The new Covid-19 is hampering “ahead” decisions. Who to prepare for? / Article / LSM.lv

The Minister of Health Daniels Pavļuts (“Development / P!”) Said on March 2 that serious, proactive measures should be considered in Latvia to prevent the third wave of Covid-19 with the rapid spread of the new, more contagious virus. At the same press conference, where Prime Minister Krišjānis Kariņš (“New Unity”) said that decisions on it would be made in a week. This means that as if the anticipatory decisions are expected at least two months after the discovery of the first most contagious coronavirus variant in Latvia, which was reported on January 10, the LTV program “De facto” reports. In the meantime, it is clear that the rapid spread of the virus will again require an increase in healthcare, testing and analysis of virus samples.

IN SHORT:

• The most contagious variant of Great Britain, which is also in Latvia, is even 50% more infectious.
• In Estonia, too, the deterioration is linked to the new strain of the virus, as well as the easing of premature restrictions.
• NMPD Director Liene Cipule: Predictable morbidity figures seem to be the next impossible challenge.
• The way in which the new type of virus came to us shows that there was a lack of precaution in certain directions before.
• The new variety has been distributed by immigrants.
• Sequencing capacity is increasing by sending some samples to Germany in addition to local capacity; it is organized by the Reference Laboratory.
• The plan of the Ministry of Health is to test more, provide oxygen therapy at home, and, if necessary, equip hospitals even more.
• Previous experience has already taught you – having fun overcoming the virus and relaxing can be a hurry.

Experts have warned of this since the new strain of the virus was discovered in the UK in late 2020. Later in the second half of January, Yuri Perevoshchikov, an epidemiologist at the Center for Disease Prevention and Control (SPKC), emphasized in the Cabinet that the experience of Great Britain, Portugal and Ireland had already shown that the third wave could be much more severe.

The most contagious variant of Great Britain, which is also in Latvia, is even 50% more infectious and in a short time became almost completely dominant in the United Kingdom.

Already at the end of last year, it was observed that under the same restrictions, the number of people further infected with the virus mutation common in this country is 0.92, but for the new variant – 1.45. This means that in one case, under the same conditions, the prevalence is declining and in another, it is expanding.

In Estonia, too, the deterioration is linked to the new strain of the virus, as well as the easing of premature restrictions.

SPKC forecasts that in a similar situation to Estonia, the number of patients in hospitals in Latvia will approach two thousand at the beginning of April. But if as in the UK – more than 2,000 simultaneous patients in the hospital. This would be another challenge for the Emergency Service (EMS) when planning where to take patients.

The main challenge for hospitals is staff

NMPD director Liene Cipule said: “When we started drawing these forecasts in January, looking at the events in Portugal and Great Britain, there was no talk of Denmark yet, there were also problems in the Czech Republic, we modeled these forecasts. And these numbers, compared to the autumn, seem to be the next impossible challenge. Because they are very large numbers. They can be as much as two and three times larger than we could have imagined in the autumn. ”

Although the NMPD and hospitals are more prepared, because investments have been made to be able to install more beds, to provide the necessary equipment, but there is also a ceiling for all this in any case. “Therefore, we cannot say exactly how much resources we will need. We can do the best we can, but we cannot tell people today that we are ready for a very large number of patients.

No, we are not ready for it and we cannot be, because it is not possible to develop all things in such a short time to provide very complex treatment, and mainly because of the staff, ”said Cipule.

Therefore, the healthcare industry strongly insists on restrictions to control the virus. The way in which the new type of virus came to us shows that there was a lack of precaution in certain directions before. This can be deduced from sequencing or study of the structure of viral genes, which allows the detection of viral mutations. It is the variants that are characteristic of Latvia that have disappeared over time, while more and more new ones have been brought in from abroad.

Samples will also be sent to Germany

“In the autumn, we had a wide variety of viruses, about ten, four of which were predominant. Initially, they were brought, but we see that they are developing further in Latvia. Then the surprise came earlier this year when we found that they had all been replaced by one dominant strain of the virus, which is most common in the UK. This also led to the conclusion that there has been a fairly large influx at some point, and it is the migrants who have spread the virus further, ”explained Jānis Kloviņš, Director of the Biomedical Center, where sequencing is performed.

It should be emphasized that this is not a case of the most contagious species, but of mutations in the United Kingdom in general. The particularly contagious variant in Latvia has so far been found in a total of 36 samples. However, a small proportion of positive samples are analyzed in this way, and the source found is mostly unknown, so it is only one step in a single wider distribution chain.

However, sequencing capacity is now increasing, with some local samples being sent to Germany in addition to local capacity, organized by the Reference Laboratory. The first results from there are expected after March 9. True, it also has its own ceiling.

Acting head of the National Reference Laboratory Sergei Nikišin explained: “It is not a simple method – a routine method, but quite complex, which requires not only equipment but also human resources. Also bioinformatics who analyze the data that processes the received sequencing data. We also need to analyze the data from Europe ourselves and draw all our conclusions. ”

However, laboratory experts emphasize that the quantity of sequencing is not so important either.

Rather, its job is to keep up with ever new mutations. However, when they are discovered, it is already a matter of epidemiological analysis and situation management.

Plans to provide oxygen therapy at home

When it comes to preparing for the wider spread of this type (or other new varieties), the Ministry of Health also emphasizes the role of society – what is happening must be taken seriously.

“Unfortunately, there is still a situation where this number of vaccinated people is not so large. Restrictive measures, I would say, are the first step, and only then is the capacity of hospitals. Here everything works in complexes. Here, in principle, everything works according to the principle of connected dishes, ”said Sanita Janka, Head of the Medical Quality Department of the Ministry.

However, she pointed out that from the point of view of strengthening resources, preparations are also underway. More tests will be provided, oxygen therapy will be provided at home, if necessary, hospitals will be equipped even more. True, not everything planned will be done in the near future. For example, the additional equipment of hospitals from the money allocated at the beginning of the year could be fully completed in May, June, because, for example, the purchase of medical equipment takes time.

It should be noted that previous experience has already taught us – having fun overcoming the virus and relaxing can be hasty.

At the end of last summer and the beginning of autumn, Latvia was shown as an example of curbing the virus, and Prime Minister Krišjānis Kariņš told about it on the TV channel CNN. But soon after, Latvia had one of the highest prevalence of the virus in Europe. And what is happening in Estonia now is a similar example.

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