Infections among young people are behind the latest turn that the epidemic curve has taken in Spain. New infections in the country had been declining since April, although in recent weeks the fall was increasingly gradual and last Wednesday it finally broke the trend and began to rebound to 117 cases per 100,000 inhabitants this Wednesday. The rise in infections, however, is irregular by age group and focuses, essentially, on twenty-somethings and adolescents from 12 to 19 years of age: in the latter group, the accumulated incidence (AI) at 14 days exceeds 287 cases per 100,000 inhabitants. ; Among young people between the ages of 20 and 29, the AI ​​rises more than 40 points in one day to 293 cases.

There are eight communities where these levels of incidence in young people are more so: Andalusia, Asturias, Catalonia, Cantabria, La Rioja, the Balearic Islands, Castilla y León and the Basque Country exceed the average number of infections in the country among adolescents, twentysomethings or in both groups . Cantabria, for example, reaches 727 cases per 100,000 in the group from 20 to 29 and is already considering closing nightlife again. The Minister of Health, Carolina Darias, has called for “prudence” and experts warn that, although the disease occurs mildly in young people, it can cause serious symptoms in older people in their environment who still do not have the pattern complete vaccination.

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Young people are the perfect breeding ground for the virus, since the acceleration of the vaccination campaign immunizes the older age groups. This group is the most unprotected because it has just begun to receive the first punctures and, due to its social dynamics of more mobility and interaction between people, they encourage the transmission of the virus. All this, spiced up with a global scenario of relaxation of restrictions and reopening of activities such as nightlife, has led to this “explosion” of infections among adolescents and twenty-somethings, the experts consulted agree. The most paradigmatic case is that of the macro outbreak in Mallorca, which already affects more than a thousand students. But this infectious episode is not the only one: the situation is replicated, on a smaller scale, in almost all of Spain. “We will be with oscillations [en la curva de contagios], but of course, we are convinced that vaccination will prevent us from going to a higher increase. But we cannot trust ourselves because the virus is there, ”Darias warned after the Interterritorial Health Council on Wednesday. The minister has asked the population for “responsibility” and “not to lower our guard.”

Daniel López-Acuña, former Director of Emergencies of the World Health Organization, points out that “a microola is being produced in young people and it influences the general incidence. And this is not a phenomenon linked to the macro outbreak of Mallorca, it is a problem associated with the end of the state of alarm, the fall of the curfew and the relaxation of nightlife. In addition, the feeling of false security due to the alleged invulnerability of young people to the virus has contributed ”. Almost all of Spain carries this upward trend in infections among young people that weighs down the global epidemic curve, but there are communities that are especially affected and with incidences higher than the Spanish average.

In Barcelona, ​​for example, the positives among young people have quadrupled since the end of the state of alarm and the Catalan Minister of Health, Josep Maria Argimon, warned this Wednesday that the situation is “worrying”, although the rise in contagions is not having an impact, for now, in greater hospital pressure. Magda Campins, head of epidemiology at the Vall d’Hebron Hospital in Barcelona, ​​agrees: “The explosive increase in cases worries me, not because of the young people themselves, but because they interact at home with their parents or grandparents and not all of them are vaccinated or with the complete vaccination regimen. If these young people are not cautious, in the next few days we can see their parents’ income ”.

The Catalan capital, with 273 cases per 100,000, and the south of its metropolitan area bear the worst of it, but the boom in infections among adolescents and twenty-somethings is global in the community, which registers an incidence of 470 cases per 100,000 inhabitants in the group aged 12 to 19 and 555 among kids aged 20 to 29, almost three times the overall Catalan average (183). Argimon has ruled out, for now, taking steps back in the de-escalation, although he has already decided to open vaccination to those under 30 to accelerate protection for this group.

Several people make a bottle in the Terenci Moix square in the Raval neighborhood of Barcelona on May 14.Albert garcia

Campins points out that, in the case of Catalonia, in addition to increased mobility and social interaction, the spread of the delta variant of the virus, discovered in India and up to 60% more contagious, plays a role, according to the European Center for Disease Control (ECDC). Last week, the Catalan government estimated that this lineage already caused more than 30% of new infections, a percentage that Campins now raises above 50%. The latest report from the Ministry of Health on the presence of the variants reduces the presence of the delta to 2.7% of the sequenced samples, although it assumes the heterogeneity in the expansion of this lineage between the communities. The director of the Center for Health Alerts and Emergencies, Fernando Simón, insisted on Monday that this boom in infections is not linked to the delta variant, but experts disagree. “The scenario of the European Center for Disease Prevention and Control is that this summer the infections with the delta will be between 70% and 90%. And here we are also walking towards that ”, Tercia López-Acuña.

