths by covid-19. Sandra Duarte Cardoso, president of that association, points to the absence of studies on this issue, but admits that the death of the owners of dogs and cats has a meaning in their abandonment.

“There are cases in which the keepers die of various health complications and the families do not welcome the animals, leaving them to be abandoned. As the crime is attributed only to the keepers of the animals, the families are not responsible”, he laments. Loss of income also precipitates the practice of this crime.

SOS Animal and the Lisbon Animal Ombudsman point out that the financial inability to pay rent on houses in large cities causes residents to move and leave animals behind. The destination of dogs and cats becomes the streets.

The data, provided by GNR and PSP to JN, point to 667 cases of abandonment of pets, since the beginning of the year and until the end of August, throughout the national territory. Most of the situations occurred in urban centres, under the jurisdiction of the PSP. In the same period last year, the cases did not reach 500.

Animal mistreatment, on the other hand, follows the reverse trend across the country, with a special focus on the area under the protection of the PSP. In 2019, there were 538 crimes under investigation in urban centres. Currently, agents are investigating 377 cases.

Maria Quaresma dos Reis believes that this reduction in crimes of mistreatment can be explained by the thickening of affective bonds between people and animals during the quarantine period. There may also be cases where crimes are not reported. For example, “in situations of domestic violence, the victim watches cruelty, but does not report it to the authorities for fear of the aggressor”, identifies the provider.

“In many homes, quarantine and teleworking have strengthened the effective ties between animals and their keepers, avoiding many situations of abuse, such as violence or the lack of food and drink,” he says. Already

Sandra Duarte Cardoso understands that the number of cases under investigation does not reflect the real dimension of the problem. “Despite the fact that the authorities are increasingly aware of these situations, they face problems in the investigation, such as the lack of space to accommodate animals in overcrowded kennels or the unavailability of veterinarians to monitor the operations”.

Original article JN

 

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The Council of the European Union (EU) and the European Parliament today reached agreement on changes to the European visa system to increase security in the Schengen area, increasing vigilance over short-term and residence permits.

“In response to the challenges of migration and security, the EU is improving its Visa Information System [VIS], an instrument used by the authorities to register and verify people applying for a short-stay visa to enter the Schengen area ”, informs the EU Council in a statement.

In this context, according to the structure in which the Member States are represented, “the German Presidency of the Council and the European Parliament reached an interim agreement today on the main political elements of a draft regulation amending the regulation on the VIS”

In particular, after the entry into force of this new regulation, there will be an increase in the security of the short-stay visa procedure and long-term permits and residence permits will be covered by this control system.

Until now, VIS only collected information on short-stay visas, but that will change with the agreement reached today, since all these permits allow free movement within the Schengen area.

At the same time, the VIS will become interconnected with “other relevant EU systems and databases”, namely the Schengen Information System (SIS), the Entry and Exit System (EES), the European Information Authorization System (ETIAS), data from the European police service (Europol) and the International Criminal Police Organization (Interpol) and also with Eurodac, which stores fingerprints of asylum seekers and migrants.

Another of the planned changes is the digitalization of the biographical data page of the travel documents, which will now be available in digital format.

To combat child trafficking, the age for taking fingerprints from children will be reduced from 12 to six years.

An upper age limit will also be introduced, including fingerprints of people over 75 years of age not included in the VIS.

In addition, the current photograph on paper will be replaced by a live facial image with sufficient resolution and image quality to be used in automated biometric correspondence.

Social Democratic MEP Paulo Rangel, European Parliament negotiator for the European visa system, welcomes in a statement these changes, arguing that the VIS reform agreement “substantially increases the capacity to fight organized crime and terrorism , having an impact on long-term visas, including the famous ‘gold visas’ ”, ie residence permits for investment in the EU.

“From 2023 onwards, it will be almost impossible to enter the EU with false documents”, says Paulo Rangel, stressing that “the enormous reinforcement of the protection of children against trafficking networks” is also very important.

