Portugal Situation Report Wednesday 19^th January 2022

Introduction

Good morning – I start today, not with Covid-19, but with the devastation caused to the tiny islands of Tonga resulting from the Hunga Tonga-Hunga Ha’apai volcanic eruption on 15^th January 2022. Our sympathy goes to all those affected who have suffered a great deal, transforming some parts of the idyllic islands from tranquillity, to areas covered by ash, mud and damaged buildings and livelihoods. Let us hope they can recover from this soon, assisted by aid that is on its way. A tragedy on a monumental scale.

Turning to Covid matters, our lead story is the media briefing yesterday by WHO Director – General Dr. Tedros Adhanom Ghebreyesus. We have included this as our headline article as it puts the spread of Omicron in a global context and how governments should move forward from where we are at present.

He highlighted, “In some countries, cases seem to have peaked, which gives hope that the worst of this latest wave is done with, but no country is out of the woods yet. I remain particularly concerned about many countries that have low vaccination rates, as people are many times more at risk of severe illness and death if they’re unvaccinated.”

I used to say in the context of crime prevention, that security is only as good as the weakest link, and this is certainly true when it comes to Covid-19.

Portugal according to some forecasts is expected to reach the peak of the covid-19 pandemic between this Thursday and the following Monday. According to the calculations made by mathematicians from the Instituto Superior Técnico, at that time there will be about 45,000 diagnosed cases of infection and 40 deaths per day. Yesterday in fact there were just over 43,000 and 46 deaths so in terms of deaths slightly higher.

After reaching close to 45,000 daily cases, Portugal’s epidemiological curve should begin to decline in the following days. On the other hand, the peak of hospitalizations and intensive care should arrive at the beginning of February.

The transmission rates are continuing to decrease, so this maybe a good sign that the peak will, as the experts state, be in a matter of days and therefore towards the end of next week, new cases begin to decrease from the highs we are currently experiencing. In terms of hospitalisations, those in ICU and deaths we are well below the levels at this time last year.

A reminder that since Monday users aged 40 or over can self-schedule, to receive the booster dose against covid-19. The self-scheduling request is made on the SNS website dedicated to vaccination. Self-scheduling is also open for people over 60 years old (booster dose and flu shot) and those over 18 years old vaccinated with Janssen for 90 days or more.

Portugal has already administered 4 million booster doses of the vaccine against COVID-19. Of these, and until the end of yesterday, January 17, 2,041,675 doses had been administered to users aged 65 or over. Since the start of the vaccination campaign against COVID-19, in total, close to 20.2 million doses of vaccines have been administered.

Over the last two weeks DGS has made a number of changes to their website and as a result of this page links have therefore changed. As a consequences some people may have experienced difficulty finding various services and in some media reports even up to now are still providing links to pages which no longer exist. We have updated our website accordingly giving priority to the vaccination page. The new links are on that page relative to vaccinations and digital certificates. There may well be more changes so if you encounter any difficulty with any DGS/SNS page please let us know.

Yesterday we published a report “Social Balance 2021” concerning poverty in Portugal. One alarming statistic (and there several) was that among those who are poor, 43% live in homes without sufficient heat. The report noted that nearly a quarter of the elderly could not afford to heat their homes. We will be publishing more from this report over the next few days, but it is sombre reading especially as the survey which led to the findings was conducted just before or early in the pandemic, when the full effects had not yet been felt.

The above is one of the reasons why police (PSP and the GNR) have safe elderly programs here in Portugal checking regularly on the elderly living alone in isolated areas. It is important that we all do what we can through the various charities here, to help those in need, and in the case of elderly neighbours to check from time to time they are OK especially in this colder weather at present

With that have a Safe Day

Headlines

WHO Director-General’s opening remarks at the media briefing on COVID-19 — 18 January 2022

Director – General Dr. Tedros Adhanom Ghebreyesus – “Omicron continues to sweep the world. Last week, there were more than 18 million reported cases. The number of deaths remains stable for the moment but we are concerned about the impact Omicron is having on already exhausted health workers and overburdened health systems.

In some countries, cases seem to have peaked, which gives hope that the worst of this latest wave is done with, but no country is out of the woods yet. I remain particularly concerned about many countries that have low vaccination rates, as people are many times more at risk of severe illness and death if they’re unvaccinated.

