By the end of January, experts expect the peak of the epidemic wave of coronavirus, the strongest in Greece in a year and a half. A very large number of cases led to a significant increase in hospitalisations and, at the same time, the intense circulation of seasonal influenza viruses, as well as other infections, such as respiratory syncytial virus (RSV), caused an explosive winter cocktail.
In this context, the Ministry of Health and the National Public Health Organization (EODY) issue a strong recommendation for the use of masks in health structures and areas with co-housing, vaccination for those citizens over 60 years old and vulnerable, as well as compliance with individual hygiene measures and self-check through tests.
Each high-intensity cycle of COVID-19 ends in two months at most, as has been seen over the past three years. The duration of each flare-up, of course, depends on many factors. Given that the current epidemic wave started around mid-November, it is estimated that it will peak by the end of this month, and then the effect of the coronavirus on the community will begin to decrease.
However, until the peak comes and the decline in traffic follows, COVID-19 will continue to infect, with the next few days considered difficult and requiring increased caution. According to the deputy professor of Epidemiology of the Greek Academy of Sciences and a member of the Committee of Experts of the Ministry of Health, Gika Mayorkini, an additional increase of 20% in cases is expected.
“Measures are not applied as in other phases to estimate when the wave will end. When action is taken, what is done is to drop the active reproduction rate and cause a flattening of the wave. Based on our simulations, each epidemic phase lasts two months. After immunity is created in a large part of the population, then there is a decline, which is not sustained for too long,” he said to Proto Thema.
The current coronavirus outbreak is the largest and strongest in about a year and a half. “From the summer of 2022, we are going to see so much tension”, Mr. Majorkinis points out.
The wave is not reflected in the number of cases, as most are not declared since citizens mostly carry out self-tests and isolate themselves. However, two indicators are the most indicative of the dynamic circulation of the coronavirus today in our country.
15,000 requests for antivirals
The first is the requests for antiviral drugs, the number of which has increased fivefold in a month! According to the president of the Hellenic Pulmonology Society, Stelios Loukidis, in the last 15 days of November, 3,000 applications for antivirals were registered, while in the corresponding period of December, their number rose to 15,000.
The second indicator is hospitalisations. Hospitals are now managing many patients with COVID-19 – and more. Indicatively, last Wednesday, the new admissions exceeded 300, and the total number of hospitalised patients with coronavirus in ordinary beds and Intensive Care Units (ICU) was close to 1,700.
It is worth noting that the treatment of patients had nothing to do with the first waves of the pandemic, as Mr. Loukidis clarified, based on his experience at Attikon Hospital and doctors from other nursing institutions.
This means that patients stay in the hospital for a few days, and the number of those who are seriously ill and require intubation and ICU hospitalisation is not high. It is typical that alongside the large number of admissions, an equally large number of discharges from hospitals is recorded daily.
The unstable factor
But why is there now such a strong wave of coronavirus? According to Mr Mayorkini, it is a combination of the new subvariant (JN.1), the drop in temperature and the holidays.
“Each of these mutations has a higher immune evasion rate than its predecessor. But we cannot compare them. A comparison would be made if the entire population were diseased. In other words, it had never been stuck. We say that this new subvariant is the most contagious for the given phase and the given immunity of the population at the moment,” he said.
It is recalled that the prevalence of JN.1 and its rapidly increasing spread led the WHO to separate it from BA.2.86 (also known as Pirola), from which it originates, and place it alone in the subvariant list of interest. Given the incidence of the new subvariant in the US and Europe, it is likely that it will reach 60% of the cases in Greece.
The holidays raised the epidemiological curve high, but the danger lurks behind an incalculable factor: the reopening of schools from today. “The school is not participating in the increased transmission today. It is very likely that it will have an additional impact on the spread,” said Mr Loukidis to Proto Thema. The Ministries of Health and Education are in constant cooperation for the smooth operation of the school units.
School principals and Heads of Education have received an updated guidance document on COVID-19, influenza and viruses, reminding them of good practices to limit transmission and the need for vaccination.
According to experts and the Ministry of Education, parents should not send their children to school if they show respiratory infection symptoms and stay home until their health condition improves.
Strong recommendation for a mask
The threat to the elderly and vulnerable remains even now that hybrid immunity has been built into the population. In this context, the Ministry of Health updated the strong recommendations to limit respiratory infections after meeting the Ministry’s Committee of Experts.
Based on the latest announcements:
■ It is necessary to vaccinate as soon as possible with the updated vaccine for COVID-19 and the flu vaccine for those over 60 years old and with underlying diseases, as the National Immunization Committee recommends. ■ It is extremely important to use a protective mask in all areas of health facilities (e.g. hospitals, Health Centers), Elderly Care Units (FCUs), and in closed structures that host vulnerable populations. ■ Especially for people who belong to the vulnerable groups of the population (elderly, people with underlying diseases), upon symptoms, to seek medical advice in time to make a timely diagnosis and immediate treatment. ■ It is essential that people living in nursing homes and other closed vulnerable population structures adhere to preventive measures and get vaccinated against influenza and COVID-19 with the updated vaccine.
In addition, it is strongly recommended that the general population observe the measures to prevent viral respiratory infections: hand hygiene, systematic ventilation of closed spaces, isolation upon symptoms, continuous use of a mask, especially in crowded areas, limiting contact with vulnerable people and carrying out diagnostic tests.
Influenza is sweeping
In addition to the large circulation of the coronavirus, that of influenza viruses is also intense, as well as other infections. According to pharmacists, the double self-tests, i.e. those that detect the coronavirus and influenza type A and type B, have become widespread.
As can be seen from the results of these tests and the experience of doctors with the patients they examine in their offices, the seasonal flu is particularly “lively” this year.
“Influenza is ahead in both the number and severity of cases. We have many admissions and serious incidents. Attikon Hospital, we have a large number of patients with influenza,” said Mr. Loukidis.
An increased impact on the community is also recorded from RSV, but also from other infections caused by viruses and bacteria. It is typical that many parents have faced streptococcus infection in their children.
The co-circulation of viruses, however, has not caused the desired interest in vaccination. As health ministry sources and experts emphasise, there is a need to intensify vaccinations for COVID-19.
As of last Wednesday, 177,821 vaccinations had been administered, and more than 42,000 appointments scheduled. The numbers are certainly higher than before Christmas, as many citizens were alarmed by the large increase in infections and made appointments, but they remain low.
In addition, the anti-flu vaccination is also moving in lower… flights compared to the previous winters. In particular, until last Tuesday, 1,583,622 flu vaccinations were carried out with a medical prescription and another 1,217,940 without a prescription, directly at private pharmacies. Experts advise the groups for which the flu vaccination is recommended to get the vaccine even now to have protection for the rest of the winter.