Created in 2011, VIS is a database with biographical (name, sex, age) and biometric (photo and fingerprint) data of third-country nationals authorized to move within the Schengen area.

 

Also applying to ‘gold visas’, this system is addressed to the authorities responsible for borders, asylum and migration.

The reform now agreed has an estimated cost of 250 million and is expected to be implemented in 2023.

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Translation by Safe Communities volunteer Eliana Tavares

António Costa spoke to the country this Saturday at 15h00 and announced the measures decided in the Council of Ministers for the forthcoming festive period. At Christmas, travel between municipalities will be allowed, but in the New Year this restriction remains in place.

The Prime Minister began by saying that measures to circulation on public roads would remain in force for the next 15 days from 13h00 on Saturday and Sunday in municipalities at extreme and very high risk.

For the Christmas and New Year period, however, exceptions will be adopted, subject to evaluation on 18 December to confirm that the trend of improvement in the pandemic situation is confirmed and that it will not be necessary to “pull the emergency brake,” announced the head of government.

The main exception for Christmas will be the permission to travel between municipalities on 23, 24, 25 and 26 December. In addition, on Christmas Eve and on Christmas Day you can circulate on public roads until 02h00. The Government advises that at Christmas families should avoid meeting many people, avoid spending too much time without a mask and prefer open and ventilated spaces.

Another exception for Christmas will be the restaurant opening hours. On the nights of 24th and 25th December they can be open until 01h00 and on the 26th they can serve lunch until 15h30.

In the New Year the exceptions will not be as comprehensive. Movement between municipalities is prohibited between 00h00 on 31 December and 05h00 on 4 January.

The only relaxation will be on New Year’s Eve, when movement on the public road is now allowed until 02h00. On January 1st, however, it will be changed to 23h00.

No public parties or open to the public will be allowed on New Year’s Eve, nor gatherings on the public road with more than six people.

Restaurants can be open on the evening of 31 December until 01h00 and on the first day of 2021 they can serve until 15h30.

The prime minister explained that the government’s strategy was to extend the restriction measures until Christmas, and then to reduce them on 24, 25 December and 1 January, returning to the level of restrictions.

At the press conference after the meeting of the Council of Ministers in which the measures to implement the new state of emergency were announced, António Costa called on families to “avoid fraternisation with many people”, long periods without masks and “in closed spaces, small or not very ventilated”.

“It must be a sharing Christmas”, he said, but “it must not be a time of involuntary transmission of the virus”. “May we all be effectively safe as a family,” the Prime Minister said. “Let us not share the virus. That cannot be our Christmas gift”. António Costa explained that it was vital to maintain the effort so that “the goal of reaching Christmas with as few infected people as possible” could be achieved since “the less infected people are, the lower the risk of transmission”.

By November, the executive had already divided the continent’s 278 municipalities into four groups, depending on the level of risk of transmission: moderate, high, very high and extremely high.

According to António Costa, there are 27 municipalities at very high or high risk which, due to a “frankly positive development in the last fortnight”, have changed to moderate, while another 12 come out of the extremely high level and two come out of the very high level.

They are: Abrantes, Albufeira, Barquinha, Batalha, Benavente, Cadaval, Campo Maior, Constância, Coruche, Estremoz, Idanha-a-Nova, Mangualde, Mora, Nazaré, Monforte, Oliveira de Frades, Paredes de Coura, Ponte de Sor, Porto de Mós, Proença-a-Nova, Redondo, Ribeira de Pena, Salvaterra de Magos, São João da Pesqueira, Tondela, Viana do Alentejo and Vila Nova da Vila Viçosa.

António Costa stressed the need to maintain the measures that have been applied in these territories for the next 15 days.