Omicron may be less severe, on average of course, but the narrative that it is mild disease is misleading, hurts the overall response and costs more lives.  Make no mistake, Omicron is causing hospitalizations and deaths, and even the less severe cases are inundating health facilities. The virus is circulating far too intensely with many still vulnerable.

For many countries, the next few weeks remain really critical for health workers and health systems. I urge everyone to do their best to reduce risk of infection so that you can help take pressure off the system. Now is not the time to give up and wave the white flag.

We can still significantly reduce the impact of the current wave by sharing and using health tools effectively and implementing public health and social measures that we know work.

I am proud COVAX delivered its one-billionth dose over the weekend. Of course it’s not enough and we should do more.

At a time of Omicron, it remains more important than ever to get vaccines to the unvaccinated.

Vaccines may be less effective at preventing infection and transmission of Omicron than they were for previous variants, but they still are exceptionally good at preventing serious disease and death.

This is key to protecting hospitals from becoming overwhelmed. We’ve been able to track new variants like Omicron and this virus’ evolution in real time thanks to efforts of thousands of scientists and experts around the world.

More than 7 million whole genome sequences from 180 countries have now been submitted to GISAID, which was initially set up to track flu. This pandemic is nowhere near over and with the incredible growth of Omicron globally, new variants are likely to emerge, which is why tracking and assessment remain critical.

New formulations of vaccines are being developed and assessed for how they perform against Omicron and other strains. I am concerned that unless that if we change the current model we’ll enter a second and even more destructive phase of vaccine inequity. We need to make sure we share current vaccines equitably and we develop distributed manufacturing around the world.

We can only beat this virus if we work together and share health tools equitably. It’s really that simple”.

COVID-19 DGS Situation report for 18^TH January 2022

Confirmed: 1,950.620 (+43729 / +2.29%)

Admitted in hospital: 1,955 (+17 / +0.88%)

Admitted to ICU: 160 (-14 / -8.05%)

Deaths: 19,380 (+46 / +0.24%)

Recovered: 1.598.454 (+42055 / +2.70%)

Active cases: 332,786 (+1628 / +0.49%)

TRENDS

Deaths are above the average of the last seven days (31.3) and well above the average of the last 30 days (20.1).

The Lisbon and Tagus Valley region recorded 25 deaths from covid-19 in the last 24 hours: the highest number ever since the beginning of the pandemic in Portugal

New cases are the highest for one day since the start of the pandemic, however,

Largest daily number of recoveries since start of pandemic

A smaller increase in hospitalisation since over one week.

A moderate decrease in those in ICU, but general trend remains fairly stable following small increases over the last few days.

Lowest daily increase in active case for some time.

COMPARISON WITH 2021

On this day last year there were a large 167 additional recorded deaths, 5165 in hospital, an increase of 276 from the previous day and 664 in IC

Health

Covid-19: more than four million people are vaccinated with the booster dose

The update of the administration of booster doses of the vaccine against covid-19 was made, in the early afternoon of this Tuesday, by the Directorate-General for Health (DGS).

Of these four million doses, “and until the end of yesterday, January 17, 2,041,675 doses were administered to users aged 65 or over”, specifies the DGS.

Taking the opportunity to make a total balance, the DGS points out that since the beginning of the vaccination campaign, on December 27, 2020, “nearly 20.2 million doses of vaccines have already been administered”.

The DGS reiterates, in the statement sent to the newsrooms, that “vaccination is the best form of protection against serious illness, hospitalizations and death”, and reinforces the appeal to “people, over 40 years of age, who are not yet vaccinated with the booster dose” schedule the vaccination on the DGS portal.

Attorney General’s Office opens investigation into the death of a child at Santa Maria Hospital

The Attorney General’s Office confirmed today the opening of an investigation to investigate the case of the death of the child with a positive test for SARS-CoV-2 on Sunday at the Hospital de Santa Maria.

In response to SAPO24, the PGR’s communication office confirms “the opening of an inquiry that runs under the Lisbon DIAP”.

