“We are entering a post-pandemic phase”: infectious disease specialists see the end of the covid health emergency in sight.

The covid-19 will soon cease to be a health emergency. “‘De facto’ it no longer is. It remains for that qualification to be withdrawn.” He argues that Robert Güerri, head of the Infectious Diseases Section of the Hospital del Mar of Barcelona, who believes that, if the World Health Organization (WHO) assures that “the world has never been so close to the end of the pandemic” (so stated its director general, Tedros Adhnaom Ghebreyesus, last week), it is because the organism is “preparing” the ground to withdraw the concept of health emergency. Without going any further, President Joe Biden announced yesterday “the end of the pandemic” in the United States, but the European Medicines Agency (EMA) has opted on Tuesday for caution: it has warned that Europe considers the pandemic “still ongoing.” and has urged the reinforcement of vaccination against the virus.

“I see the situation as the WHO does. We are entering a post-pandemic phase. It is a new situation that we do not know what impact it will have on our lives. We have to see how the virus stays with us, but the situation we have lived through these last two years has already passed,” Güerri explains to this newspaper.

Data show that the covid pandemic is still going on at its lowest levels since it broke out two years ago. This Tuesday, in Catalonia, the number of people admitted to hospitals for coronavirus has dropped from 400 (there are 392 people, 32 less than last week), while in the ucis there are 13 sick people (four more than seven days ago), according to data updated by the Conselleria de Salut.

In addition, in the last week seven people have died in the territory and, yes, the number of infections is increasing: there are again more than 3,000 a week. Despite the continued circulation of the virus, hospital pressure indicates that severe disease has virtually disappeared and that mortality has declined greatly thanks mainly to the immunity generated by vaccines.

According to Daniel López Codina, researcher of the Computational Biology and Complex Systems Group. (Biocomsc) of the Universitat Politècnica de Catalunya (UPC), “it is likely that, in a month, there will be an increase in the number of cases,” but there is not expected to be a “peak of severe disease”. because the immunological situation of the population is very good. “At the moment Catalonia is in a downward situation, but tending towards stability. We can start to go up, but what is transcendent is that there is no serious illness.” says López Codina, who agrees with the WHO that the pandemic is close to its end, as long as it does not appear a “new variant” that revolutionizes everything.

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An “epidemic virus”

“We have to be realistic and call a spade a spade: the situation we have lived in these years we are not going to live it anymore. It is true that there may be a mutation of the virus, but what is circulating now and the protection of the vaccinated population leads us to think that the impact will not be like it was in the past,” says this infectologist at the Hospital del Mar. Society, he assures us, will never again be confined by covid-19. “In our environment, it is no longer a health emergency, but an epidemic virus. Yes, we have to see how it behaves. But it’s not a health emergency like 2020 and 2021.”

The WHO appeals to three criteria for declaring an international emergency: that it be a extraordinary situation, representing an public health risk to third countries due to international spread and which requires the coordination of an international response.

According to Güerri, in Western countries the pandemic is in a “stable” situation and SARS-CoV-2 affects in a manner severely only to very old people or those who have some type of immunosuppression. “The virus circulates, there continues to be positives in healthy people. This is the profile of the infected person and what we are facing in autumn, when the virus will circulate more,” Güerri points out.

Discrepancies with the WHO

However, there are voices in the medical world that consider assessments such as the recent WHO ones to be hasty. “I beg to differ. It is true that we are in a phase we haven’t seen for a long time, in terms of number of cases and impact, but from this to saying the end of the pandemic seems to me, to say the least, somewhat adventurous. For me, end of the pandemic would mean having zero cases.” for his part, writes Pere Domingo, senior consultant in Infectious Diseases and covid coordinator at the Hospital de la Santa Creu i Sant Pau in Barcelona.

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Domingo puts the focus on the fact that there are still “much of the world’s population” unvaccinated. And, also, “animal reservoirs”. “We already know that mink, hamsters, deer can be infected. If there is an animal reservoir, it will be very difficult to get to total infection control. All these conditioning factors are against reaching the end of the pandemic in a short period of time.” Domingo points out. Like Güerri, he emphasizes that the vaccine, in Western countries, has built a “wall of defenses” (“not only of antibodies, but also of cellular memory,” he specifies), which fortunately makes the health impact and the mortality per covid are lower than in the past.

Concern for autumn and winter

Doctors take it for granted that cases will rise not only of covid-19, but of other respiratory viruses. “We do not expect an explosive increase in infections of coronaviruses because we have herd immunity, but we will be more in enclosed spaces, there is a relaxation of containment measures, and all this will increase infections,” Domingo says.

From the Hospital del Mar, Güerri, despite taking for granted that the end of the pandemic is near, believes that the coronavirus, which will continue to circulate despite ceasing to be a health emergency, can generate “complex health situations.” “There will be outbreaks at certain times. Every year we live through complex situations with influenza and now we will have the aggravating factor that. there will be two viruses that can complicate things for us,” says this infectologist.

For example, one of the things he fears is that the usual overcrowding in the emergency room which occurred every year, before the pandemic, with influenza, is lengthened. “In Infectious Diseases we know that, between January and mid-March, there were always two and a half very bad months because of the flu. The emergency room is chaotic…. Maybe now this time will last longer because covid infections start in November. That really has to worry us,” Güerri says. “We are very concerned that there is a constant blockage situation from November to March.” he concludes.

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