Meeting at Infarmed Wednesday 5th January 2022
Present at the meeting at Infarmed’s headquarters, in Lisbon, are only the President of the Republic, Marcelo Rebelo de Sousa, the President of the Assembly of the Republic, Ferro Rodrigues, and the Prime Minister, António Costa, in addition to the Minister of Health, Marta Temido, will be present. , and from the experts.
The rest – party representatives, members of the Council of State or social partners – will participate in the session by videoconference.
The epidemiological situation in Portugal will be presented by Pedro Pinto Leite, from the General Directorate of Health,
João Paulo Gomes, from the National Institute of Health Doctor Ricardo Jorge (INSA), will speak about the evolution of the prevalence and transmissibility of the Omicron variant of the SARS coronavirus -CoV-2.
Ana Paula Rodrigues, also from INSA, will present data on the severity of the infection and the effectiveness of the vaccines,
Baltazar Nunes, from the same institute, who will explain the impact of Ómicron on the Portuguese population.
The certainties and uncertainties of the pandemic will be addressed by Henrique Barros, from the Institute of Public Health of the University of Porto.
Andreia Leite, from the National School of Public Health, will present behaviours and social perceptions during the festive period .
The recommendations for the management of the pandemic will be made by Raquel Duarte, from the Institute of Public Health of the University of Porto, which will be followed by:
A review of the status of vaccination against covid-19 by Colonel Carlos Penha-Gonçalves.
Meeting started at 10.00 hrs
The Minister of Health opens the session. The first speaker is Pedro Pinto Leite, from DGS, who will speak about the epidemiological situation in the country.
Pedro Pinto Leite, from DGS, says that Portugal is “in a different phase” of the pandemic, with “historic” values in terms of cases. The current incidence is 2007 cases per 100,000 inhabitants, 131% more compared to the previous week. In the last week, there were an average of 21 thousand cases per day.
There is an increase in incidence in all age groups, but especially among the youngest. In the last week, there were about 1.7 million tests. These had 10.4% positivity, higher than the 4% reference value stipulated by ECDC.
Pedro Pinto Leite confirmed that, apparently, the omicron variant has “lower gravity”. Even so, he stated that the number of admissions requires “some caution”: there are 1167 inpatients (28% more than in the previous period), although the ICUs are at 147 (2% less). Those admitted to the ICU are 58% off the stipulated red line (255 beds).
The risk of hospitalization is two to six times lower in people with complete vaccination over 50 years of age.
Portugal has 19 deaths per million inhabitants, an average calculated over 14 days. The figure is “far below” what has been seen at other times in the pandemic. Pedro Pinto Leite considers it “stable” and even with a “decreasing” trend. “We find ourselves with a moderate mortality”.
The risk of death is three to five times lower in people with full vaccination over 60 years of age. In the age group aged 80 and over, in every 100 cases, 26.8 died; but with vaccination, the value was reduced to 8.6 and, with the booster dose, it dropped to 5.
10.24 Hrs
João Paulo Gomes, from the Ricardo Jorge Institute, responsible for the presentation on the genetic diversity of the virus, the evolution of prevalence in Portugal and the new omicron variant, notes that about 80% of the virus genomes sequenced in Portugal are related to the omicron variant identified, according to the World Health Organization, in more than 90 countries around the world.
According to the official, to date 25,000 Sars-CoV-2 viruses have been sequenced in Portugal, but, taking into account the characteristics of the micron, sequencing (which implies a delay of one week) is not the best model to follow. Priority is real-time monitoring of the failure of the “S” gene (the spike protein).
According to the official, to date 25,000 Sars-CoV-2 viruses have been sequenced in Portugal, but, taking into account the characteristics of the omicron variant, sequencing “is not the ideal strategy”, because it has a delay of about one week.
Therefore, a strategy similar to the one used with the alpha variant has been used, monitoring, in real time, the failure of the “S” gene (Spike protein) – which “constitutes enormous predictive value”, which allows for “a daily surveillance”.
The omicron variant, with “far more mutations than the delta variant”, justifies, at least in part, its greater transmissibility.
The number of omicron mutations (much higher than the others), the higher rate of replication in the upper airways and the greater ability to “escape” from our humanitarian system are the three factors that explain its greater transmissibility .
On the other hand, it has a lower capacity than other variants to multiply in the lungs, which justifies its lower severity .
10.35 hrs
Ana Paula Rodrigues, from INSA, cited a study that reveals that, in South Africa, the risk of hospitalization of those infected with the omicron variant is about one fifth of that of the delta variant. In Scotland, this risk is a third of what it was before, and in the US, the probability of hospitalization for those who have contracted the new variant has also dropped to “less than half”.
This reduction in the risk of hospitalization results from the “conjunction of two factors”: the “potential less seriousness of the infection” and immunity (whether by vaccination or by infection).
Vaccination effectiveness against omicron is “lower” than against delta. The vaccine booster against the new variant has “moderate to high” efficacy.
The effectiveness of the vaccine against hospitalization after the booster dose in relation to those infected with omicron “reaches high values, in the order of 88%”.
In October, 86.4% of the Portuguese population had antibodies against covid-19. The values were even higher (93%) in the population over 70 years old.
Vaccination effectiveness against omicron is “lower” than against delta. The vaccine booster against the new variant has “moderate to high” efficacy.
