We may be leaving the “peak” of the second wave, but...

We may be leaving the “peak” of the second wave, but...
We may be leaving the “peak” of the second wave, but...

On 9 November, Portugal entered a new state of emergency to combat the second wave of SARS-CoV-2 infections. Stricter measures were applied to limit the mobility of the Portuguese and thus reduce the levels of contagion. It is too early to assess with certainty whether the application of the restrictions has allowed the control of the epidemiological situation to be regained, but the incidence data show a slight deceleration of contagions: the contagion curve seems to be reaching a plateau, albeit at levels of contagion too for the sustainability of health services.

With the 5444 new cases reported on Friday (and which relate to the country’s situation on Thursday), Portugal now has a 14-day incidence rate of 789.9 new cases per 100,000 inhabitants, the seventh highest Europe – behind Luxembourg (1237.2), Croatia (974.0), Slovenia (970.9), Austria (932.7), Liechtenstein (862.5) and Lithuania (857.0), according to the latest figures from the European Center for Disease Control (ECDC).

The 14-day incidence has stabilized in Portugal in the last week, with the highest value being recorded on 20 November (803.7), having always remained above 790 since then. The apparent stagnation is also accompanied by a decrease in the number of cases identified since last Friday: 36,340 new infections were detected in the country, a decrease of 10% compared to the 40,549 identified in the previous week.

Infecciologist António Silva Graça recognizes that there is a reduction in the incidence to 14 days, but considers that this is a result not of the state of emergency, which “does not yet have three weeks”, but of the measures applied at the weekend of the Day of the Dead. The expert says that the week ahead is on the way to a “significant reduction” in the average daily number of cases compared to the last week, but warns that a larger sample is needed to attest to the decline.

“Can we already say that we are leaving the peak of the wave? It is possible, but we need to have the evolution of two, three weeks in the descending plan to be able to conclude this ”, he explains to PÚBLICO.

António Silva Graça recalls that “it is not yet time to rest”, since the response of the National Health Service (SNS) is dependent on the evolution that is taking place now.

“There may be a clear peak and a descending branch evident on the curve, and this would mean that the SNS was tested in a sudden way, being required a lot, but in a timely manner. But it can also happen that there is no significant decrease: it may not grow any more, but remain with a small variation for two, three weeks, being even more demanding for the NHS ”, he warns.

The strategy to ensure that stabilization is followed by a decrease in the incidence and, consequently, in the number of hospitalized infected people, involves maintaining the restraint measures in the municipalities for “a longer period” that allows to see results. In the opinion of the infectious disease specialist, the measures adjusted to each municipality end up being too “surgical”.

“There is some instability in the measures and it does not seem to me that this helps a lot in their implementation. (…) When we do a reevaluation after two weeks, we don’t have enough data, we end up making adjustments a little bit blind. The measures should not be so localized. It was preferable to do this in a generalized way with a reassessment three weeks later ”, argues António Silva Graça.

Portugal again out of step with Europe, but for different reasons

According to the weekly report of the European Center for Disease Control, published on Thursday with data going up to 22 November, Portugal was one of only five countries that recorded a steady growth in notifications of new cases for more than seven days, alongside Estonia, Latvia, Lithuania and Sweden. Conversely, ECDC identifies 24 countries, including all those that are still ahead of Portugal in the list of highest incidence rates and others such as Spain, France and Germany, in which the results of the measures applied for three weeks are already being felt. before.

These countries began to observe a decrease in contagions following the partial confinements applied at the start of November, about a week and a half before the President of the Republic decreed a state of emergency in Portugal. The time lag in the epidemiological curves is again similar to what was seen between these European countries in the first wave of the pandemic, even though the two waves of infection have “many differences between them”, particularly regarding the most affected age groups.

For António Silva Graça, if the mismatch that occurred in the Spring could be justified by the “peripheral situation of the country” in relation to the European countries – something “beneficial for our preparation” – the current one appears in a very different epidemiological reality, making the the gap between Portugal and countries like Spain or France is “a coincidence”.

“There are other factors, these already internal, that are responsible for growth. It is a little random to have happened a little later than in other countries, the conditions are now very local, not so peripheral ”, he observes.

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