Portugal Situation Report Wednesday 28th July 2021
Introduction
Good morning – Well yesterday was dominated by the Infarmed meeting attended by the President of the Republic and the Prime Minister together with various experts. This was the first since 28th May 2021.
There is some optimism reflected by the fact that the increase in the number of new cases is slowing down although still of concern in the north. The Rt is decreasing and if this drops to less than one then the number of new cases will reduce as well.
During the meeting, as expected experts advocated the implementation of a four-phase plan to gradually ease restrictions currently in place. In the first recommendation, where we currently find ourselves, the restrictions remain the same. They suggest that the mask be kept indoors and at public events, where social distancing is also mandatory. From the second level onwards, circulation without a mask must be guaranteed.
In specific cases of trips to the beach and campsites, the mask should only be mandatory in common places and when the distance cannot be fulfilled. In restaurants, experts suggest a limit of people per table – which should gradually increase as levels advance – but do not make any recommendations about times. Weddings and baptisms may have more people as the levels advance, starting at 50% capacity.
There was also a focus on the risk matrix by increasing the incidence to 480 cases (and not 240 cases) per 100,000 inhabitants, as well as increasing the alert threshold for intensive care from 245 to 255 in “red lines”. We await how this will transpire but it appears this was acceptable to the Minister of Health.
There was also a great deal on focus on the success of the vaccination plan in which Portugal stands out with one of the highest vaccination rates in Europe and on 25th July being placed at 9th place in the world according to Our World in Data. The plan is to extend vaccinations down to 16 and 17 year olds starting 14th August. Clearly this is important given that the greatest increases in cases are in the younger age groups.
On the question of travel, the minister of health stated that even as the countries have different rates of vaccination, “the variants have entered through the circulation of nationals from other countries” and that is why it is necessary to pay attention to travel. “With rules it is possible to return to some normality, but rules are very important”, she says.
These recommendations and analysis will allow the Government to consider the situation at the Council of Ministers Meeting tomorrow and decide whether existing measures need to continue, (if so for how long) or whether there can be some relaxation in view of the current situation. We should hear some news during the usual press conference following the COM as well as in the official communique.
As usual there will likely be a great deal of speculation today in the media what may or may not happen, but as we have seen before nothing is certain until the outcome of the COM and even then changes can be made in the lead up to the publication of the decree law.
As we head towards the coming weekend the IPMA forecast a considerable increase in the rural fire risk with a larger number of municipalities at maximum level than we have seen for some time. We will as usual be providing the daily rural fire risk reports on a daily basis supplement with advice to prevent fires as well as self-protection measures in the event that you are affected by a fire. As we have said repeatedly it is vitally important for those living in rural areas, particularly those parishes at high risk to have an action plan in place should a fire break out. Leaving it to when a fire starts is too late. In windy and dry conditions fires can spread very quickly and change direction depending on the wind conditions.
Lastly I would like to extend our best wishes and many thanks to Jennie Kelly who for over the last year or so has been publishing our morning and overseas reports on our website as well as being the Editor of our Newsletter. She has done an excellent job as a volunteer. Jennie has just moved back to the UK for a while with her husband Phil, but we understand this is a temporary measure and we look forward to seeing her return in due course. She remains an advisor to our association. We welcome at the same time our new volunteer Susan Wright who has been a follower of SCP for some years. Susan lives in Vila Nova de Gaia and has kindly offered to help us by publishing the reports on our website and other assistance as needed. A warm welcome to the team Susan.
With that please have a Safe Day.
Covid-19 Report published 27th July 2021
New confirmed cases: 956.985 (+2316 / +0.24%)
Number in hospital: 928 (+9 / +0.98%)
Number in ICU: 200 (+2 / +1.01%)
Deaths: 17.307 (+6 / +0.03%)
Recoveries: 888.423 (+5051 / +0.57%)
Active cases: (51,255 (-2741/-5.07%)
Safe Communities comparisons/trends show that deaths are less than last weeks’ daily average; new daily cases were higher than yesterday but less than last week’s daily average. Cases in north again higher than those in Lisbon and Vale do Tejo. There was a smaller increase in hospitalisations but highest total since 16th March 2021 and also a small increase in ICU cases for one day. Highest total since 17th March 2021. Good news is that active cases showed a very significant decrease the biggest since March. – In Algarve new cases slowing down – daily increase 6.3% of all new cases
Health
Infarmed meeting Statistics
André Peralta Santos, from DGS, revealed that the incidence is higher than 400 cases per 100,000 inhabitants. However, the rate of increase in the number of cases “has been decreasing”.
