Catalonia's drama: why AI is still the best method to predict a Covid wave

One of the great mistakes of this fifth wave has been to insist on assuming something that did not have to be entirely true. Being the first wave with extensive vaccination, perhaps we should have all been more cautious in the analyzes and not insist so much that it was impossible for hospitals to fill up and even more impossible for there to be a relevant number of deaths. We had data to think that it was unlikely, but we should still have waited before imposing an excess of tranquility by decree.

One of the great mantras of this rebound has been that of “incidence is useless, you just have to look at those hospitalized”. It is taking to the extreme something that may have a certain meaning but that must be clarified a lot. If you want to know the problem you are facing and that problem is the virus, you need to know where it is. And that is the incidence, there is no more turning the page.

If you want to know if you are on a wave or not, you cannot wait until the hospitals are already full or to check if they are still empty. You cannot trust the present. The order, no matter where we are, remains the same: positivity begins to rise, then incidence in seven days, then fourteen, and then the rest.

The problem of neglecting advocacy, of all the days that we have spent saying “it does not matter, there are no serious cases” is the time we have lost on the way. It is true that it can happen – and it has happened for example in Castilla y León or so we hope – that a region has a very high incidence without it being transferred to hospital care … but the opposite can also happen and, if it happens, you have burned the reaction margin.

What is not going to happen, of course, is that the hospitals fill up without previous high incidences. Furthermore, this effort to measure everything according to the number of ICU beds occupied is a lack of respect for the possible medium-long-term consequences of the disease and, above all, for the primary care professionals who serve as the first containment barrier .

Weekly income in Spain.

Looking only at the hospitalized and in the present makes things like Catalonia happen to you. The July 13, the cumulative incidence exceeded 1,000 cases per 100,000 inhabitants after several days reporting more than eight thousand positives per day. They were unusual numbers in Catalonia. Never, throughout the pandemic, have we seen anything similar.

Solo a couple of days, during the worst of the October wave, we had seen the number of new daily cases exceed 6,000 and now we were almost 9,000. The warning was clear and could not be ignored. In fact, the first measures and the first regrets of Josep María Argimon, Minister of Health of the Generalitat, come from those dates.

Now, by then it was too late. Although the hospitals were still without extreme pressure (1,420 total hospitalized, 251 in ICU, an occupation of 20% of the total available beds and 22 deaths per week, that is, three per day) the trend was horrible. Obviously, with the usual delay, that incidence was being transferred to hospital care without any foresight.

The data for this Friday, ten days later, are devastating: the incidence is decreasing little by little, but it continues in 1,184.80 cases per one hundred thousand inhabitants. Everything else is upside down: there are 2,677 total hospitalized, 88.52% more, of which 505 (+ 101.2%) are in the ICU. The Covid occupancy in beds reserved for critical patients is 40.05%, which indicates a saturation of the system, especially in Barcelona and its metropolitan area.

The thing does not end there: of the twenty-two weekly deaths, we have gone to seventy. From three a day to ten a day in just over a week. That, in consolidated figures. The unconsolidated ones point to even higher growth that we will see in the coming days.

Even foreseeing a drastic drop in the trend of the increase, a mere 33% rise in the number of occupied ICUs next week it would leave us at 672. The maximum, throughout the entire pandemic, was 824 on February 1. If we had taken the incident seriously earlier, we could have at least prepared for what was to come. We took it for granted that it was impossible and we were wrong.

Deaths per week in Catalonia.

Deaths per week in Catalonia.

The doubt now is what is going to happen in the rest of the country, because, for the moment, fortunately, we do not see anything similar to that of Catalonia. In these same ten days, the incidence in the country as a whole has gone from 436.75 to 677.67 and still rising, albeit slightly. Excluding the region chaired by Pere Aragonès, hospitalization has gone from 2,763 to 5,278 (+ 91%).

Critically ill patients increased from 498 to 787 (+ 58.03%). There is not such a radical rise in critically ill patients, of course, but it is rare that, when a problem is detected, that problem remains enclosed within geographic limits, especially at a time when mobility remains almost total at the length and breadth of the country.

Yes, there is a significant increase in the death toll: during the beginning of this fifth wave, barely 10-15 were reported per day. In the last week, the Autonomous Communities have notified a total of 215 deaths. This, taking into account that Aragon and the Basque Country update late and that is why their figures are not included. We are talking about more than 30 deaths a day with a very clear upward trend that could lead us 1,000-1,500 deaths over a month.

How many would they be without vaccines? Impossible to know. We have been so concerned to remember that the rate of hospitalization and death due to contagion was going to be lower than before … that we have not taken enough time to attend to reality. At an average of 30,000 new cases per business day, we would bring more than a week putting more than 3,000 people each of those days in hospitals.

Fortunately, over the last week, as can be seen in the first graph in this article, there have been “only” 6,459, that is, 1,291 per day, less than half. The ICUs would be at 35-40% and they are at 14.1%. It is difficult to imagine that in a couple of weeks we will not begin to see almost a thousand deaths per day or even more. With vaccines, they will not exceed a hundred.

Now, if we continue to ignore the incidents, if we continue to consider that they do not indicate the danger we are in, these numbers will continue to rise because all this, as we said on Thursday, works in percentages. If before 10% of those infected entered, now 3% do … But if you let the infections go to 600,000 a month, the situation is going to be chaotic anyway.

If before 1.5% of those infected died, now it does not reach 0.15% … but we are in the same state if we do not lower the volume. We have gotten carried away not only legally but personally. We have rushed into the message. We have the virus everywhere, even in the Spanish delegation in Tokyo, and now let’s see how we control things.

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