Source: RTP

 

In sum:

Following the renewal of the State of Emergency decreed by the President of the Republic, the Council of Ministers approved the decree regulating the measures to be adopted, throughout the continental territory, in the period between 00h00 on 9 December 2020 and 23h59 on 23 December, as well as the measures applicable considering the possible renewal of the State of Emergency.

The decree essentially maintains the current rules and establishes special measures for the Christmas and New Year periods. The government has therefore decided:

  • To maintain the rules currently in force, as well as the staggering of their application according to the risk of transmission of Covid-19 in each municipality – moderate, high, very high and extreme. It should be noted that the ban on circulating on public roads will continue to apply on the weekends of 12-13 and 19-20 December from 13h00 in municipalities at very high and extreme risk.
  • Update the list of at-risk municipalities and their distribution over the different levels.
  • On 18 December, review the risk map and re-evaluate the epidemiological situation in each county, if necessary worsening the measures.

For the Christmas period:

  • Circulation between municipalities:
  • Circulation on public roads:
    • Night from 23 to 24: allowed only for those who are travelling;
    • Days 24 and 25: allowed until 02h00 the following day;
    • Day 26: permitted until 23h00.
  • Opening hours:
    • On the nights of 24 and 25, restaurants are allowed to operate until 01h00.
    • On the 26th, restaurants are allowed to operate until 15h30 in very high and extreme risk municipalities.
    • On the 24th and 25th the closing times do not apply to cultural establishments.

 

  • For the New Year period:
    • Circulation between municipalities:
      • Prohibited between 00h00 on 31 December and 05h00 on 4 January.
    • Movement on public roads:
      • New Year’s Eve: allowed until 02h00;
      • 1 January: allowed until 23h00.
    • Opening hours:
      • On the evening of the 31st, operation of restaurants allowed until 01h00.
      • On the 1st January, restaurants are allowed to operate until 15h30 in very high and extreme risk municipalities.
    • Public parties or parties open to the public are forbidden.
    • No street gatherings with more than 6 people.

 

The Government also decided to recommend avoiding:

  • Gathering a lot of people;
  • Spending long periods without a mask on;
  • Closed, small and not very ventilated spaces.

 

Source: https://covid19estamoson.gov.pt/

 

 

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State of emergency renewed until 23 December. “Pressure in intensive care” and “high death toll” worry the President.

The decision to renew the state of emergency, despite the slowdown in cases, is due to “pressure in intensive care” and “high number of deaths”, the President of the Republic said this Friday at 20h00 in a statement to the country. Marcelo Rebelo de Sousa said that it was important to maintain efforts to relieve the pressure in hospitals. On vaccinations, he confirmed that the “arrival to all Portuguese” follows “extended timetables” and that “it will be a matter of weeks” rather than days. The President hopes that “this will be clear so as not to create excessive expectations and, therefore, immediate disappointments”.

The less intense regime on Christmas, if it comes to pass, will be designed for families to achieve the “desired and legitimate” encounter, but avoiding uncontrollability. The President of the Republic stressed the importance of these meetings being made with caution in order to avoid a possible “third wave” and lack of control in January. The aim, explains Marcelo Rebelo de Sousa, is to live Christmas, “but without concentrating on a single moment and with increased respect for the rules that can prevent widespread family contagion”.

The President of the Republic also left a message of praise to the Portuguese, for, in general, having complied with the rules, quoting the State adviser and neuroscientist António Damásio, who, in an interview with PÚBLICO, said: “There is a great distribution of generosity, patience and calm in the Portuguese”.

The presidential decree to renew the state of emergency, despite having a maximum validity of 15 days, should be renewed in the same way during Christmas week, to be in force until 7 January. The decree provides for approximately the same restrictions of rights that were already in force, and it is now up to the government to define the specific rules for each period. On Saturday, the Council of Ministers will meet again to define the specific measures which will be in force during the same period, in particular the Christmas and New Year periods.

