Catalonia, about to reach the ICU occupation that cost Madrid the state of alarm in October

On October 9, 2020 and after a heated meeting of the Interterritorial Health Council, the Council of Ministers agreed to decree a state of alarm for Madrid in the face of the angry protest of the Community government. Among all the factors that were alluded to, there was one that was specific to Madrid and that allowed the capital to be isolated and not to extend the decree to any other area of ​​the country: 35% of Covid occupancy in ICU.

Today, in its report, Health announces 32.35% for Catalonia. Although the regional health system itself has warned of a possible collapse of the Catalan ICUs by the end of this week, it is not ruled out if the rate continues so high that we reach the dreaded 35% occupancy in a couple of days and beds have to be expanded. a bit wherever.

As we said last Saturday, Catalonia has become an anomaly within the fifth Spanish wave. Not only the incidence continues to rise in 1233.93 cases per 100,000 inhabitants Rather, it is one of the few places where we see a dangerous increase in hospitalized patients that is beginning to show in the death toll. In one week, the total number of admitted has gone from 1,296 to 2,288 (+ 76.54%).

But that’s not the worst. The The situation of the ICUs is not only comparable to the second wave, but may soon be comparable to the third wave if weekly growth continues at around 70.56% today. Paradoxically, Catalonia had not reached 32% Covid occupancy in the ICU since May 10, just after the lifting of the second state of national alarm.

The number of deaths does not seem alarming yet, but this may have to do with a certain delay in communication from the Ministry. Communities are giving figures already around 25-30 daily deaths when Sanidad barely consolidates six to seven per day.

In Catalonia, for example, progress is being too fast: In the seven days prior to the weekend, 37 people died for 18 of the previous week and 10 of the previous one. In other words, the number of deaths has almost quadrupled in two weeks, although the base is very low and lends itself to these scandals.

If we stop to look at the ages of the deceased in Catalonia, 22 of the 25 deceased between July 9 and 15 were over 50 years old … and another 15 were over 80. Once again, and there are five, when it is said that there will be no seriously ill or deceased because the infected are very young, the usual is obvious: that the young end up infecting the elderly … and that the elderly, still 100% vaccinated , they do not always manage to develop sufficient defenses.

Vaccines are an indisputable success of science, but they do not make us immortal. Perhaps a bit of pedagogy would have been helpful in this regard.

Evolution of ICU occupation in Catalonia since the beginning of the pandemic.

Outside of Catalonia, it is difficult to find the balance between maintain a reasoned level of alertness while not encouraging gratuitous panic. This fifth wave is being a true litmus test in that sense because the same data, exactly the same, lend themselves to different interpretations.

It is the problem that trend and volume are so far apart right now. In other waves, we knew that sooner or later they coincided and that the increase in one of the parameters meant, in the long term, the increase in all. That has obviously changed.

The only indicator in which trend and volume have been triggered for three weeks is that of positives detected, the famous cumulative incidence. This Monday, we have the highest record of weekend cases (61,628) since February 1, which represents an increase of 29.74% compared to the previous weekend.

We are not only in sky-high numbers –323.98 cases per 100,000 inhabitants every seven days, 599.69 cases per 100,000 inhabitants every fourteen– but these figures are increasing. Last Monday, we were at 257 and 400.41 respectively, according to our own calculation since Health did not include data from the Valencian Community and the Balearic Islands.

It is true that a depletion of the trend seems to be observed, but that is up to a point reasonable in these amounts. In the best scenario, and right now it seems the most probable, we will have reached the peak of daily cases this Tuesday or Wednesday.

Now, the risks of maintaining such a wild transmission of the virus are obvious: from the outset, from a health point of view, we keep the primary care circuit in a state of unsustainable stress. It also coincides with the vacation date of most health center personnel, with which the pressure on those who stay is much greater.

Evolution of the European countries hardest hit by the fifth wave since the end of the state of alarm

Evolution of the European countries hardest hit by the fifth wave since the end of the state of alarm

Besides, a high transmission of the virus is dangerous in itself. Throughout the month of July, More than half a million Spaniards are going to be infected with a pathogen whose short-term action and medium-long-term consequences are unknown to us.. It is a very high risk that we are running.

As if that were not enough, the fact that the virus is rampant multiply the chances of a mutation that ends up being even more dangerous. If the virus is not transmitted, it cannot mutate. And if it is transmitted little, that mutation can be detected easily. Among hundreds of thousands of weekly cases, it is impossible to keep up to date, and that can lead to a huge problem when the protection that vaccines give us decreases, something that we do not know for sure when it will happen.

Now, this logical alert in regards to the number of infections, it is difficult to quantify it in terms of hospitalized patients and deaths, with the aforementioned exception of Catalonia. As we said last saturday, the number of admissions in Spain has multiplied by three in just two weeks.

The data of this Monday -1,069 new hospitalizations- points to another week of increase. It is the first time since April 30 that a thousand new entries have been exceeded in a single day. The total number of hospitalized patients rose to 6,482, 66.55% more than last Monday, while the number of ICU beds also increased after a difficult weekend: 1,039, 44.51% more than seven days ago.

All that said, it’s worth taking a comparative look at the total volume. It is difficult for me to talk about the total volume because it changes with too much speed, but we cannot ignore the fact that touching the 6,500 hospitalized already makes us flirt with the numbers prior to the second wave, just the one that was conceived throughout last summer to explode in October.

In fact, they are more or less what we had on August 28 (6,224). The same could be said of the ICUs: the Occupancy percentage over the total at the state level already stands at 11.42% when at the end of August 2020 it was at 7%.

No vaccines, we would have been touching the thousand dead for days. With vaccines, there are only about ten, that is, those that are outside the percentage of effectiveness of each laboratory. Care is not over with risk groups. We have managed to save more than nine out of ten lives, but if the incidence among those over 70 continues to be around 125, as it is now, the number of deaths per month could be close to a thousand. It is not a negligible number, in my opinion.

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