Faced with increasing cases, Spain adapts its influenza surveillance system to Covid-19 | Society


As the highly transmissible omicron variant of the coronavirus continues to spread in Spain, authorities are finalizing a plan for a new Covid-19 surveillance system that will mirror one that has been used for years to monitor influenza. The new system will extrapolate numbers from a statistically significant sample, rather than relying on daily reporting of each infection diagnosed.

The system comes as the number of cases in Spain continues to hit new records: on Friday, the health ministry reported 242,440 new infections. More than seven million cases of coronavirus have now been detected since the start of the pandemic. Speaking on Friday, Spain’s Prime Minister Pedro Sánchez said most of the recorded cases were asymptomatic, adding: “We’re going to have to learn to live with it. [the coronavirus] as we do with many other viruses.

Health officials have been working for months to adapt what’s called sentinel influenza surveillance. In the new system, there will be no more reporting of every infection diagnosed, and tests will no longer be performed for any symptoms. The coronavirus will be monitored like any other respiratory disease.

A group of health professionals from primary care centers and hospitals will be created to monitor the situation. The goal will be to create a statistically significant sample with information collected across the country, as is done with surveys. This will help determine how the disease spreads – both in its mild and severe forms – by extrapolation rather than a careful count of cases.

The strategy has been in development since summer 2020 and is now entering its final phase. A representative sample of officials from the Health Alert and Emergency Coordination Center (CCAES), the National Epidemiology Center (CNE) and the Ponencia de Alertas, which includes regional health technicians, will meet several times this week. to discuss when and how the new surveillance system is expected to come into effect. There is no date set yet, although the transition is not expected until the current wave ends.

“Given how extremely transmissible Covid is right now, it is a huge challenge to strictly adhere to universal surveillance protocols; it becomes impossible, ”said Amparo Larrauri, head of the influenza and other respiratory diseases surveillance group at CNE. Reflecting this difficulty, the protocols have already been relaxed in Spain, where close contacts of positive cases no longer need to be tested unless they show symptoms.

“Faced with this new reality, we are working to move from universal surveillance to sentinel surveillance of mild respiratory infections in primary care centers and severe in hospitals. But you can’t change things overnight. We have international commitments [to report all cases] and sentinel systems must be consolidated, ”she added.

Five Spanish regions have launched pilot programs in their primary care centers and nine have introduced them in hospitals. “With consolidated surveillance systems, we could probably gather better and better information and avoid what is happening now,” said Larrauri, speaking of the current pressure on the primary health system and the difficulties of reporting new ones. case with the highly transmissible omicron variant.

The sixth wave has not yet reached its peak and could still overwhelm hospitals. Although mass vaccination and mutations in the virus lead to milder cases, the large number of infections is also responsible for high volumes of hospital admissions. As of Friday, there were 14,426 patients, more than the peak of the fourth and fifth waves. Of these, 2,056 were in intensive care, more than at the peak of Wave 5 (2,031) and near the peak of Wave 4 (2,356).

Iván Sanz, head of the National Influenza Center in Valladolid, noted that treating Covid-19 like the flu does not mean minimizing its importance. According to an estimate by the Carlos III Health Institute, influenza caused around 15,000 deaths, directly or indirectly, during the 2017-2018 season, for an average of 41 each day.

Back to school

Secondary school students from the Valencia region.Monica torres

Spanish children returned to school on Monday after the Christmas holidays in an uncertain situation. Workers in all sectors of the economy have been infected – sick leave increased sevenfold in December – and teachers are no exception. The Education Ministry has admitted there will likely be an increase in teacher absences due to illness, but hopes the trend will slow down by the end of January.

Whether schools are ready to deal with these staff shortages is another story, and the majority opinion among teachers seems to be that they are not, especially in areas where the number of substitute teachers has been reduced. reduced. Madrid and Andalusia, for example, announced last year that they would have respectively 7,679 and 5,300 fewer teachers this academic year compared to 2020-2021.

Spanish schools will also not carry out routine tests on teachers and pupils, as is the case in other European countries. Only the northeastern region of Catalonia has said it will test close contacts of those infected. And last week, a meeting of central and regional health officials decided that from now on, an entire class would only be quarantined if there were five or more positive cases among the group of students. The move affects preschool and elementary education, where children remain largely unvaccinated.

For comparison, students in France who are close contacts of a positive case have to take a free test, while in Germany students get tested every week and in Italy there will be screenings at large scale in educational centers.

“We do things on the fly, without being informed. There should be a complementary strategy from the regions to, say, test teachers and students, but there is absolutely nothing, ”said Vicente Mañes, president of the association of directors of public schools. Mañes said that in Spain, schools are not seen as a place of learning but rather a place to help families reconcile their family and work needs.

“We must quickly carry out PCRs on students and teachers, and find immediate replacements for those who are sick,” added Juan Villegas, teacher at Maestro Juan de Ávila secondary school in Ciudad Real. “Without such measures, the decision to keep schools open is effective from a social standpoint, but not from an educational standpoint.”


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