Specialists call for change in way Covid is ‘monitored’ in Portugal

Specialists are calling time on the daily Covid bulletins that bombard citizens with numbers every day.

An article in Expresso this weekend explains that Omicron has changed the landscape.

“It makes no sense to continue to count all the positive cases”, says the paper, because the variant, albeit highly transmissible, leaves the vast majority of  its ‘victims’ unscathed.

Once this winter ‘wave’ is over – or at least settled – it will be time to ring the changes, start monitoring the virus in much the same way authorities monitor strains of flu.

Gustavo Tato Borges, president of the national association of public health doctors (ANMSP), tells Expresso: “I predict that from Spring or Autumn, Covid-19 will become integrated into the weekly flu bulletin, dispensing with daily vigilance and focus on cases. It will be a normal winter illness”.

“In this scenario, anyone who has a positive self-test will only have to stay at home to recover from symptoms (if they exist) – and it would only be in the case of not improving that it would be necessary to get in touch with a doctor.

“The whole of Europe will make this transition in 2022”, Tato Borges ventured, suggesting “Portugal will be a pioneer due to its (very high) level of vaccination”.

According to Expresso, Tato Borges’ thinking is echoed by “various” peers: João Tiago Guimarães, a pathologist at Porto’s Hospital de São João is all for starting to prepare for a “different approach”.

People who have no symptoms should not count, because if they have no symptoms, they are not ill – and thus they do not need to resort to seeking healthcare”, he told the paper.

Indirect monitoring of the SARS-CoV-2 virus has actually been performed weekly in Portugal since October 2020.  Every Friday wastewaters coming out of Porto and Gondomar are checked for the presence of the virus. It is an initiative that involves ISUP (the Porto Institute of Public Health), the Interdisciplinary Centre for Marine and Environmental Investigation and offshoots of Águas do Norte.

“The results have tallied with the number of cases registered (by the DGS)”, says  ISUP epidemiologist Milton Severo.

Investigators have also created a sentinel surveillance project, using certain schools to give a picture of how outbreaks are affecting the sector on a nationwide basis.

According to Portugal’s experts, Spain is already thinking along the same lines. Indeed, Spain is understood to have set up a sentinel surveillance project for the healthcare system.

It’s the same strategy used in Portugal to monitor flu – and it would be “very easy to adapt” to Covid-19 after the winter, says Tato Borges – adding that for the time being the DGS is not discussing, and never has discussed the pandemic with his association.

Filipe Frões is another of the country’s experts – a little notorious these days (click here). But on this topic he is totally supportive of Tato Borges et al.

“It is not a question of knowing if we are going to change (the system of monitoring), it’s a question of when”, he told the paper. “It makes no sense continuing to count all the cases as we have been doing up till now”.

The DGS nonetheless “did not respond to Expresso’s questions on these possibilities”, said the paper.

It is not as if the experts have said anything particularly groundbreaking. Virologist Pedro Simas – a still familiar face on national television screens, but less ‘rolled out by authorities’ than some of his peers – has been saying as much for weeks (click here).

The problem appears to be how to handle a measured ‘throttling back’ of the apocalyptic narrative.

“To alter the strategy now could bring more risks than advantages”, concedes Filipe Frões… but to continue with the current approach could equally put unnecessary strain on the heaving health system (many hospitals have been affected by the rules that send any positive cases (among staff members) home for seven days, whether they have symptoms or not).

Says Expresso, those in the business of making ‘calculated predictions’ see the current ‘wave’ of Omicron infections peaking between January 20 and 24.

“Only after this should the transition to a new system of monitoring be done, agree the experts” – which, coincidentally, should tie-in fairly neatly with the elections, and the emergence of a new government.

LABYRINTH OF RULES

This is the next issue. With all the twists and turns of the last two years have come “a labyrinth” of health authority ‘normas’ (rules).

GP Rui Nogueira tells Expresso that doctors find themselves wading through 30 pages of PDFs, trying to work out exactly what they are meant to do ‘when/ if’ etc. “We need to have more speed, clarity and accessibility (to the rules)”, he said. Other countries have managed to change with the times (he cited Scandinavian nations and the United Kingdom). “Portugal should follow the examples”.

This new phase as SARS-CoV-2 passes to becoming endemic, should “give greater capacity to self-evaluation of risks, by making ‘easy-to-understand’ tools available to people in real time” he said.

As Expresso stressed, so far no confirmation has come from the DGS health authority on this issue – and daily bulletins are released by all media channels in the same ominous tones as they were in the early days of the pandemic when case numbers were far lower, but deaths and hospitalisations many times higher.

natasha.donn@algarveresident.com