“This decree keeps unchanged the framework that allows to impose, between 9 and 23 December, the same rigour for the current period and underlies the same purpose for the following period, until January 7, with the possible exception that is expected to be well understood and well experienced at Christmas,” said the President. “It is obviously in everyone’s interest that January may represent a consolidation of the steps taken in December and not a new and frustrating rise that will eventually accentuate the dimension of a dreaded third wave,” he warned.

Meeting the constitutional deadlines, the renewal of the state of emergency will last 15 days, beginning at 00h00 on 9 December 2020 and ending at 23h59 on 23 December 2020. But renewal is already guaranteed on these terms, at least until 7 January 2021.

The current state of emergency started on 24 November and ends at 23h59 on Tuesday 8 December. This renewal takes effect from 00h00 on Wednesday 9 December.

According to the Constitution, this legal framework, which allows for the suspension of the exercise of certain rights, freedoms and guarantees, may not last more than 15 days, without prejudice to possible renewals with the same time limit.

This Saturday, António Costa will announce the measures for this period.

Source: PÚBLICO and RTP.

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The availability of vaccines, when they happen and at the rate at which they happen, will continue to need to be accompanied, for many months, by the fulfillment of the other essential rules to keep our social and economic systems responding in the period when they are not yet has achieved immunity ”, said the Minister of Health, Marta Temido in the presentation of the vaccination plan against Covid-19, in Lisbon.
The Minister highlighted the technical rigor of the plan’s coordination team for the distribution and administration of vaccines. The vaccination-related process does not start now, since Portugal has, since June, been following the European Union’s process on the development, production and availability of vaccines, he said.
Marta Temido stated that “the vaccines to be distributed will have a universal and free character”, will be “administered according to the characteristics of the medicine”, and “made available at the National Health Service, using the NHS chain as much as possible, and then eventually expandable to other points in the health »system, with secure logistics and records that allow monitoring the process.
The Minister also mentioned that there are still technical uncertainties, of production by the pharmaceutical industry and approval by technical entities, in the session chaired by Prime Minister António Costa.
Plan
The coordinator of the working group that prepared the plan, Francisco Ramos, stated that the objectives of the plan are “to reduce mortality and hospitalization in Intensive Care Units, control outbreaks in the most vulnerable populations, and preserve the response capacity of the services universal ‘.
The priority groups were defined based on known data, which show that people over 50 years old are 97% of deaths, 91% of hospital admissions and 81% of intensive care admissions. There are other diseases that are important risk factors, especially coronary, renal and pulmonary.
Phases 
According to the plan, in the first phase, people aged 50 or over with one of the diseases mentioned above will be vaccinated, residents of nursing homes and long-term care units and their professionals, health professionals and essential services, representing on the 950 thousand people.
In the second phase, two groups of people will be vaccinated: those over 65 without disease, and those between 50 and 65 who have diabetes, cancer, liver and kidney failure, obesity and hypertension, representing the first subgroup, 1, 8 million and the second plus 900 thousand.
In the third phase, the rest of the population will be vaccinated if the industry is able to produce vaccines at sufficient speed; if not, new priority subgroups will be created, which will be vaccinated at the rate at which vaccines are produced.
Vaccination in Portugal starts in January, as in the whole of the European Union – the vaccine will be distributed to all countries at the same time -, but still undated, as it depends on the approval of the vaccines and the pace of production.
In time, the first phase should take place in January and February depending on the pace of vaccine supply, and may extend until April. The second is expected to take place in the second quarter.
Locations
The vaccination points will be those of the National Health Service, which has 40 years of experience, stabilized circuits and routines and 1200 points that exist throughout the country.
Residents in nursing homes and hospitalized in long-term care units will be vaccinated in these places, by the nursing teams themselves or by teams from the health centers, the professionals will be vaccinated by the respective occupational health services. The remaining 400 thousand Portuguese in the first group will be vaccinated in the 1200 points of the NHS.
There is still no detailed plan for the second phase, which implies the expansion of the vaccination network, depending on the pace of vaccine supply.
There will be a very tight record, strengthening the common electronic vaccine registration, as health services have to make sure that whoever takes a first dose gets the second dose immediately, with date, place and the guarantee that is administered to same vaccine in the second dose.
In the first phase, the system will be the call of 400 thousand people for health services, through health centers, or, for those who do not use the SNS by medical declaration.
Due to the novelty of the vaccine, there will be clinical follow-up and effectiveness studies.
In logistics, contrary to the normal decentralization of the SNS, there will be command and control of the entire operation at the Ministry of Health, supported by the Armed Forces and security forces.
Communication
There will have to be a very wide communication, which generates confidence in the population: a website with all the relevant information and telephone lines to support the population and professionals.
Francisco Ramos, like the Minister of Health, highlighted the uncertainty that exists throughout the process, referring that until the approval of a vaccine by the British authority of the medicine, the only information about the vaccines came from the pharmaceutical companies that are producing them.
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PORTUGAL COVID-19 VACCINATION PLAN ANNOUNCEMENT

