Local Daily News 30th November

The covid passport requirement comes into force on Friday after the endorsement of the Supreme Court

The Fourth Section of the Contentious-Administrative Chamber of the Superior Court of Justice of the Valencian Community gave its approval for this measure that aims to stop the expansion of the pandemic before Christmas and increase the percentage of people vaccinated.

With the approval of the Supreme Court, the measure will begin to be applied on Friday and will remain in force for a month, including all the Christmas holidays. According to the roadmap set by the President of the Generalitat, Ximo Puig, the next step now is to convene the security boards to involve all the security forces in complying with this measure.

Being vaccinated or presenting a PCR or negative antigen test will be a requirement to enter hotels, restaurants and leisure establishments with a capacity of more than 50 people, music festivals and events and celebrations with more than 500 attendees, as well as to visit patients in hospitals and homes, among other activities.

The Supreme Court considers that they are “balanced” measures, since they derive from them “more benefits for the general interest – containment of the pandemic – than damage to other assets or values ​​in conflict”.

The magistrates argue that these measures are ideal to reduce the risk of transmission of the virus indoors in places where it is not possible to make continuous use of the mask.

The resolution refers to the scientific data collected in the epidemiological report provided by the Generalitat, which supports that the risk of infection is lower among vaccinated than in non-vaccinated and that, in case of infection, the transmission of covid is much lower among the vaccinated people.

The measures, therefore, are necessary, since no others are known “to achieve the purpose with equal efficiency”, and they are “essential if the objective of reducing or -at least- minimizing the increase in the transmission of the virus is to be achieved”, specify the court.

In addition, the requirement of the covid certificate seeks to avoid reaching “the stage of new restrictions on fundamental rights much more intense than the one in question here” and the announcement of its implementation has already encouraged vaccination.

The measure is equally proportionate – continues the Superior Court – because “it will hardly affect economic activity” and even “may facilitate it”, so that it obtains “a good fit of the two most important pieces of this unusual puzzle that represents the current pandemic”.

One of the incongruities of the covid passport is that it will limit access to the premises of hotels, hospitals and nursing homes for those people who are not vaccinated, but on the contrary, it will not be possible to act on those workers of these establishments who have not wanted to be immunized . Only in the case of nursing homes, this figure represents 6% of employees. A situation that has a bad legal fit “because one thing is to carry out a voluntary activity, such as entering a bar or a restaurant, and quite another is that the continuity of your work depends on something that is not mandatory, such as vaccination,” Points out Carmen Viqueira, professor of Labor Law at the University of Alicante.

In this sense, she believes that a national regulatory umbrella would be necessary to try to force workers to be immunized, since this measure cannot be accommodated in current occupational risk prevention regulations. “The current legal framework is not designed for such complex situations,” says Viqueira, for whom the only possibility is that vaccination is mandatory in the field of public health, through the mechanisms contemplated by the organic laws of 2011 and 1986, so its application in any case depends on the regulatory changes that the central government could make.

One in five unvaccinated people in the province lives in the Torrevieja health area

89.5% of the population in the province of Alicante has been vaccinated against the coronavirus. However, there are regions in which the resistance to immunization is higher than in others.

This is the case of the department of Torrevieja, where 18% of the population of the health department has not been vaccinated against covid. There are a total of 30,811 people from the ten municipalities that make up the coastal area. Or what is the same, 82% of the population of the department – 133,565 residents – has the complete vaccination course. The data corresponds to the set of the municipalities of Torrevieja, Orihuela Costa, Pilar de la Horadada, Rojales, Guardamar del Segura, San Miguel de Salinas, San Fulgencio, Los Montesinos, Benijófar and Formentera del Segura. In the entire province there are 177,011 people who, even having the opportunity to be immunized, have not done so. Of them, 17% live in the Torrevieja area.

