Uruguay is in a fight between two forces. While the number of daily COVID-19 infections does not subside and they number in the thousands, the number of vaccinated population begins to show some results that the government defends as auspicious, although immunization will still not be enough to lower new cases per day. In this the variant P1 is a determining factor.
The immunologist Álvaro Díaz explained to The Observer that this strain “at a certain point” escapes neutralizing antibodies generated by vaccines. On Sinovac, for example, the level of antibodies that these doses generate falls four times in front of P1 and although the effectiveness data presented by the Ministry of Public Health (MSP) about this vaccine “is very good news”, it is for the reduction of severe infection causing ICC admissions or death.
And that is the expected scenario. When vaccination began, both the MSP and the National Vaccination Advisory Commission (CNAV) explained that the plan had, basically, three objectives: reduce the mortality, paintings graves and the pressure on him Health System, which was prioritized and vaccinated with Pfizer.
“There is a 95% prevention number for ICU admission, it is a very good level of protection in the context of Uruguay “, Diaz considered about the Sinovac vaccine.
The impact of vaccination on ITCs
Then, When will that effectiveness begin to translate into a reduction in intensive care admissions? For the president of the Uruguayan Society of Intensive Medicine (SUMI), Julio Pontet, you can start to descend when the 45% or 50% of the population has achieved full immunization, that is, when 14 days have passed since the application of the second dose. For the intensivist “it is difficult” to anticipate when that moment will be, but the truth is that in the next two weeks there will be no decline.
Díaz agreed with that forecast. “Possibly that descent you could see when 45% are fully immunized “, He said.
Although, the expert clarified that to specify a date it is necessary to do a data analysis. “Guessing, over the course of next month we can start to see CTI’s revenue drop.” as an effect of vaccination because the effectiveness data reported by the MSP “guarantee that the two main vaccines used by Uruguay” have an “enormous” level of protection to avoid entering CTI, even in a scenario where variant P1 is predominant, he pointed.
Even, the immunologist remarked, it is possible that vaccines are already avoiding some income to CTI, but the number of daily infections does not allow us to clearly visualize this phenomenon. The decline will largely depend on vaccination but also on the number of cases there are.
In some countries the decrease in serious pictures that require hospitalization in intensive care, began to be seen when 40% of the population was fully vaccinated. But, in Uruguay that scenario “seems too optimistic”Due to the high community circulation of the virus, the correlation of the increase in cases with that of admissions to CTI and the incidence of variant P1, Pontet explained.
“Israel considered that it had a 58% herd immunity, but we we are against the worst variant, in principle, because it is more contagious, “he exemplified. In turn, Israel vaccinated its population with doses of Pfizer, which are more effective than those of Sinovac, which Uruguay applied in a majority way.
When the percentages of vaccinated in the population begin to increase, “the need for admission of fully immunized patients to ICCs is going to be a rare event”Pontet considered.
Until now, Uruguay has been vaccinated with two doses at 28.23% of the population, according to data from monitor of vaccination of the MSP. In total, that number represents one million people; to reach the 45% proposed by Pontet and Díaz, it will be necessary to vaccinate about 600 thousand more people.
For both experts, it will not be necessary to reach 70% of the fully immunized population so that the serious pictures of covid-19 begin to decrease, but, the other side of the coin is that this percentage will not be necessary for the infections to decrease.
“Herd immunity is a long way off,” Diaz said and added that with the level of effectiveness demonstrated in the MSP study –which is 57% reduction of infection for Sinovac and 75% for Pfizer– “It is very difficult for us to achieve a herd immunity.” In this ideal, everyday life can dispense with non-pharmacological measures – such as the use of a mask and social distance – and it is a moment “in which vaccines hold their own”.
But, in the context of Uruguay, “even if we had 70% with two doses, with the vaccines that we use and the efficacy that we see, probably it would not be enough with the vaccines alone“, I consider.
While vaccines “they are going to force themselves” to reduce infections, “they will not be enough.” The objective of the plan is aimed at reduce bass pictures and sanitary measures must continue to collaborate with the decrease in cases and even, it will be necessary to resort to a third booster dose.
There is still no scientific evidence on the cross between Sinovac and Pfizer, which are the vaccines that Uruguay acquired in the majority, but those studies “sooner or later will come,” said the immunologist, because other countries, such as Chile or BrazilThey will also be interested in crossing doses to boost immunity.
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