AIMS, PRIORITY GROUPS AND HOW IT WILL BE ADMINISTERED

The Minister of Health, Marta Temido, considered that “today is an important day” for the country, since, despite the “uncertainties” that still exist around the vaccine, Portugal takes “one more step” in planning how this will be administered.

Marta Temido stressed that the vaccine will have a “universal and free character”, being made available “in several points” of the NHS and using “as much as possible” that network.

Francisco Ramos, vaccination plan coordinator, details objectives and priority groups

– reduce mortality and hospitalizations, especially in ICUs
– control outbreaks especially in the most vulnerable populations
– minimize the impact on the economy

Priority groups:

Vaccination plan will have three phases

Francisco Ramos, coordinator of the working group created to develop the vaccination plan, released the details:

1st phase: Residents in nursing home users and professionals (about 250 thousand people), citizens from risk groups (400 thousand), health professionals and security agents (300 thousand people); Includes those with serious pathologies, such as coronary heart disease, kidney failure, heart failure or respiratory disease.
– 2nd phase: people aged 65 and over, with or without pathologies, people between 60 and 64 with severe and / or chronic diseases (900 thousand), also includes those 50 -74 with a wide range of pre-existing conditions from diabetes to obesity (1.8 million). Should go onto April.
3rd phase: remaining population

In the first vaccination phase, which starts in January and should go on until March, as Francisco Ramos predicts, the vaccination points will be the usual ones in the country, that is, health centres. There are about 1200 of these points and will have the mission of vaccinating about 950 thousand people

The choice involves utilising experience, circuits and professionals already trained for the purpose, which, in this case, are nurses.

The exception is made for homes and for long-term care services, since in these two cases users will be vaccinated in their own places, sometimes by the nursing team itself, other times by a team that will go to the place for the purpose.

It will be up to the health centres to identify the Portuguese who, due to their characteristics, should get the vaccine in this first phase, find them and call them for their respective intake.

CENTRALISATION

Thus, the process will be centralized. “What we propose is a logic of command and control, not decentralized. We will maintain collaboration by all entities, but due to the timings and relevance of the process, also due to uncertainty, there should be a central command in the Ministry of Health, with DGS. With the support of the armed forces and security forces. We are outlining all operations in as much detail as possible, to find out what will happen up to the vaccine administration site. Raising security issues, we are ensuring the safety of everything. ”

Communication is also being prepared. “We want communication to be very broad, to generate confidence in the population, to guarantee the application of the vaccine.”

Thus, there will be a portal on the internet where all the relevant information is. “And telephone lines to support the general population and health professionals.”