The Centro Hospitalar Universitário Lisboa Norte (CHULN) announced this Monday that a six-year-old boy who tested positive for SARS-CoV-2 died on Sunday at Hospital Santa Maria and that the causes of death are being analysed.

The hospital said, in a statement, that the child was admitted to Hospital de Santa Maria on Saturday with “a condition of cardiorespiratory arrest”.

“The child had the first dose of the vaccine against covid-19, and CHULN notified the case to Infarmed and the Directorate-General for Health”, says the statement.

Also this Monday, Infarmed confirmed that it had received the notification of suspected adverse reaction in the case of the child who died.

“We confirm that we received the notification of a suspected adverse reaction today and that it is being treated by Infarmed together with the Regional Pharmacovigilance Unit of Lisbon, Setúbal and Santarém”, said the National Medicines Authority

According to the national regulator, “additional data are being collected by the notifier for the analysis and assessment of the imputation of causality, since, since the apparent temporal relationship is not the only determinant in the assessment of causality, it is necessary to proceed with the collection of all clinical information”

Twelve emergency team leaders at the Beja hospital present their resignation

Twelve emergency team leaders at the Beja hospital today resigned from their posts, claiming they are unable to treat patients with quality and safety, mainly due to the lack of doctors and work overload.

In the resignation request, to which the Lusa agency had access, the 12 heads of the Internal Medicine team consider that “the current conditions do not allow to ensure care to patients with the quality and safety due” in the Emergency Department (SU) of the hospital of Beja, managed by the Baixo Alentejo Local Health Unit (ULSBA).

Therefore, the specialists presented the resignation of the positions “until a reassessment of the situation” of the SU, “with resolution of the lack of medical human resources and reappraisal of the competences of the team leaders”.

The doctors refer that the decision to present the resignation was taken now “due to a ‘dragged’ situation of decline in working and organizational conditions” of the SU, “to which the attention of the board of directors” of the ULSBA was requested. , “innumerable times, without any effective response”.

The resigning team leaders consider “a two-week deadline to schedule a meeting between interested parties” and warn that, “in the absence of a response, additional measures are planned”.

The 12 team leaders have also asked to be excused from civil liability, along with four more specialist doctors from the Beja hospital.

According to the resigning doctors, the covid-19 pandemic “has worsened the conditions, already precarious, in which the work is carried out” in the hospital’s emergency rooms.

European Centre asks governments to treat covid-19 like flu

European centre calls for a change in strategy in the future, so that countries do not live forever in public health emergencies.

The European Centre for Disease Prevention and Control (ECDC) is asking European countries to consider a change in strategy in the treatment of covid-19: to start monitoring it as if it were the flu virus.

In the case of Portugal, this could mean having data updated weekly and not daily, as is currently the case with the daily bulletins of the Directorate-General for Health (DGS).

An ECDC source told the Spanish newspaper “El País” that countries must “make the transition from an emergency surveillance system to more sustainable and goal-oriented ones”.

Across Europe, governments have reduced periods of quarantine and isolation, due to higher vaccination rates.

In Portugal, the National Institute Dr. Ricardo Jorge (INSA) monitors the flu virus on a weekly basis. JN contacted INSA, DGS and the Ministry of Health about whether a change in strategy was being considered, but has not yet received a response 

Portuguese Dental Association warn of the dangers of buying dental appliances and services on the net

The Ordem dos Médicos Dentistas (Portuguese Dental Association) launched a campaign to warn of the dangers of orthodontic teleconsultations and the purchase of dental appliances online, a situation that has already been reported to the Health Regulatory Authority.

The association is concerned about the growing offer of medical-dental services on the internet without the intervention of the dentist, including orthodontic self-treatment in which the patient directly places the device.

“All this comes from the participation of several colleagues and also of some patients regarding the growing offer of dental services”, through online advertisements, which misrepresent “the principles of medical practice”, explains the chairman of the association.

Miguel Pavão points out that orthodontic treatment has “some complexity” and requires “knowledge of the facts by the dentist and also a close and highly committed follow-up” by the specialist.

“You can never dispense with any type of diagnostic, planning, evaluation and control consultations, and what can never be at stake here is the patient taking crucial steps towards that same diagnosis”, he warned.

Miguel Pavão exemplified that there are cases in which the patient himself performs the self-assessment, through selfie-type photographs obtained by cell phone.

