It is not a perception. The cases of covid have been increasing for weeks. In one month, they have gone from 75 cases per 100,000 inhabitants to 137. And surely, public health experts say, the number is higher, because they have not been counted in detail for some time. At the moment, the incidence in citizens aged 60 and over is monitored, but the Ministry of Health has not provided the data since the end of June (20 cases per 100,000 inhabitants over 60 on June 30), nor do primary care centers and hospitals through the Respiratory Infection Sentinel Surveillance System (Sivira).
But why are the cases rising? The experts are clear: the loss of immunity from vaccines over time is the cause of these increases, says epidemiologist Daniel López Acuña. For this reason, the public health officials of the Ministry of Health and the autonomous communities agreed yesterday to allow the start of covid and flu vaccination (jointly) in the last week of September for those over 60 , with priority for those 80 and over and residents in senior centers.
The upload takes place in all communities. In Catalonia, covid cases grew steadily from the end of June (1,951 cases) until mid-August, when 6,326 infections were recorded. Since then, there has been a slight decline and maintenance over the last three weeks, with 5,742 cases in the last assessment (week of September 4 to 10). The figure is significantly higher than that of last year at the same time, when 3,447 infections were registered, a circumstance that raises the precautions of the health authorities due to the arrival of the most favorable season for respiratory viruses.
The forecasts are that, with the return of children to school, the arrival of autumn and the increase of coexistence in interior spaces, the cases will continue to rise. Despite this, there is no excessive concern among the health authorities because although the vaccines lose effectiveness, it is also true that the majority of the population still has enough antibodies thanks to the vaccination: 92.6% of the population has the complete guideline, a percentage that drops to 56% in the case of the first reminder dose, although in the group over 60 years of age, this figure reaches 91.2%. To this we must add that the vast majority of citizens have entrusted themselves at least once.
Peace of mind, they say, because there are more cases, but it does not translate into an increase in hospitalizations (2.9 cases per 100,000 inhabitants, far from last year at the same time, when it reached 6.1, although it has risen 0.9 points in a month). And because, in addition, the variants that circulate are sub-variants of omicron. The last few weeks have been XBB.1.5 (29%), BA.2.75 (14%) and XBB.1.5-like F456L (14%), according to the latest Sivira report.
But the increase in circulation, not only in Spain but also in Europe and America, increases the chances that it will change and that these mutations will manage to evade the protection of vaccines. At the moment there are two variants of particular interest, the EG5 (Eris) and the BA.2.86. The first began to be detected last month and is almost the majority in China (70% of cases). The other, with numerous mutations (more than 30), has already been detected in 14 countries, including Denmark, the United Kingdom, the United States and Israel.
What can we do about it? Experts remind us of what we already know: that the most effective weapon against this virus is none other than the vaccine, especially to protect the most vulnerable. Also use the mask and maintain interpersonal distance if we are in charge, explains epidemiologist Daniel López Acuña, who, as the World Health Organization has already done, calls on countries to closely monitor the circulation of the virus, to carry out analyzes sequential, which they track, which the vast majority have stopped doing after the end of the pandemic. "It is necessary to know the penetration of the new variants that have been emerging and to check if, due to the mutations, they can escape the immune responses of a previous infection or vaccination", he points out.
On the loss of natural and pharmacological immunity due to the passage of time, López Acuña puts on the table the need to study whether it is necessary to do a new round of vaccination, with vaccine formulations with the new variants (there are already an approved one). "This is important for our immunological protection", he says.
Precisely yesterday, the Public Health Commission, made up of the Ministry of Health and the autonomous communities, addressed the vaccination strategy for vulnerable groups for the coming autumn. The first to receive it will be those over 80, together with the flu from the end of September. Also residents of centers for the elderly and disabled.
These groups include those over 60, the chronically ill, health and social care professionals and people with direct occupational exposure to animals or their secretions in farms or poultry, pig or mink farms, or to wildlife ( birds, wild boars or mustelids), and also livestock farmers, veterinarians, farm workers, hunters, ornithologists, environmental officers, zoo staff, etc. The purpose is to reduce the chance of a concomitant human and avian or porcine virus infection, to reduce the possibility of recombination or genetic exchange between the two viruses.
Which covid vaccine will be given during this campaign? Comirnaty XBB.1.5 is expected to arrive this month, to respond to the new variants of the virus. In case this was not the case, Spain has enough doses of the Spanish vaccine, Hipra, as a reminder dose for people aged 16 and over who have previously received an mRNA vaccine against covid.