PROCUREMENT PROCESS

The vaccine procurement process is coordinated by the European Union, says Rui Ivo, president of Infarmed, the National Medicines Authority, which has participated, on behalf of the Ministry of Health

After a brief introduction by Marta Temido, Rui Ivo, president of Infarmed, spoke to explain how the vaccine acquisition and evaluation process has been carried out. The process is the result of a coordinated strategy within the scope of the European Union, on which two pillars of action were created: guaranteeing the necessary quantity of vaccines, through several procurement judgments, and the adaptation of the evaluation rules.

Rui Ivo also said that there are six judgments concluded by the European Commission, noting that the first was made with Astrazeneca, on August 14, in which 6.9 million doses will be for Portugal. Note also for the 4.5 million doses of the Johnson & Johnson vaccine destined for Portugal, the 4.5 million doses of the Pfizer vaccine and the 1.8 million doses of the vaccine for Moderna.

Regarding the evaluation of vaccines, the president of Infarmed reveals that it was done in a different way than usual, the so-called scientific advice, in which there was interaction between the authorities – in this case, the European Medicines Agency – and the companies that are developing the vaccine. This was done with the aim of saving time, not waiting for the completion of the studies, but starting to receive interim data throughout the trials.

PRIME MINISTER

We really have a light at the end of the tunnel. But the tunnel is still very long and quite painful. The 22 million do not arrive on the first day, they arrive gradually throughout the year 2021. It is therefore very important that they are defined priority criteria. The ones that the commission puts forward are clear: first, homes, health care, essential services. Second, more vulnerable populations, due to age or mobility – it is a criterion that we all understand. ”

Then, Costa recalls that there are imponderables – and some that are not in the hands of the country. “” Trust requires that the Portuguese be aware that it is necessary to speak the truth. But we must know that there is a significant set of imponderables: production, licensing does not depend on us. If there is a delay there, we have to readjust the timetable. ”

MANAGING UNCERTAINTY

Francisco Ramos, coordinator of the vaccination plan, said that it is necessary to “manage uncertainty” and that the information must be “ always available to be reviewed and updated”.

The official also calls for the need to maintain “a fine balance between managing uncertainty and creating confidence in citizens during the coming months”, adding that it gives him “ enormous tranquility” to be working with the Armed Forces.

Vice-Admiral Gouveia e Melo spoke later to say that ” the Portuguese population must have confidence in this process”, that being “complex” and having “many variables and uncertainties”, will have the help of the Armed Forces.

PRIME INISTER SUMMING UP

Prime Minister closes with some confidence (always with warnings):

“The difficulties start here. And they will be growing. The operation will be easier in the first weeks when we have few doses and limited recipients. They will be much more demanding when there are more doses and the universe to be vaccinated wider.

It is an immense effort, but it is not less than what the Portuguese have been doing depriving themselves of freedoms, which families have been doing with bearing losses of income, which companies have been doing in order to survive. These crises will only be overcome when we have reached a sufficient level of immunization.

It is good to know that there is a light, but we still have a very long way to go. Even after we reach collective immunization, we will still have several pains to treat. But we are at a better point today than last week, much better than six months ago. So there is confidence ”.

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The meeting began shortly after 1000 hrs with an introduction by the Health Minister, Marta Temido and with the President of the Republic and the Prime Minister in attendance.

OVERALL AND GEOGRAPHICAL SITUATION

André Peralta Gomes, from DGS, pointed out that there is “good news” with regard to the country’s epidemiological situation: on November 25 there was a “consolidation of a peak” and there has been a “downward trend” of contagions, which is expected to be consolidated in the coming days.

There was a “relief in several municipalities, especially in the North”, although there, the incidences are still “very high”. In the Center and in Lisbon and Vale do Tejo it is also going down, but in Alentejo and the Azores it continues to go up.

Óscar Felgueiras, from the Faculty of Sciences of the University of Porto, said that in recent days there has been “an improvement” with regard to the situation in the North region. There was a “generalized decrease in almost all districts” in the region, except for the north of the Vila Real district. The areas of Porto, Maia and Matosinhos already have less than 960 infected per 100 thousand inhabitants.