There is greater incidence in the metropolitan areas of Lisbon and Porto, as well as in the Algarve. In Lisbon and the Algarve, there is already “a trend of stabilization or descent”. In Porto, there are still “growth areas”, since, here, the resurgence of the pandemic occurred after it had occurred in Lisbon.
Since early June there has been an “increasing trend” in admissions, with 198 in ICU and 900 in total on 25 July. At the moment, there is an occupancy of 78% of the reference value of 255 beds. The age group with the highest occupation in the ICU is between 40 and 59 years old.
Until recently (week 26 of the pandemic), only 2% of those admitted to the ward had the complete vaccination schedule. This value rises to 5% in the case of those admitted to the ICU.
Health Minister says youth vaccination “is already clarified”
The Minister of Health considered, this Tuesday, that the vaccination of young people under 18 years is clarified and that it will be addressed in the Council of Ministers, although the final position of the Directorate-General for Health is not yet known.
“On the subject of vaccinations, the decision to vaccinate from 18 to 16 years of age has already been clarified, and vaccination from 12 to 15 in cases of comorbidities is already clarified, which will now be listed by the General Directorate of Health (DGS)”, said Marta Temido, without failing to stress that the Government will meet to “appreciate the current measures” and also “to reflect on the recommendations left today by the experts ” in the Council of Ministers on Thursday.
According to the official, who was speaking to journalists after the meeting at Infarmed, in Lisbon, which brought together specialists, the Government, the President of the Republic and the President of the Assembly of the Republic, technicians from the technical commission for vaccination against covid-19 are still analysing ” the benefit-risk balance regarding vaccination at these “younger ages”, but emphasized that there is a political decision.
“We all want to have this information as soon as possible and we are prepared to vaccinate these age groups in logistic terms, we now depend on this technical assessment and there is also a decision that can be taken beyond this technical decision”, he said.
Marta Temido also refuted the thesis of greater resistance to vaccination against covid-19 among younger people, citing the study presented this Tuesday by the director of the National School of Public Health (ENSP) of the Universidade Nova de Lisboa, Carla Nunes
Covid-19: Medical Association reiterates the need for a new risk matrix
Lisbon, July 27, 2021 (Lusa) – The President of the Medical Association today reiterated the need to review the risk matrix, arguing that the indicator proposed to the Government two weeks ago allows to understand the effects of vaccination on the evolution of the covid- 19.
“From the moment that vaccination began to accelerate, we started to have a situation that was not being contemplated in the Government’s risk matrix, which is the question of the severity of the disease,” he told the Lusa Miguel Guimarães agency on the day in that another meeting of experts is held at Infarmed on the epidemiological situation in Portugal.
The proposal of the Medical Association (OM), developed in collaboration with the Instituto Superior Técnico, adds to the two existing indicators – incidence and transmissibility (Rt) – three more: lethality, admissions to the ward and admissions to intensive care units.
These indicators, explained the Chairman, allow us to assess the severity of the disease, also reflecting the effects of vaccination against SARS-CoV-2, and this is what the Order would like to see in the Government’s risk matrix, to which it sent the new matrix.
For its part, the Ministry of Health told Lusa that these data are already considered in decisions about the pandemic, the same justification also given to the OM in a letter delivered on Monday, and sent any changes to after the Infarmed meeting, which takes place today.
“We fulfilled our mission”, said Miguel Guimarães, considering that the new indicators are “the best way to protect the economy and health”.
More than 11,000 adverse reactions to covid-19 vaccines
Infarmed has received more than 11,000 reports of side effects from vaccines against SARS-CoV-2. Of these, four thousand were considered serious.
As of July 22, the National Medicines Authority (Infarmed ) has received 11 314 reports of adverse reactions to vaccines against covid-19. Of these, 4015 were considered serious. Until the same date, 11 002 989 inoculations were administered, which represents, according to the same source, one case of side effects reported for every thousand vaccines administered.
