The epidemiological reports of the National Public Health Organization (EODY) increasingly emphatically testify to the fact that scientists are repeating monotonously, that the coronavirus pandemic has not ended - just as the protective measures against the virus have not ended.
The epidemic wave, which is currently underway, is growing stronger as it approaches its peak. The number of cases clearly reflects this rise: 30,588 infections were reported yesterday, with 5,022 being the number of reinfections. This is the second highest number of daily cases since the beginning of the year in our country. In first place is 11 January, with 32,011 positive cases of coronavirus, close to the peak of the wave lifted by subvariants BA.1 and BA.2 of Omicron.
According to EODY data, about 150,000 to 200.000 people have active covid-19 infection and the disease replication index, Rt, is at a high level, at 1.3 - this means that 100 covirus-positive individuals infect at least another 130, rapidly increasing the chain of transmission.
The greatest increase in cases is found in tourist areas due to the relaxing climate during the holiday season. Apart from Attica, which is in the frame of "red" areas, Crete, the south Aegean islands and the Ionian Islands are also counting a large number of reported cases, with experts suggesting that under-reporting is taking place since testing is optional. However, scientists believe that the increase in popular, island areas is less worrying partly because the islands are partly geographically isolated and partly because of the young age of the bulk of tourists. Indicatively, in Attica, 15,155 cases were recorded yesterday, in Crete 1,986 cases, in Corfu 531, in Rhodes 440.
The hospitals of Attica bear the greatest burden of patients with covid-19 infection. Overall, the total number of inpatients in the last 24 hours was close to 1,720, but 374 were in units and of these 98 were intubated. The average number of hospital admissions in the last 7 days is 292 patients compared to 100 patients three weeks ago. The pressure on hospitals, currently at the level of single beds, is evident from the figures.
The fact that admissions to ICU remain stable despite the increase in hospitalisations is seen as positive by scientists. In fact, as first vice-president and associate professor of Epidemiology at the Athens Medical School, Mr. Dimitris Paraskevis, explained during the EODY's briefing, "the time period (window) from the beginning of the increase in cases to the beginning of the increase in hospitalizations ranged in previous waves at 12 to 15 days, with the exception of July 2021. In the current surge, although 28 days have passed, there is no increase in ICU hospitalisations, meaning that the surge, in terms of intubations and therefore ICU pressure, is expected to be milder."
The debate about reintroducing the mask
Despite the optimistic assessment of the hard indicators of the epidemic, however, the strong wave of thousands of cases per day brings the mask back into focus. In recent days there have been increasing voices of scientists who are once again calling for the mandatory use of the mask indoors, some five weeks after its suspension. It is recalled that the mask is compulsory in certainy indoor spaces, such as public transport, hospitals and ships.
As was pointed out at the briefing of journalists by the president and the two vice-presidents of the EHRC last Monday, the reintroduction of the mask will be reviewed by the Committee of Experts on the basis of epidemiological data - it is not excluded that it will also be discussed at today's regular meeting.
For his part, however, Secretary General Marios Themistocleous, speaking to ERT about the suspended measures, said that "we are a country that keeps the most measures compared to other countries and in fact we were very late in lifting them," he said. While referring to the mask, he said that "the mandatory mask everywhere is not currently on the table as we have to enter a new daily life in which we will co-exist with the virus, even with this increase in cases."
"This increase in cases does not seem at the moment to be leading to an increase in pressure in hospitals and hospitalizations so it is right that masks are not mandatory in the outdoors and indoors," the secretary general of Primary Health Care added.
Commenting on the epidemiological picture of the country, the president of the Panhellenic Medical Association (PIS) and member of the Expert Committee, Mr. Athanasios Exadaktylos, did not rule out the reintroduction of the mandatory use of masks. "Personally, I do not understand the man who gets on a plane that is suffocatingly full and does not wear a mask, I do not understand what he may be thinking at that time," he said, speaking to SKAI , about the use of the mask with individual responsibility of each person. Asked if there is a possibility of making the mask mandatory again, Mr. Exadaktylos replied: "I think yes, there is." And he explained by saying: "We cannot say that no action will be taken if we see that it is not being adhered to. We will not let the situation go unchecked because, you know, it's not just about whether or not the hospitals and intensive care units will be filled or not filled. It is the issue of human losses and it is also the disruption to social and economic life caused by people who are sick," he stressed.
The value of the mask, with or without compulsory use, is highlighted by Professor of Pulmonology at the Athens Medical School and front-line doctor at Evangelismos Hospital, Mr. Yannis Kalomenidis.
"With the argument of the mildness of the variations driving the summer wave, the refusal to take measures that "would harm tourism" is also supported. Who can dispute the importance of tourism to national income? But who can explain how maintaining mandatory indoor mask use would harm tourism? You know, the concept of compulsory is not helped by the fact that the measure is enforced with the threat of a fine, as much as it is by the message the state is sending to society. It's one thing to say "no big deal, rage on" and another to say "have a good summer, with care and caution," he says in a Facebook post. And he continues, not at all optimistic, adding: "Hoping that widespread relative immunity from prior infection and vaccination will drastically reduce the number of those of us who become seriously ill and at risk is not enough. As in winter, if infections are in the tens of thousands, the hospitalizations brought on by the "mild" variants will be many (already rising) and the wrongful deaths, among the most vulnerable among us, will be too. The country is defending its position at the top of Europe" he concludes.
On this issue, the Assistant Professor of Epidemiology at the Athens Medical School and member of the Committee of Experts, Mr. Gikas Majorkinis. According to the professor, the use of the mask cannot be horizontal, but only targeted to protect the vulnerable. "Putting people across the street who are 'tired' after two years and 'shooting' them is not helpful at this stage," he says.
"Every time we have an outbreak of coronavirus there are calls for measures to be taken. What the general public has learned as measures are so-called non-pharmaceutical interventions (e.g. lockdown, social distancing, mask use). The central role of non-pharmaceutical interventions (NPIs) is to reduce the active reproductive number (also known as Rt) by completely avoiding infecting individuals."
The role of NPIs in the early phases of the pandemic was catalytic because it helped us flatten the epidemic curve resulting in a more manageable pressure in hospitals. It also helped us gain time to develop adequate pharmaceutical interventions, namely vaccines and drugs.
The use of NSAIDs in the phase of the pandemic that we are in, where eradication is NOT EFFECTIVE, has been misunderstood by many. Some think that the pandemic outbreak is "a storm that comes and goes", just protect ourselves via PMS and it will pass. This is not true. Taking NPS mainly flattens the curve, it does not dramatically reduce the number of infections in the long run as with the reversal of NPS, which sooner or later has to happen, we will immediately see an outbreak again until the temporary wall of immunity is reached that will eventually drive the outbreak into remission. The reason they are being abandoned as horizontal measures now is because there is no apparent need to flatten the curve at this time.
Also those of us involved in public health issues know that in the long run, behavioral interventions that reduce people's quality of life do not have sustained compliance. Putting people across the street who are "tired" after 2 years and "shooting them" is not helpful at this stage.
On the other hand the big advantage of pharmaceutical interventions is that they accelerate the remission of an exacerbation as well: 1) they reduce the pressure on the health system, while 2) they accelerate and strengthen the necessary (albeit temporary) wall of immunity that will drive the outbreak into remission.
In summary:
1) epidemic outbreaks are not weather events or "waves that break and pass us by";
remission comes mainly when an even temporary wall of immunity is built up. The weather helps, but transiently.
2) NFIs at this stage should be used in a targeted manner to protect the vulnerable and not horizontally as their contribution is not sustainable in the long run."
Source: protothema.gr
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