“In certain cases, it is the patient who makes impressions [study models] himself, who makes the record of the arch and the shape of his teeth, and this really has some risks for the patient and calls into question errors in this diagnosis and obviously throughout the treatment plan”, he stressed.

After this procedure, the devices (generally aligners) are sent to the patient by mail for a fee, and the monitoring of the progress of the treatment takes place, mostly or exclusively, without physical contact between the dentist and the patient.

Although the Portuguese Dental Association has already conveyed this concern to the Health Regulatory Authority , it decided to launch a campaign aimed at the population to warn of “the serious consequences of these procedures, whether results of inferior quality, the need for additional treatments or, in the most serious cases , irreversible damage to oral health”.

Covid-19: Infarmed confirms notification of suspected adverse reaction in the case of a child who died

According to the national regulator, “additional data are being collected by the notifier for analysis and assessment of the imputation of causality”

Infarmed confirmed that it received today notification of a suspected adverse reaction in the case of the death of a child who tested positive for SARS-CoV-2 on Sunday at Santa Maria Hospital.

“We confirm that we received the notification of a suspected adverse reaction today and that it is being treated by Infarmed together with the Regional Pharmacovigilance Unit of Lisbon, Setúbal and Santarém”, stated the National Medicines Authority.

According to the national regulator, “additional data are being collected by the notifier for the analysis and assessment of the imputation of causality, since, since the apparent temporal relationship is not the only determinant in the assessment of causality, it is necessary to proceed with the collection of all clinical information”.

This review precedes its reporting to the European EudraVigilance database, the system for managing and analysing information on suspected adverse drug reactions that have been authorized or under study in clinical trials in the European Economic Area.

The Centro Hospitalar Universitário Lisboa Norte (CHULN) announced today that a six-year-old boy who tested positive for SARS-CoV-2 died on Sunday at Hospital Santa Maria and that the causes of death are being analysed.

The hospital said, in a statement, that the child was admitted to the Hospital de Santa Maria on Saturday with “a condition of cardiorespiratory arrest”.

“The child had the first dose of the vaccine against covid-19, and CHULN notified the case to Infarmed and the Directorate-General for Health”, says the statement.

According to data from the DGS, since the beginning of the pandemic, three children have died from covid-19 between zero and nine years old. 

Portugal is fourth EU country and sixth in the world with the most new daily infection

Portugal is the fourth country in the European Union (EU) and sixth in the world with the most new daily cases of contagion with SARS-CoV-2 per million inhabitants in the last seven days, according to the statistical website Our World in Data.

According to data updated on Monday, the member state with the highest average of new infections is France, with 4,370 per million inhabitants, followed by Denmark (3,970) and Ireland (3,590), while Portugal has an average of 3,440 new cases per million inhabitants in the last seven days.

Worldwide in this indicator, and considering only countries and territories with more than one million inhabitants, at the top of the list is Israel, with a daily average of 4,440 new cases, followed by France, Australia (4,100), Denmark, Ireland and Portugal.

Last week, Portugal was the seventh EU country with the most new cases, with a daily average of 2,390.

The European average on this indicator rose this week from 1,830 new cases to 2,130, while the world average rose from 307 to 372.

In the EU context, the countries with the lowest average number of new cases per million inhabitants are to the east: Poland (377), Romania (439), Slovakia (534) and Hungary (653).

Last week Portugal was the fourth with the fewest deaths attributed to covid-19 per million inhabitants in the previous seven days, with an average of 1.52, but today it is at 2.67

The member state with the highest average of seven-day daily deaths continues this week to be Bulgaria, with 10.9, followed by Poland (9.6), Slovakia (8.8) and Croatia (8.4).

Bulgaria, Poland, Georgia (9.4), Slovakia and Greece (8.1) are the countries with the highest average daily deaths attributed to covid-19 worldwide.

The EU average for this indicator stands at 3.98 (slight increase of four tenths) and the world average at 0.9, one tenth more than last week. 

Border Enforcement – Covid-19 measures

More than 2,300 passengers were fined, between December 1 and January 16, for trying to enter Portugal through air borders without a negative test for SARS-CoV-2, the Ministry of Internal Administration (MAI) indicated this Monday.