While the department drags vaccination percentages that are ten percent below the average for the Valencian Community, a circumstance that is explained, in part, by the demographic relevance of the communities of foreign neighbors, the rebound of the pandemic advance as the Torrevieja University Hospital has 17 patients admitted with covid in hospitalization and three in the Intensive Care Unit (ICU). In the last week two people have died from the infection in the department. The accumulated incidence is close to 200 cases for every one hundred thousand inhabitants in the department, compared to 55 in the Orihuela area, and has especially affected schools, where there are more than five hundred students from municipalities in the area currently confined.

This is the data of the last balance that the Torrevieja health department has made, more detailed than the one transferred by the Ribera concessionaire on the covid situation. In them, the number of residents (by age group) in whom the disease causes complications, hospitalizations, ICU admissions and death who have decided not to attend the appointment to get vaccinated, is striking: of the 30,811 residents with a health card who have not been vaccinated, 1,288 are over the age of eighty; 3,275 are between 70 and 80; 1,410 are between 66 and 69, and finally 2,278 are between 60 and 65 years old.

On the other hand, vaccines continue to demonstrate their high efficacy against the coronavirus almost a year after the first doses began to be administered in Spain. Vaccine protection against severe covid infection – the possibility of being admitted to the ICU or dying from the virus – continues to be very high, around 85% with new mutations. On the other hand, what has fallen is the percentage of protection against infection, which was originally 75-85% and six months after vaccination it is around 50% with the delta variant, which is the one that has colonized the entire territory. The data has been revealed by Salvador Peiró, a researcher from the Fisabio Department of Public Health, during a scientific conference on the Valencian Covid-19 Vaccine Research Program (ProVaVac) that was held at the Ministry of Health.

“The effect is being lost in terms of protecting from infection but it holds up very well with respect to developing a serious case of covid,” he stresses, hence the importance of third doses “because they significantly reduce transmission as we are seeing in Israel and reduces severe cases somewhat. To those who are more at risk, the sooner the better,” he added.

Thanks to this effectiveness of the vaccines, Peiró believes that we are much better than last year. “The growth is sustained… If we end up having a lot of cases, there will be complicated cases, but less than last year.”

In this sense, Peiró believes that the priority at the moment is to focus on vaccination with third doses, before even vaccinating children, a campaign that could begin in January if the authorizations of the corresponding health agencies continue their course.

First case of omicron variant detected in Spain, in a traveler from South Africa

Spain is seeking to protect itself from the new variant of the coronavirus, which has been designated omicron. The mutations in the virus detected a week ago in South Africa and Botswana have been identified in half-a-dozen or so European countries, and Spanish hospitals are already searching for them.

On Monday, the microbiology department at the Gregorio Marañón Hospital in Madrid confirmed the first case detected in Spain so far of the new variant. It was found in a traveler who had arrived from South Africa. “We managed to use an ultra-fast procedure that permits us to get the result in the same day,” the hospital’s laboratory explained via its Twitter account. “The patient is doing well.”

As the search for this variant progresses, today the Health Ministry strengthened controls on all passengers arriving in Spain from the south of Africa: those traveling from South Africa, Botswana, Eswatini, Lesotho, Mozambique, Namibia and Zimbabwe will have to quarantine for 10 days.

Given the uncertainty over the effects of this new variant – for now it is unconfirmed as to whether it is more transmissible, causes more serious illness or could evade the protection offered by the vaccines – the Health Ministry has also strengthened controls for risk countries. Until now, anyone arriving in Spain from a country with growing infection numbers or where variants of concern are circulating had to show a certificate proving they have been vaccinated, have recovered from Covid-19 or have tested negative. From now on, according to an order published on Saturday in the Official State Gazette (BOE), arrivals “will be required, regardless of their vaccination status or if they have previously had the disease, to present a diagnostic certificate of active Covid-19 infection with a negative result.”

On Monday, another order was issued to put travelers from the aforementioned seven countries in quarantine on arrival in Spain, “with or without intermediate layovers.” “During the quarantine period, [travelers] must remain in their home or accommodation, limiting their movements, as well as access of third parties to the home or accommodation, to those essential for the carrying out of the following activities: acquiring groceries or pharmaceutical and essential products, attendance of healthcare centers, services and establishments, and for reasons of force majeure or situations of necessity,” the text reads. The order allows the quarantine to be reduced from 10 to seven days if a test comes back negative after a week.

