few vaccines in sight and younger in therapy, the uncertain scenario of the under-60s

Daily cases of coronavirus, weekly average, increased by 70% over the past week, a leap forward that had not been seen throughout the pandemic. Intensive therapies are filling up and there is no longer any doubt that the the second wave is much worse than the first, with the unanswered question of what will happen to the death rate. As older people are vaccinated, all eyes are on a very large population that appears to belong to one Gray area, in the absence of massive access to vaccination: under-60.

Without counting children and adolescents, that is to say by taking those who are between 20 and 60 years old, we are almost talking about 65% of the infected accumulated. In CABA they reach the 75%. Now, to what extent does this group end up having to be hospitalized?

The numbers are so dynamic that it’s hard to keep pace. 10 days ago, the Nation’s Ministry of Health informed Bugle that in February and March, patients from 20 to 60 years had accounted for 20% of hospitalizations due to Covid. This Wednesday, from the Argentine Union of Health Entities (UAS), they reported that it was more than double: patients in this group in the AMBA represent the 47% of people hospitalized for SARS-CoV-2.

The conclusion they reached updates the pandemic profile in Argentina: the average age of hospitalization for coronavirus went from 8 to 10 years, if the first and second wave are compared.

A few days ago, the coordinator of the Intensive Therapy of Sanatorio Güemes, Diego Pereyra, pointed out to this columnist an uncomfortable question, related to this data: “We receive younger patients. The average age was 70, but it seems to go back a bit to fifty or sixty. “

“A priori, in this segment, the death rate from Covid is decreasing, but if we take into account the fact that this patient brings several times comorbidities (obesity, hypertension, diabetes or some immune or rheumatological suppression) their risk is equal to that of the elderly patient, ”he stressed.

Then? What is uncomfortable is the question of whether vaccination of this segment should not be a priority. According to Pereyra, “we must consider that it is Economically active population, people who, in many cases, are the breadwinners. It’s a difficult debate, but many doctors are asking for it ”.

On the elusive path of community transmission, Covid is known to circulate “where it can”. As many activities promoting contagion are permitted (beyond the new restrictions, the realization of which depends on the philanthropic appeal to individual good deed), this population, which to a large extent takes children to school and attends their place exposed.

Another variable is added. Last year there was one segment of the under-60s the virus was comfortable with: the personal health.

As this segment is predominantly vaccinated, the spectrum of those under 60 who may be infected has gradually narrowed. However, as long as there is no real “herd immunity”, the pressure on susceptible people of these ages is proportionately high.

Current photo

Doctors from the city and province of Buenos Aires have given their opinion on the profile of infected and hospitalized people they see every day.

According to Cristina Freuler, responsible for infectious diseases at the German hospital, “all the diagnoses of the last days concerned people of 25 to 45 years old. This means that there are a lot more patients at home than before, but, anyway, the hospitalizations are on the increase compared to a month ago because there are a lot more infections ”.

In fact, he assessed, “this wave has already levels above the last peak time, only that the increase occurred much more sharply. We assume that it will have larger dimensions ”.

Ten days ago Ricardo Teijeiro, an infectologist at Pirovano hospital, warned that what was to come was going to have “two or three times the size of the 2020 wave“. The reality of the figures is starting to prove him right.

De las Ages explained that he observes “a very high attack rate among young people. 17 to 40. They take few precautions, have light to moderate photos, and most will not fit indoors. As for those of 50 to 60 years with comorbidities, they are seen, and many end up being hospitalized ”.

The doctor clarified that “the percentage of this segment still does not exceed the elderly, who have the comorbidity of age, but since the vaccination rate of this other segment is very low, it could change.

Head of the infectology department of the Santojanni hospital, Pablo Scapellato contributed (“without precise statistics in hand”) to his impression of these days: “The people who come for Covid are more and more younger“.

“I don’t know if hospitalized patients have more comorbidities, but it seems reasonable to me because, according to my interpretation, we have learned to better manage ambulatory patients and we hospitalize less. Those with co-morbidities are mostly hospitalized, ”he explained.

His outlook for the coming weeks is not encouraging: “We started from a higher floor and we already have many cases. Lethality, I dare not give an answer. But I mean the health system is Out of print. Although we are vaccinated, we are working in the same or worse conditions than last year. During these months more staff could have been trained ”.

Too Pablo Pratesi, Head of Intensive Care at Austral Hospital, gave his vision: “We see younger patients, between 20 and 60 years old. And you see more pneumonia than before. But we also learned more about the disease and we are attentive to things that we had not seen before ”.

Scenarios

Jorge aliaga, physicist, director of planning at Hurlingham National University and dedicated pandemic figures analyst, explained that “at the start, in March 2020, the average age of people infected with Covid was older than now because those infected were, to a large extent, people who went on vacation abroad. And there were few cases ”.

“Then, in May, the average was linked to the explosion of infections in working-class neighborhoods, where many young people live. By suppressing these events, the average age of infected people remained more or less stable throughout these months, but in the last few weeks it has gone down a bit“.

The curves that this expert broadcasts daily speak for themselves: at the peak of last year, the average age of those infected was 41.3 years. Now, 38.2.

“75% of newly infected people are under 50 and since only about 5% are over 70 – both as a first effect of vaccination or because they continue to take good care of themselves – this changes the death toll, “remarked

The glass half full? The doctors consulted agree that in this avalanche of cases, a “dedicated” behavior dominates, compared to last year. The youngest consults at the slightest symptom and quickly.

According to Teijeiro, “people are warned. Last year he was scared to admit he might have coronavirus, and if he had a fever he would wait a day or two to see if it passed. Now they go to one of them and line up to wipe themselves off ”.

However, he concluded, “this apparent awareness does not translate into prevention. Everything that comes from here will depend on how we move forward with the sanitary rules ”.

PS