Spain proposes treating COVID-19 as an endemic disease and opens the debate

Spain has called for considering the coronavirus as an endemic disease, a position that the WHO and several experts consider premature, but that has opened the debate between governments in need of normality and a medical community that defends keeping its guard up.

The Spanish left-wing government has been the one that has spoken most openly about taking steps to start considering the coronavirus as a disease with which to live normally, like the flu, always clarifying that it was not an imminent step.

Spain “works with the scientific community” to, when the time comes, “move from managing the pandemic to managing a disease that we hope science can make endemic,” reiterated the President of the Spanish government, Pedro Sánchez, at a press conference with his German counterpart, Olaf Scholz.

The variant of the ómicron coronavirus has multiplied cases like no other, but without so many deaths or hospitalizations, which has led many governments to ease restrictions in the midst of the sixth wave, taking a few steps in the direction Spain is pointing to. .

However, the director general of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, replied on Tuesday that the pandemic “is far from over”, warning that “new variants are likely to emerge”.

The WHO also warned against the temptation to downplay an endemic disease.

“Endemic in and of itself doesn’t mean it’s good; endemic just means it’s here forever,” WHO emergencies director Michael Ryan told a virtual session of the World Economic Forum on Tuesday, citing malaria as an example.

Spain is in a good position to open the debate, as it has one of the highest vaccination rates in the world, with 90.5% of its population over 12 years of age fully immunized. “With a high vaccination rate, the pandemic can be better overcome,” German Chancellor Scholz admitted on Monday, alongside Sánchez.

“False illusions”

For Fernando García, from the National Center for Epidemiology and spokesman for the Madrid Public Health Association, to even speak of an endemic at this point “is creating false illusions,” he told AFP.

“We are moving towards making the virus more endemic, but I think we cannot say that we have already reached that situation,” said Marco Cavaleri, head of the European Medicines Agency’s (EMA) vaccination strategy.

There is no numerical frontier of cases that separates an epidemic from an endemic one.

“Epidemia is when there is a very important outbreak of cases, above normal, which is what we have been experiencing since the beginning of 2020. And endemic are cases that may have a seasonal behavior, but that do not put pressure on the health system,” he estimated. Dr Garcia.

Nor is it written that a virus will evolve to cause less damage.

“Future gravity remains a big unknown. There is no law that dictates that a virus must become milder,” said Antoine Flahault, director of the ISG (Institute of Global Health) in Geneva, on Twitter.

Mild symptoms and few hospitalizations

When the coronavirus is endemic, “most people will have mild symptoms, there will be a few who suffer complications that take them to the hospital and die,” said Dr. García.

“It will never happen that a quarter of intensive care unit beds are occupied by covid, not even 5%. It will probably be handled in the field of primary care, “said García.

Spain currently has more than 23% of intensive care unit beds occupied by covid patients, and more than 91,000 people have died since the start of the pandemic in March 2020, 2,610 of them between December 17 and on January 18.

Other professionals, on the other hand, have aligned themselves with the Spanish government.

“Let’s stop visiting and testing healthy people with minor symptoms, let’s stop tracking and testing their contacts, let’s abandon isolation and quarantine,” a panel from the Spanish Society of Family and Community Medicine (Semfyc) wrote in January in a article entitled “Towards the end of exceptionality”.

“All these activities, which made sense in the past, have been overcome with acquired immunity (both by infection and by vaccination) and the arrival of omicron”, they sentenced. (I)