At the same time, hospital laboratories in Spain are actively trying to locate the new variant. The European Union has called on member states to begin sequencing between 5 and 10% of diagnostic test results. This is the proportion that they consider sufficient to detect a mutation that is already circulating in a territory. Since August 9, Spain has sequenced an average of 5.9% of positive results, according to data from the Health Ministry. Depending on the week, the figure has swung between 2.5% to 8.5%. In a context of low diagnostic testing, as has been the case over this period, it is easier to sequence a high number of samples, given that this is a process that can take some days. When the wave of infections rises, hospitals can sequence a smaller proportion of cases.

As the sequencing process can take up to two days to complete given its complexity, current PCR tests can get ahead of this work by detecting the presence (or absence) in just a few hours of particular mutations in the analyzed sample. This allows for the suspicion that a new case detected could correspond to the variant identified a week ago in South Africa and Botswana.

The PCR test from the Thermo Fisher brand, for example, looks for mutations in three different parts of the virus. Juan Carlos Galán, the head of virology at the Ramón y Cajal Hospital, explains: “The first information that we have indicates that a mutation of the new variant means that the PCR test does not detect the S gene. If a sample tests positive for that gene, then it is definition that this is not the omicron variant. But if you get a negative result for the S gene and a positive one for the other two targets, that allows for the suspicion that it is. This is a warning, an alert, although it can’t be ruled out that other variants could give the same result, meaning that genetic sequencing will always be necessary.”

Not all hospitals in Spain, however, use the Thermo Fisher PCR test, given that it is just one of those available in the market. Other large healthcare centers use other systems and some use several at a time. But the cumulative experience and the knowledge of how the mutations in each variant are combined allow for something approaching a trustworthy result. The San Cecilio Hospital in Granada, which has a leading Microbiology department in eastern Andalusia, developed another system that allowed for the identification of the delta variant by focusing on two parts of the virus.

Federico García, the head of microbiology at the San Cecilio, explains: “The results that we get with the delta variant, which currently account for more than 90% of positive cases, will be different with omicron, which lacks the target mutations used for delta. This would allow us to suspect an omicron case, although it would have to be confirmed via genetic sequencing, which is still the benchmark test.”

The number of minors treated for eating disorders increases by 44% compared to 2020

The healthcare resources of the Ministry of Health have attended from January to October 2021 to 14,444 patients with some type of eating disorder (ED). Specifically, during this period of time 10,476 women attended compared to 3,968 men. Every year, on the 30th of November, the International Day against Eating Disorders is celebrated.

According to the evolution of the figures, the profile of the patient who comes to healthcare services for an eating disorder is that of a woman aged between 15 and 19 years. In fact, although the figures for 2021 do not cover the entire year, there is already an increase of 43.93% compared to all of 2020 in minors who have needed health care for these pathologies.

Thus, from January to October, 1,845 people under the age of 15 to 19 were treated (1,517 women and 328 men). The increase is observed in adolescent women, who in the year 2020 of the onset of the pandemic were attended to 1,054 aged between 15 and 19 years, and in 2019 there were 935 minors.

The public health system of the Valencian Community takes care of eating disorders through mental health resources, and also has three specific units and hospitalization for the care of this type of disorders, one in each province.

In this sense, during the first ten months of this year almost 29,000 consultations have been attended: 18,148 for anorexia, 10,368 for another type of eating disorder and 370 consultations for hyperphagia. For its part, in 2020, 26,712 ED inquiries were attended and in 2019 there were 31,648.

Regarding new diagnoses, so far this year there have been 562 new cases of anorexia nervosa, 501 new cases of bulimia nervosa, 565 of another type of eating disorder, such as compulsive ingestion, and 1,184 new cases of unspecified eating disorder. In total, 2,812 new cases of ED.

The coronavirus pandemic has influenced the appearance of cases of eating disorders, although from the healthcare services, specifically, during the confinement the rhythm of care has been maintained thanks to online resources.

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