The parishes of Paços de Ferreria, peaking on November 3, Lousada (November 6), Felgueiras (November 16), were the most critical municipalities. “When there are neighbouring counties, the peak occurs first in the counties with the highest incidence”, he defends. “The neighbourhood with a higher incidence should be considered a risk factor”, he says.

SOURCES OF INFECTION AND TRENDS

According to André Peralta Santos, the source of the infection (epidemiological link) is known in 13% of confirmed cases in the last week. “As the link is information filled in by doctors, it may be delayed,” said the person in charge of the statistics department at DGS. In these 13% where the source of contagion was identified, family contact had the greatest preponderance.

“In the older age groups, the peak will have been between 9 and 12 November, which prolongs the influx to hospitals”, says Felgueiras. The age group between 0 and 29 years old will have been the first to reach the peak.

TRANSMISSION FACTOR BELOW ONE

Baltazar Nunes, responsible for the Ricardo Jorge Institute’s epidemiological research unit, says that the RT indicator, which reflects the number of people infected with each positive case, continues to fall and is now at 0.99 nationwide. That is, an infected person does not get to infect another.

DECREASING MOBILITY

According to Baltazar Nunes, Portugal entered the group of countries that are in a “phase of decreasing notifications”. But this fall in incidence is recent and we need to wait some more time. The reduction in the number of effective contacts was decisive for this evolution.

Looking at the mobility of the Portuguese, there was a 20% to 30% reduction in mobility related to work, commerce and in the face of the period before the pandemic. And if you look only at the situation in the last three weekends, subject to more restrictive measures of circulation and collection, the reduction in mobility reaches 50%, a value close to what was seen in April, during the general confinement.

DEATHS TRENDS FORECAST

Manuel Carmo Gomes, professor of Epidemiology at the Faculty of Sciences of the University of Lisbon (FCUL), began to make short-term projections. Deaths will peak at the end of this month, with an average of 76 daily deaths.

The total number of deaths accumulated in 2020 with covid-19 will be in the range of 6000 to 6500 deaths, the expert also projected.

The number of inpatients in intensive care units is expected to peak between 2 and 6 December, with an average seven days of 530.

PATIENTS WHO WENT TO INTENSIVE CARE MOST PROTECTED

João Gonçalves, from the Faculty of Pharmacy, University of Lisbon, discusses the functioning of future vaccines against covid-19. Highlighting that “the patients who had more symptoms and went to intensive care are those who have more protection. That is what the vaccine will bring, a high protection without symptoms”, he says.

A “vaccine capable of preventing disease and preventing transmission capacity” is the goal, but the starting point is that immunity will not be the same for everyone who takes it. “It is important to continue to protect groups at risk,” he says.

“All the phases that we have in the development of the vaccines are being carried out”, he guarantees, defending that the monitoring of the results and side effects should be done in the first vaccination times.

VACCINES

274 Vaccines under development

274 vaccines, 59 of which are already in clinical trials, 11 of which are in the third phase of testing, says Fátima Ventura, from Infarmed, on vaccines against covid-19. European Union secured six.

NEW OUTBREAKS EXPECTED

António Roldão, from the Vaccine Development Laboratory, stressed that the outbreak of new outbreaks is expected to be added to the 20 or so that emerged in the 21st century. This is because of increased mobility, greater interaction with animals and climate change.

In this sense, it is necessary to invest in vaccine production, in order to be “proactive instead of being reactive”, he added.

ABOUT A MILLION IN PORTUGAL HAVE HAD CONTACT WITH THE VIRUS

Henrique Barros, a professor at the University of Porto, now says that, with the data he has “we can imagine that at this moment there will already be one million people who had. With a wide margin of error, there are between 600 thousand and 1.8 million “. And he adds: “Between 15% to 20% of the population will already be immunized, due to contact with viruses. If they will be effectively protected it is one of the faces of this uncertainty that we have.”