In the Balearic Islands, the focus of the beginning of the macro-outbreak among students who were on an end-of-year trip, there is also concern about the growth in the incidence among adolescents (349) and twenty-somethings (195), well above the global average for the community (95) . One of the areas that worries the most is Menorca, where in a single day 70 new infections have been registered, many of them related to an outbreak that arose in the Sant Joan de Ciutadella festivities that involves young people. In full escalation of cases, the Government of the islands also opened vaccination this Tuesday for young people between 16 and 29 years old on the island of Mallorca (since Saturday it was open in Menorca, Ibiza and Formentera).

Another community with a soaring incidence among young people is Cantabria: 573 and 727 cases per 100,000 inhabitants among adolescents and twenty-somethings, respectively. His Health Minister, Miguel Rodríguez, has admitted that the growth of infections is especially worrying in the municipalities of Santander, Camargo, Piélagos, El Astillero and Laredo. Rodríguez has assured that his department is considering the closure of nightlife to mitigate cases or limit group meetings in the private sphere or in the hospitality industry.

La Rioja, for its part, is close to 460 cases per 100,000 among twentysomethings and a rate of 270 in adolescents. Castilla y León also registers an incidence in the group aged 12 to 19 years (315) above the Spanish average and Asturias has reported 348 cases per 100,000 in the group aged 20 to 29.

Several people walk through the Alameda de Hércules in Seville on June 26.
Several people walk through the Alameda de Hércules in Seville on June 26.María José López / Europa Press

In Andalusia, with 163 cases per 100,000 inhabitants, all age groups exceed the Spanish average, although the trend continues to decline slowly for the twelfth consecutive day. Currently there is a Sevillian municipality, Cantillana, with more than 1,000 cases per 100,000 inhabitants, in which freedom of movement is restricted and non-essential activity is closed. Córdoba, with a rate of 258, and Granada, with 207, are the Andalusian provinces with the highest incidence rate. Figures that more than double when considering the age range of 15 to 29 years. Unlike Catalonia or the Balearic Islands, the Andalusian Health Minister, Jesús Aguirre, affirmed this Tuesday that the vaccination plan will not be altered because in the 30 to 40 age range, which is the one that is receiving the second dose, the covid causes more hospitalization than in those aged 15 to 29 years.

Nor will the Basque Country modulate its vaccination strategy. Despite the fact that the infection rate is higher among those under 30 years of age – the incidence among adolescents exceeds 341 cases per 100,000 – Osakidetza maintains its agenda unchanged, although it hopes to reach the youngest population group in both next weeks. The situation in this community is complex: in the Guipuzcoan town of Hernani, infections have soared coinciding with the celebration of the San Juan festivities last week and the incidence has jumped in just two days from 74 cases per 100,000 inhabitants to 402 ,5.

Epidemiological surveillance

Experts agree that the key to curbing contagions is, right now, exhaustive epidemiological surveillance of positives and close contacts to cut the chains of transmission and educate young people. “As restrictive measures are equal, there is inequality in compliance. You don’t have to stigmatize young people, but you do have to be realistic: you have to explain to them the magnitude of this and how it is hitting them. No action is being taken to target this group. We must intensify the screening aimed at this population, ”says López-Acuña. Immediate vaccination, he assures, “is not the solution because the effect will arrive in a month.” The priority, Campins agrees, is to finish puncturing the most vulnerable: “I am afraid that those aged 16 to 25 will be vaccinated earlier than those aged 29. The important thing is to vaccinate those most at risk.” In Spain, 25.3 million people have already received at least one puncture, but coverage is higher in older age groups. 34% of the group aged 40 to 49 years have not yet received the first dose of the vaccine and 26% of the group aged 50 to 59 have not yet completed the vaccination regimen. Among those in their sixties, considered a group at risk of developing severe covid, 53% of them have not yet received the second puncture.

The experts consulted most disagree on the advisability of reversing the de-escalation. Campins suggests that, until the contagion boom does not impact the hospital system and the tension in the ICU picks up, it is not necessary to restrict measures. López-Acuña, however, defends “stopping relaxation measures and putting limits on social interaction.” “If we want to lower the curve, we must stop the de-escalation”, the epidemiologist solves. In Spain, there are currently 2,375 people hospitalized and, specifically, in the ICU, the occupation of patients with covid is 6.5% (there are 601 critically ill patients). The professionals agree, of course, that the hospital tension will be transferred to primary care, which will have to assume the detection and monitoring of the flood of mild positives and their close contacts, in addition to attending to their usual patients.

With information from Lucia Bohórquez, Mikel Ormazábal, Juan Navarro Y Margot Molina.

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