the unexpected aggressiveness of a variant

Whether in Germany or Brazil, the data are the same and alarming in the same way, beyond the differences in the management of the pandemic on either side of the ocean. In this second wave, not only are there more cases of coronavirus among the youngest, but there are also major complications. Is this the scenario we will soon face in Argentina?

“In the last few weeks not only are cases increasing in young people but in generalSays Roberto Debbag, vice-president of the Latin American Society of Pediatric Infectious Diseases. So far in 2021 compared to the second half of 2020, there has already been an increase in the percentage of cases in the 10-30 age groups. And compared to the first half of last year, there is also a slight increase in the 40-50 band.

On the other side of the border, in Brazil, the panorama is already chaotic, with a toll of cases and deaths which push the debate on the closure of entry to the neighboring country. Deaths of Brazilians aged 30 to 59 started to rise in December and in nearly three months rose from 20% to almost 27% of the total. The AFP agency traced it with the testimony of doctors from the São Paulo Emilio Ribas hospital. There, half of the hospitalized patients are under 60 years old, whereas a year ago, they were 33. And there is a prevalence of younger patients, without comorbidities, hospitalized with very serious photos.

In Brazil, the percentage of the population having received at least one dose is 4.6%. In Germany, it is 8.6%, but there, we also see that “in hospitals, patients have changed. They’re getting younger, now they’re the least protected”, Explained Lars Schaade, vice-president of the Robert Koch Institute, the federal agency for disease prevention. In the UK and Italy, as this newspaper reported, an increase in cases has also been reported among young people, including children and adolescents.

In countries where vaccination is progressing, the virus “hits” the vaccinated elderly and searches for new routes: thus, the rate of infection among the younger population increases. The vaccine itself is partly responsible for this paradigm shift, but not the only or the most determining cause. According to Debbag, the increase in these age groups is also linked to a slackening of care due to increased circulation and “a factor that we do not talk about and which is very important in Argentina: that the adequate strategy of screening, monitoring and isolating people is not implemented ”. As at the start of the pandemic, once again the experts are sounding the alarm that in the second wave that will come the “test, test, test” will be the key.

In that there is also a coincidence, although the scientific evidence is still in permanent construction, is that the new variants, especially the UK and Manaus, they describe this new “young face” that the pandemic is now showing.

“Most of the cases are of the Manaus variant. There is a 20% drop in hospitalizations among those over 80, while the number of people under 60 in hospitals is the majority. There is a significant number of young adults between 30 and 50 boarding schools, which is the base of the social pyramid. Although 90% have mild illness, 10% is a huge number in absolute numbers», Analysis on the situation in Brazil the pulmonologist and researcher Renato Stein, director of the infantile center in Brazil.

How and why do these variants impact a greater number of cases? According to Josefina Campos, researcher at ANLIS-Malbrán, “it is being studied because transmissibility and aggressiveness require epidemiological studies where the variants circulate and this takes time”. However, there are already some clues. From the British variant, for example, it was known from the start that it is up to 70% more transmissible, and now it has been determined that it is not just because of the way the famous’ protein peak ”is associated with the recipient cell. but also because of the very dynamics of viral replication which triggers viral load.

But in addition, research that has just been published in the journal Nature suggests that this variant it is also linked to an increase in complications and mortality. Researchers at the London School of Hygiene and Tropical Medicine analyzed data from 17,452 deaths that occurred in Britain between September and February, estimating a 61% increased risk of death associated with variant B.1.1.7. “Our analysis suggests that it is not only more transmissible than the pre-existing variants, but also causes more severe disease,” they noted.

The mutations of the Manaus variant too make it more transmissible and are associated with hospitalization. “There is an observation that indirectly, it can cause more mortalityStein adds. For Debbag, in Argentina, we have undetected community circulation of this variant, which has caused a “viral spill” from the Amazon to the cosmopolitan cities of Brazil and from there to the rest of the countries. And this has an additional complication in the likelihood of re-infection: “Months ago, we said that re-infections were infrequent, but with this variant, we see that they are more frequent”.

The expert warns that the scenario we face in Argentina is complicated if there are no strategic changes. And talk about “Hurricane Covid” for which they influence four variables: more contagious and severe variants with a ripple effect on our country; relaxation of the population in health measures with fewer tests; probability of reinfection with new variants; and delay in vaccination.

“If between this month and May 7.4 million people over 60 are not vaccinated, mortality will be very high. And I also need to vaccinate 5 million more who have co-morbidities. If I don’t do it quickly, it’s a level 5 hurricane.“, Graphics.

AS