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What are the strategies of Spain and Israel to combat the omicron wave and prepare for the next phase

The Uruguayan government announced on Monday that it will not modify its strategy to combat covid despite the increase in cases, and insisted on vaccination as a way to prevent the advance of the virus, in addition to emphasizing the importance of individual care.

With nuances, it is the same strategy that Israel has applied, which appeals to the vaccine on the understanding that restrictive measures will not be able to stop the incidence of the disease and will only punish the economy. Meanwhile, Spain goes a step further, under one premise: maintain care in the middle of the wave, but begin to project a stage in which the covid is treated as one more contagious disease.

Spain: the end of testing?

The Spanish government announced that plans to change strategy once the omicron wave passes, to start a stage where mass testing is abandoned and a similar approach is applied to the one applied each year in the fight against influenza: not to follow each contagion but to serious cases, and also to establish a series of “sentinel” centers , which serve as a sample to verify if there are increases in the incidence of the disease.

“Faced with this new reality, we are working on the transition from universal surveillance to a sentinel of mild acute respiratory infection in primary care and severe in hospitals. But it cannot be changed overnight. We have international commitments [de notificación de todos los casos] and the sentinel systems must be consolidated, ”” explained Amparo Larrauri, head of the surveillance group for influenza and other respiratory viruses at the National Epidemiology Center (CNE), to El País.

“Now, given the enormous transmissibility of covid, it is a very big challenge to strictly comply with universal surveillance protocols, it is becoming impossible,” explained Larrauri.

Uruguay made the same decision a couple of weeks ago, when it stopped testing asymptomatic people who have three doses and are close contacts. This Tuesday the WHO recalled that, in scenarios where testing is required, it recommends a priority system at the time of testing.

“Neither the health system nor society as a whole can afford to continue testing asymptomatic patients or those with mild symptoms and isolating all those who are positive, with the consequences that this entails at the social and economic level due to the massive sick leave of healthy people. We must end the exceptionality: Covid-19 should be treated like other diseases. Acquired immunity and the arrival of omicron allow it “, resumió in a statement the Spanish Society of Family and Community Medicine

In turn, schools nor they will suspend classes Unless there are five infected children in the same group.

Israel: fourth dose

Israel, facing its own wave due to the omicron variant, offers a fourth dose of vaccine and appeals to the “responsibility” of its citizens, but declined to confine.

The Hebrew state closed its borders after the discovery of the first omicron case at the end of November, but reopened it on Sunday, despite the fact that the authorities face a record of contaminations in a country that was one of the first to vaccinate massively.

What Israeli strategy to deal with omicron?

In the first weeks the government closed the borders “to limit the circulation of the virus, and we succeeded for a month,” according to Professor Cyrille Cohen of Bar Ilan University.

This period was to allow the authorities to prepare to face the wave, encouraging the population to get vaccinated or to administer a booster dose.

But the government has not managed in this period “to develop a better testing capacity,” this public health specialist told AFP.

The number of cases is increasing, with prognoses of two to four million cases in a population of 9 million inhabitants.

The government, estimating that the virus is already circulating in the country and that keeping the borders closed would not change anything – except penalizing the economy -, decided to reopen those borders to tourists.

The authorities have also limited confinement measures, kept bars and restaurants open for people with a vaccination pass, and stopped tracking cases.

Today the strategy is “to transfer part of the government’s management of the crisis to the citizens” who have the responsibility to go or not to certain places, to isolate themselves if necessary or to undergo tests, explains Cohen.

“Even if there were confinement we would have many cases, this is what we have seen in several countries: confinement does not prevent contamination,” emphasizes epidemiologist Hagai Levine, president of the Israeli Association of Public Health Specialists.

For him, the main risk is “political”. “By dint of changing the measures, this creates confusion and a feeling that the government does not control the situation, which is true, because it is not possible to control it” compared to the omicron variant, he told AFP.

The rise in contamination, to more than 37,000 a day, almost four times the worst moments of the crisis before omicron, has put pressure on the health system and personnel

Will the 4th dose help me cope with omicron?

Since December 2020, Israel was one of the first countries to massively vaccinate its population, and after proposing a new dose as of the boreal summer. 80% of the country’s adults have two doses, and just over half have taken three doses.

But as the efficacy of the vaccine declines after several months, the government gave the green light for a fourth dose for vulnerable people.

“The 3rd dose protects against severe cases and death but is less effective against contamination. And it is not yet clear whether the 4th dose increases the efficacy (of the vaccine),” says Levine.

Despite initial data from the Sheba hospital according to which antibodies are multiplied by five for people who recently received the 4th dose, it is necessary to wait a while to determine its effectiveness, according to Israeli experts.

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