The effectiveness of the vaccine against hospitalization after the booster dose in relation to those infected with omicron “reaches high values, in the order of 88%”. If the patient has only two doses, these values fall to a range between 52% and 72%, depending on how long it has been since the inoculation took place.
In October, 86.4% of the Portuguese population had antibodies against covid-19. The values were even higher (93%) in the population over 70 years old.
The specialist expects “a lower relative weight” of the most serious infections, but warns that this will not make the infection become “mild”. Thus, individual protection measures continue to be justified.
10.50 hrs
Baltazar Nunes, from the Ricardo Jorge Institute, says that “there is greater transmission of the virus across Europe” compared to November, due to the emergence of the omicron variant. Looking at the examples of England and Denmark, especially in the first one, a more accentuated increase in incidence can be observed as the variant started to gain ground. In both countries, the incidence “has surpassed historical highs”.
In Portugal, this growth is greater when compared to these two countries, which can be explained by greater testing and family reunion at the time of the holidays.
With regard to hospitalizations, there was a growth rate of 2% per day in Denmark and 4.8% in the United Kingdom – which, in the latter case, corresponds to an increase from 200 to 600 beds per 1 million inhabitants (more similar to the situation in Portugal). The specialist points out, however, that, although admissions to wards show a growing trend , the same is not true in intensive care units .
According to Baltazar Nunes, with the emergence of this variant (which began on December 14), 20% of previously infected unvaccinated people lost protection against a new infection.
What is expected for Portugal: a very high number of new infections at the beginning of January (between 42 thousand and 130 thousand); a subsequent increase in the number of people in isolation (from 4% to 12%), with absenteeism from work and school; and maximum ward beds occupied between 1300 and 3700 in late January and maximum ICU beds between 184 and 453 in early February, with a “very high” impact on first-line health services (i.e. pressure about the NHS24, pharmacies and hospital emergencies.
11.10 hrs
Henrique de Barros, from the Institute of Public Health of the University of Porto, spoke of the “huge” increase in the infection in practically all age groups, with the exception of the older age groups. But if the distance between the number of current cases and one year ago is “brutal” with prejudice to the current year, the difference for the better with regard to hospitalizations and deaths is also “brutal”.
The level of infections is explained, in part, by the lifting of movement restrictions. Mobility is currently at levels similar to or even higher than pre-pandemic. The number of tests – five times higher than a year ago – also explains this increase.
“Vaccination works and it worked”, says Henrique de Barros. In homes, the number of outbreaks “decreased six times” compared to January 2021; with ten times more infected, there are now “ten times fewer hospitalized.
“There is no reason for us to continue to reason in terms of the number of cases”, defends Henrique de Barros, since there is “a clear dissociation between the number of cases and their gravity”. “The next variant will probably be even less severe from the point of view of the disease it causes, it will tend to spread more easily,” he predicted.
The specialist also considered “unequivocal” that the vaccine “changed our lives”. Today, thanks also to advances in the study of the virus and the development of drugs, “it is possible to control the infection”.
However, there are still some “uncertainties”: from the outset, the fact that omicron is too recent does not allow, for the time being, to assess the risk in non-vaccinated individuals. Likewise, imagining that we can let the infection spread without consequences “may be a mistake and a decision that we will pay heavily.
The isolation and quarantine strategy will also have to become “maie efficient”, he recommended, particularly on the issue of schools. The objective will be to minimize the social impacts of this measure.
“With vaccination and a testing strategy, we can live very close to normal,” concluded the expert.
11.30 hrs
Andreia Leite, from the National School of Public Health (ENSP), shares the results of the analysis conducted on behaviour during the festive period. The data below was collected based on an online questionnaire that has been carried out continuously by the ENSP to “monitor the social perceptions of the Portuguese during covid-19”. During the holidays, the sample consisted of 850 responses.
There was a large increase in demand and in the number of diagnostic tests performed: the frequency of people reporting that they had never performed tests decreased in the last fortnight, dropping to less than 30% in the last week of December. People’s motivations for testing themselves were mainly “the protection of family and friends”.
According to the official, the perception of the risk of the Portuguese varied throughout the pandemic, and in the last half of December, 67% of respondents said they had a perception of “moderate or high” risk.
1140 hrs
Raquel Duarte, from the Institute of Public Health at the University of Porto, recommends encouraging “the autonomy of the population”. The specialist defends that self-tests become “accessible and free”.
Although the hospital impact of the new variant is “reduced”, it is necessary to remain “aware” of the overload of health services.
1150 hrs
Colonel Carlos Penha Gonçalves, responsible for the coordination nucleus of the vaccination plan against covid-19, presents the current situation.
Full vaccination against covid-19 already covers 88% of the population , with children and young people between the ages of 5 and 20 who have less protection, as the process is still ongoing. For children aged 5-11, vaccination starts on Thursday.
Regarding booster vaccination, it is already being extended to those over 50 years of age, as well as those over 18 who have been vaccinated with Janssen.
Simultaneous vaccination
With regard to the simultaneous vaccination campaign against flu and covid-19, 2400 people have already been vaccinated against the flu and about three thousand against covid-19. About 81% of people over 80 years of age are vaccinated and those over 60 are already being vaccinated. “Over 65 years old we have three quarters of the population vaccinated and over 60 years old we have two thirds”, he summarized.