The Incidence Must Be Less Than 50 Cases To Return To Normality

The fifth wave is subsiding, but there is still a long way to go to return to a normality similar to that of 2019, both at leisure and at work. Today, in Spain it is above 270 cases per 100,000 inhabitants, a figure that means high risk according to all international indicators. “The controllable incidence figure is between 25 and 50 cases per 100,000. Above that figure, and seeing the Delta variant, it is difficult.

In addition, one thing must be taken into account. We have seen in July how it has been primed with young people, precisely the population that was not vaccinated then. Now children under 12 will be the target group “, says José Martínez Olmos, professor at the Andalusian School of Public Health and former Secretary General of Health.

Although many jobs can continue to be carried out electronically, schools have opted for presence. “The idea is that they use the same measures as in the previous year, which worked quite well. In addition, at the level of ESO and Bachelor a large percentage will be vaccinated and that will facilitate the control of the infection. But the vaccinated infect and transmit, since that the vaccine does not sterilize, “says Marcos García, president of the Spanish Immunology Society.

In any case, the truth is that a year ago the doubts about the beginning of the school year disappeared with the passing of the months. In general terms, although there were infections, the incidence in schools was very slight, although it is true that the virus had not mutated as much as it does now.

Trials to use the vaccine in the remaining age group (under 12 years) will still be waiting. But it is also important to know that, although it seems that vaccines lose their effect over time and this affects the older population especially, young people over 12 years of age are the last to be vaccinated (most in August), so during In the early stages of the course, this could help the infections to be more or less controlled during the autumn and the first months of winter.

In any case, the doctors call the alert. The working group of the Spanish Association of Pediatrics (AEP) for the Reopening of Schooling has urged to reinforce the measures in schools due to the high incidence and the Delta variant. This group of experts published on May 18 an update of the 2020 recommendations related to face-to-face schooling and the prevention of transmission in schools, but now they warn that the conditions are different.

“The emergence and current predominance of the Delta variant, much more infectious, possibly with greater transmissibility and possible vaccine escape still to be deciphered, force us to be particularly cautious,” they explain. They also encourage vaccination among children 12 to 18 years old.

Vaccination campaign
In this pandemic it seems that the objectives are never enough to claim victory. On the verge of reaching the goal of 70% of the fully immunized population, this figure will not be enough to prevent the virus from continuing to circulate and infect with impunity. The figure that the experts handle is 85%, a challenge for any health system.

“The Delta variant is very contagious and has a certain escape from vaccines. 70% of the population vaccinated as group immunity is already ruled out by the experts and 85% must be reached. To reach the percentage that I am saying, it is necessary to vaccinate to about six million more inhabitants, “explains Olmos.

This percentage could even be higher. “Group immunity does not seem to be sufficient, reaching 70%. With the Delta variant affecting more than 90% of those infected, given its higher transmissibility and R coefficient, the group immunity percentage threshold should be higher”, Garcia explains. In fact, the research group at the Hospital Clínic de Barcelona, ​​which is now testing the Spanish Hipra vaccine, even establishes the percentage above 90% of the population, something practically impossible.

The managed figure means that those under 40 have the same behavior as those over that age. 91.7% of people over 40 years of age have the complete pattern. However, if it is observed for decades, the older the age, the greater the adherence to the vaccine (those over 80 years of age are all vaccinated while those of 40 and 50 years are 82.8%).

Now, the participation of the younger population is essential to be able to turn the page in the pandemic. Although many people of these ages already have an inoculated vaccine (73% in their 30s, 71% in their 20s and almost 66% in young people between 12 and 19 years old), there is still work to do.

Especially since people under 12 years of age cannot be vaccinated, so reaching 85% requires greater involvement from the rest of the decades. “Herd immunity is very difficult to achieve. I say this because societies have opportunistic behaviors. Many people may be thinking that they are not vaccinated because as group immunity is going to be achieved, they do not go through the puncture”, adds Martínez Elms.

If vaccination is not going to provide sufficient security in the percentages that it is today, to return to offices or to schools, other variables are still needed to consider. The masks will continue to accompany people for a time and the safety distance, especially in closed spaces, should be a rule that should not be neglected these months.