The omicron saturation forces to prioritize the attention to the vulnerable people

Ómicron has saturated the Canarian health system and has forced all of Spain to resume surveillance and care practices for the first wave pandemic. Since last December 31 and by mandate of the Ministry of Health, the most saturated healthcare systemss, including that of the capital islands of the Archipelago, should prioritizefor vulnerable people or with more serious symptoms of covid, while they reduce the control among the cases in which they are expected to have mild symptoms.

The new protocol of the Ministry for high incidence contexts, tries to alleviate the burden caused, especially, by suspected cases of coronavirus that, due to their age, health situation or their vaccination status, do not have a risk of suffering a serious covid. According to the standards set so far, they had to maintain a follow-up, confirm positive through a diagnostic test (PCR or antigens) and trace their close contacts.

With the new protocol, mild cases will have to be in charge of notifying their contacts of the positive while the follow-up of their health center will be limited to a first communication and explanation about the steps to follow, as well as an evaluation that, indeed, it is a mild case. Thus, from now on, the positives or contacts or possible positives they should isolate themselves and call the line 900 112 061. The health workers that make up this line will refer you to your doctor and tell you what to do according to your symptoms, affectation, if they are contacts or regarding your vulnerability. It will also be the doctor who decides whether to prescribe a test, in the event that the person has not done it himself.

One of the cases in which it will be prescribed will be if the person needs to process a withdrawal. In this sense, if you have not done a test on your own, you would be summoned to perform an antigen test and, later, you would have the evaluation with your doctor who will carry out the procedure for temporary disability (IT).

"It is the most reasonable reaction", affirms the Canarian epidemiologist Lucas González. As the Scottish-based expert explains, this type of measure is taken in high transmission contexts to "adapt the system to reality" and still achieve "the best possible estimate" of the pandemic situation. And the fact is that the epidemiological surveillance system, as he explains, must be functional to the point that it allows knowing "if the most serious pathology is under control." Something that is impossible to elucidate if the health services are saturated. The chief of epidemiology of the Canary Islands Government, Amos García Rojas, who insists that "in a context of high incidence it is possible that any mild clinical form is SARS-CoV-2, since it is the virus that is circulating the most." As he insists, "when we have thousands of cases", it is more important "to focus our attention on the most complex clinical pictures, because we know that this will increase."

Likewise, both epidemiologists are concerned that the idea is expanding that the growth of cases is an opportunity to let the virus roam freely and everyone to become infected to acquire "herd immunity." And, as García Rojas points out, "the more cases, the more ICU admissions there will be." "At some point we will have to live with the virus, but to get there we will have to go step by step," he clarifies.

Due to the change in the regulations, the cases of coronavirus notified by the Government of the Canary Islands will decrease in the coming weeks, since this new protocol leads the health system to carry out fewer diagnostic tests - only to the most vulnerable or serious -. However, "the cases will continue to rise until after Reyes", highlights García Rojas, who concludes that it is possible that the curve in the Canary Islands did not stabilize until "the end of January".

These measures are taken due to the saturation that is bringing health services to the brink of collapse, especially in Primary Care due to the amount of tasks that have been entrusted to them during the pandemic and their precarious base situation. Thus, to the tasks of health centers (prevention, control and monitoring of chronic patients, childhood vaccination schedule), Covid vaccination, monitoring of confirmed cases and antigen testing have been added. In addition, many health centers have found that more and more people come simply to issue the vaccination certificate. In fact, although with the implementation of the new protocol, Primary Care is less saturated, they continue to form long queues at health centers people applying for their covi passportd to be able to carry out leisure activities at level 3. It should be remembered that this document can be issued through the internet or the app my story or miCertificate Digital COVID UE.

Also due to the healthcare pressure that is being experienced in the emergency rooms of the reference hospitals, which have gone from treating an average of 200 patients a day to one of 300 due to the impact of Ómicron. In fact, the Canary Islands Health Service (SCS) only advises going to this service if you have serious symptoms, that is, fever over 39 degrees for more than three days, shortness of breath or a feeling of suffocation or chest pain. What is intended is that the population does not go to these services because they have mild respiratory symptoms (such as cough or sore throat), not having been called for follow-up, if they have a positive pharmacy test, doubts due to being close contact or due to want to take a test. In case of having compatible symptoms or doubts, you can call both 900 112 061 and make an appointment with your doctor through the internet, the miCitaPrevia app or through the phones 012 or 922 470 012/928 301 012.

Despite the reasonableness of this measure in the current context to prevent the system from collapsing, epidemiologists continue to insist that this does not mean that the pandemic is over or that the whole world becomes infected. "We do not have conclusive data on whether Ómicron produces milder cases," insists González. The studies that have been published so far do not give certainty on the matter. Although it does appear, with current epidemiological data, that those vaccinated are not affected in a milder way, the unvaccinated continue to show that the virus is as lethal as before. "We also don't know how it is going to be in the long term." The Scottish-based epidemiologist refers to the persistent covid or even the possibility - already described - that there is a first phase of mild symptoms and, two weeks later, one with more severe symptoms. "We also do not know what complications can arise from reinfection in a person with persistent covid", highlights Lucas González.

In this context, the recommendations of the Covid Free initiative, of which González is a member, continue to prevail. This strategy is based on taking three measures: wearing a mask, aggressive ventilation and reducing contacts. The use of a mask, in this sense, must be correct, with adjusters. "If the edges of the masks were sealed, their use would be greatly improved", highlights González, who insists that this type of improvement can be done at home, since, for the moment, the industry has not responded to this need . For its part, for ventilation, in the Canary Islands it could be enough to open windows and doors, guaranteeing cross ventilation. However, the use of air filters is also chosen to purify it. Likewise, it is committed to reducing infections to the most "vital and important" and, in case of showing symptoms of Omicron, "get out of circulation" as soon as possible.


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