According to the MAI, 41 airlines were also fined for boarding these passengers without a negative test.

In an assessment of this measure to control cases of covid-19, MAI told the Lusa agency that, between December 1 and January 16, PSP and SEF inspected 1,586,295 passengers and 15,309 flights, which resulted in 2,370 offences. .

Of the 2,370 infraction notices, 1,561 were raised by the PSP, which controls passengers from flights originating in the Schengen area (European area of ​​free movement of people), and 809 by the SEF, which inspects travellers from countries outside the Schengen area. .

Since December 1, 2021, all passengers arriving in Portugal by air are required to present a negative test or a recovery certificate upon disembarkation.

Passengers on domestic flights, children under 12 years of age and crews are exempt from the obligation of testing, PCR or rapid.

Airlines that carry passengers without a negative test incur a fine of between 20,000 and 40,000 euros per passenger and travellers are also subject to an administrative offence, between 300 and 800 euros, for not presenting a test on arrival.

The MAI also states that the 2,370 infractions include eight foreigners who were refused entry into the country because they did not present a test on arrival, since it is only allowed to take the test at the airport to citizens of Portuguese nationality, foreigners residing in Portugal and diplomatic personnel.

Land Border Control with 17,021 Random Operations

At land borders, also since December 1, citizens of countries outside the European Union and EU countries considered to be at red or dark red risk need a negative test or a recovery certificate.

Citizens from EU countries considered to be at low or moderate risk must have a vaccination, test or recovery certificate to enter Portugal.

The GNR and the Foreigners and Borders Service carried out 17,021 random surveillance operations at land borders until January 10th to ensure tests for covid-19, according to the MAI.

Within the scope of these operations, more than 100 thousand inspections were carried out on light and goods vehicles, motorcycles, trains, buses, which gave rise to 36 administrative offense notices for lack of a test or recovery certificate.

The MAI also mentions that 532 diagnostic tests were carried out at land borders. Control at the border areas will last until 9 February.

Other news

SEF- Execution of arrest warrants two detained

The Foreigners and Borders Service (SEF) detained two foreign citizens in Lisbon who were pending arrest warrants, the agency announced this Tuesday in a statement sent to newsrooms.

One of the detainees is a 35-year-old Cape Verdean woman, with an international arrest warrant “issued by the Cape Verdean authorities, for the purpose of extradition”, is indicted for the crimes of kidnapping, aggravated murder and criminal association, and will be still present this Tuesday to a judge to know the coercive measures.

As for the other foreign citizen arrested, the SEF has not disclosed the nationality, revealing only that she was arrested on Monday at Humberto Delgado airport, in Lisbon, in compliance with an arrest warrant for crimes of forgery and breach of trust.

North Region – If it doesn’t rain this month, mild drought in the North could turn to moderate

If it does not rain by the end of the month in the North region, a drought situation that is at a “critical” point could worsen and “the outlook is not good”, a source from the IPMA stated told Lusa.

Since November, the North region has been in a weak drought, with the exception of the northeast region, in Trás-os-Montes, where “there are points with moderate drought”, according to Vanda Pires, from the Department of Climate and Climate Change at the IPMA.

“This is the time that will greatly determine the evolution of the drought and the month of January is critical, because, if there is no precipitation, and large amounts of precipitation are not expected, at least until the end of the month, the tendency is for this to happen and itwill get worse,” she continued.

With this perspective, it remains “to be seen if in February there is any recovery”, not least because “then we start to enter months of the year in which there is less and less precipitation”, she underlined.

Therefore, he insisted that “January was a crucial month here for this situation not to worsen, but the outlook is not good”, adding that the region “may move to the moderate drought class”, with severe drought in the region of Bragança.

“We have four drought classes [mild, moderate, severe and extreme] and we are still in the first class, the least intense, but we are evolving to moderate. Bearing in mind that we have already been in the weak for two months, three consecutive months of drought, when there are three winter months, in which there is normally precipitation, these impacts could already be greater now, during the end of the month and beginning of February ”, detailed.

The specialist said that “they have been years with less and less rainfall, years with levels ​​far below normal in many of them, since the 1990s, but above all since the 2000s”.