The advance of vaccination against covid-19 across the country, coupled with the decrease in hospitalizations and the number of deaths, has brought some relief to the medical community and, mainly, to the population.
However, experts consulted by Live well draw attention to the recent increase in the number of cases of covid-19 and warn of a still uncertain future. For them, some basic guidelines remain the same, such as keeping the vaccination schedule up to date and proper hygiene. Next, see what are the prospects for the coming months.
Is there a risk of a new wave of covid-19?
Until the beginning of this week, the country had another 10,606 new known cases of the disease and, for two consecutive days, the indicator registered an upward trend.
“We are in a context where protection measures are being relaxed and the threat is forgotten. It is very natural, unfortunately, that there is an increase in the number of new cases”, says Eduardo Sprinz, head of the Infectious Diseases Service at the HCPA (Hospital de Clínicas de Porto Alegre).
Even so, the infectious disease specialist, who is also a professor at UFRGS (Federal University of Rio Grande do Sul), believes that what we have today, in terms of vaccination and drugs that are emerging, such as paxlovid, incorporated by the Ministry of Health in the last Friday, are enough to contain the severity of cases and prevent a new wave of covid-19.
Raquel Stucchi, infectious disease physician at Unicamp (State University of Campinas), shares the same opinion. “We should no longer have as important an impact on health as we had in those two years. Vaccination should be able to contain an exponential increase”, she says.
But, in any case, this does not mean that if cases continue to rise there will not be a significant increase in the number of hospitalizations and, consequently, deaths. Therefore, prevention is still essential.
Are all doses really necessary, until the fourth?
Yes, because so far, an immunizing agent that protects for an indefinite period has not been developed. And it is known that, on average, immunizers protect against Sars-CoV-2 for about six months.
In addition, some experts say that, due to the emergence of new strains, at least three doses must be given so that the disease does not progress to more severe forms. This is for the general population.
For the most vulnerable, such as the elderly, who have a lower immune response compared to other groups, the recommendation is unanimous: everyone should complete the vaccination cycle in accordance with the guidelines released by health agencies. The same is valid for immunosuppressed and the like.
“In these cases, four doses will be necessary for adequate protection”, warns Sprinz, noting that the only way for this scenario to change is for more specific antivirals to be developed for covid-19.
For the infectious disease physician at Unicamp, who is also a consultant for the SBI (Brazilian Society of Infectious Diseases), the recommendation of the fourth dose of the vaccine for these populations is practically mandatory. “Immunization with this fourth dose aims to reduce the risk of these people becoming seriously ill, requiring hospitalization, ICUs and eventually dying”, warns Stucchi.
Which vaccine is recommended for the elderly?
The elderly should preferably receive messenger RNA vaccines, such as Pfizer, as they provide a better immune response against the pathogen for this population.
“Messenger RNA vaccines should be reserved for this group, because the elderly have a smaller response that lasts less time. If they are not available, it could be something else, but the booster should not be done with CoronaVac”, emphasizes Stucchi, remembering that “CoronaVac is a great vaccine in terms of effectiveness for young people, but we currently have safer options for the elderly.”
What should be done to increase the percentage of vaccination?
Currently, according to the Ministry of Health, about 41% of the population has been vaccinated with the third dose of the vaccine. The fourth dose, which includes the elderly and immunosuppressed, was applied in only 16%.
For experts, there must be effective campaigns to combat fake news, that is, false news that appears daily associated with immunization against covid-19.
“We need to reinforce the information that the vaccine is safe and protects against evolution to more serious forms. This information needs to be evidenced in all areas”, says Sprinz, from Porto Alegre.
In general, better vaccination coverage depends on educational campaigns and better access for the population, such as more health posts that apply the vaccine and expansion of service hours, including on weekends.
New variants are constantly emerging, such as the omicron XQ subvariant, is there cause for concern?
Specialists recall that the delta variant dominated the contagion for about a year. Omicron also has a high degree of transmissibility, proof of which are the subvariants that keep appearing.
“It is expected that the ômicron will dominate for a long time”, evaluates Sprinz, noting that the fact that we have been infected once with an “X” variant will not prevent a second or third contamination.
The infectious disease physician at Unicamp also highlights possible scenarios with the emergence of new variants. “When we have new variants, we may have some that escape the vaccine’s ability to protect, that are even more transmissible or that do not respond to the action of medications that are useful to prevent the disease from worsening.”
However, the expert says that new variants are always an unknown, that is, it is not possible to define their severity. “But having new variants is always a concern,” says Stucchi.
We make preventive measures more flexible; what to expect then for the next few months?
Experts still don’t know exactly what the next few months will be like, but there is a consensus that, if vaccination continues to be applied en masse, according to guidance from health bodies, we will be in an even “more comfortable” scenario.
“We really have to move towards making prevention measures more flexible, such as removing the mandatory use of masks. With vaccines and specific antivirals we are relatively safe and serious cases of ômicron will hardly happen, for example”, reports Sprinz, infectious disease specialist and professor from UFRGS.
But flexibility is only welcome, according to experts, in places where there is already a large vaccination coverage. “In the North of the country we still only have 40% of the population vaccinated, so the use of masks should be maintained, at least now, in this autumn-winter season, because it is a period in which there is greater circulation of all respiratory viruses and for all of them, the use of a mask greatly reduces the risk of transmission”, explains Stucchi.
For the coming months, in general, it is expected that vaccination will have better adherence, especially for those considered at risk, so that the number of cases of the disease does not rise again and result in hospitalizations or death.
“It is still a moment of caution, in which we must maintain or improve testing and be on the lookout for a possible increase in the number of hospitalizations”, concludes a professor at Unicamp.
Another source consulted: Sylvia Lemosinfectious disease physician, consultant in biosafety and risk infection control, full professor of tropical medicine at UFPE (Federal University of Pernambuco) and member of SBI (Brazilian Society of Infectious Diseases).