Of the vaccines approved by the European Medicines Agency (EMA), and administered in the country, it is AstraZeneca (Vaxzevria) that registers the highest number of notifications per thousand vaccines given, about 1.7. Of the more than two million inoculations, 3480 adverse reactions were reported.
In the remaining three, it is in Pfizer’s ( Cominarty) with more doses dates (7.4 million) that more side effects have been reported (6485). The Janssen as fewer doses (444 000), which is also have fewer reactions (379). In Moderna (Spikevax), in more than 1.1 million vaccines there were 970 reactions.
Infarmed meeting – Survey report
Carla Nunes, from the National School of Public Health, revealed that younger people have lower risk perception values in case they come to be infected by covid-19 (only 37%, against 60% of the older group).
“We can imagine a winter in which life can get very close to what it was before,” he said, stressing the importance of vaccinating the youngest.
“If we don’t vaccinate the children, we’re going to have a spike in cases.”
57.1% of respondents say it is “difficult or very difficult” not to socialize with family or friends. The highest value (62.1%) is between 16 and 25 years old.
The greatest resistance to the vaccine (that is, those who do not want to take the vaccine or who have not yet decided) is found in the most active age groups, between 26 and 65 years, with about 25%. The highest number of respondents who answered that they had no intention of taking it was between 46 and 54 years old (19.9%).
Among respondents who do not want to get the vaccine, 57% said they did not have enough information. 50% said they were afraid of developing side effects and 40.7% considered that vaccines were not, in their opinion, effective.
20.9% prefer to gain immunity through contagion, 14% responded that covid-19 is not a dangerous disease for themselves and 7% believe they do not need the vaccine because they have already been contaminated. Only 2.3% said they did not believe in vaccines.
Order wants a family nurse for each patient
Lisbon, 28 Jul 2021 (Lusa) – The Ordem dos Enfermeiros wants to meet with the tutelage to discuss a proposal that aims to recover the care activity damaged by the pandemic, nurses with broad skills, more professionals in health centers and a family nurse per user.
Underlining the impact of the covid-19 pandemic on patient care, particularly with regard to chronic patients, the Ordem dos Enfermeiros (OE) wants to accelerate the implementation of the family nurse figure in terms of health care.
The proposal is one of those contained in a letter sent to the Minister of Health, Marta Temido, and the Deputy Secretary of State for Health, António Lacerda Sales, in which the OE asks for an audience to discuss the topic and the implementation of experiences.
Citing the Recovery and Resilience Plan (PRR) and what it foresees in terms of reformulating the provision of health care with a focus on primary health care, the OE proposes to increase the number of nurses assigned to these care units personalized health services.
It also wants a reinforcement of nurses at the level of community care units and in the integrated continuing care.
They also propose the “expansion of the competences and areas of intervention of nurses and specialist nurses” and the “assignment of a family nurse to each user/family”.
According to the OE, “there are currently three thousand nurses able to integrate the labor market, which, of course, should be considered for this purpose”, also referring that “at this moment, nurses are overwhelmed with requests”, whether for vaccination against covid-19, or by following up on users.
Travel
A quarter of lawsuits filed against airlines for transporting passengers to national territory without a negative Cov-19 test already paid
ANAC has filed 539 lawsuits against 40 airlines and, of these, 133 have already resulted in fines paid. Cases concern 7156 passengers who entered the country (disembarked) without covid-19 tests carried out in the 72 hours prior to the trip
Between 2020 and last week, the National Civil Aviation Authority (ANAC) filed 539 lawsuits against 40 airlines for transporting passengers to the national territory without the respective negative covid-19 test, carried out in the 72 hours prior to the trip. Of these, 133 are already completed and led to the payment of fines applied. They are about a quarter of all open procedures.
The number of lawsuits filed this year and until last Friday (282) already exceeds those of last year (257), after the entry into force of the decree-law that established the payment of fines for lack of tests to covid-19, at the end of June. The diploma establishes that companies may be subject to fines ranging between 500 and 2000 euros per passenger transported without a valid test carried out and without proof that they would not need to do so, but there are other nuances: in periods when the country was in a state of emergency, the amount of the fine would rise to twice what was expected, and in cases where there was negligence, it would fall by half.
ANAC source was unable to specify to the PUBLIC the total amount actually paid in the 133 processes that have already been completed, nor did it clarify which companies were fined, justifying not being able to do so because of the cases are still “in progress”.