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Many of the questions we had about him COVID-19 at the beginning of the pandemic they have been resolved over the months. Today, about two years after the first cases in China, several countries are already vaccinating their population and are facing new waves, but now with new tools to deal with the virus.

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Thanks to science we have known, for example, which are the populations most at risk, how important vaccines are to save lives and avoid saturation of the health system and how SARS-CoV-2 is transmitted.

Although in recent months the cases and deaths from COVID-19 have remained low, the Minister of Health Hernando Cevallos has reported a worrying increase in positives: “We are advancing dangerously in a growth of cases, we can’t speak we’re in a third wave yetBut you do have to be very careful, especially because the holidays are coming and we don’t want it to generate the problems we’ve already had ”.

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In this note, we summarize what we know about the disease so far:

We know how the virus is transmitted

Airborne droplets and aerosols can transmit the virus.  (GETTY)
Airborne droplets and aerosols can transmit the virus. (GETTY)

At the beginning of the pandemic, the focus was on transmission through respiratory surfaces and droplets that people expel by coughing or sneezing. Therefore, it was recommended social distance and the use of masks, since they could not travel beyond two meters, and the danger was considerably reduced if a mask was used.

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Over the months, the researchers analyzed outbreaks that could not be explained by these elements alone. So, airborne transmission emerged as a possibility. Aerosols, small particles expelled when speaking that remain in the immediate environment of the infected person, were identified as responsible, and then more and more evidence pointed to this as a major vehicle for contagion. The experts asked to give it due importance.

Now, bodies like the US Centers for Disease Control and Prevention. support airborne transmission: “COVID-19 spreads when an infected person exhales droplets and respiratory particles very small that contain the virus ”. The WHO did the same after more than 200 scientists urged the institution to give due importance to this route of transmission.

In this way, to the use of masks, social distance and hygiene, the importance of the ventilation of closed spaces to prevent aerosols from concentrating in one place and infecting people.

“Environmental and technical controls are essential to reduce the concentration of infectious respiratory aerosols (ie nuclei of respiratory droplets) present in the air and the contamination of surfaces and objects”, points out WHO regarding the prevention of contagion.

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We already have vaccines

Health personnel prepare a dose of the Pfizer / BioNTech vaccine against the COVID-19 coronavirus in a private school in Quito on September 13, 2021. (RODRIGO BUENDIA / AFP).
Health personnel prepare a dose of the Pfizer / BioNTech vaccine against the COVID-19 coronavirus in a private school in Quito on September 13, 2021. (RODRIGO BUENDIA / AFP).

One of the most repeated phrases in recent months is that vaccines save lives. And this is a fact that has been known for decades, but made more sense during the COVID-19 pandemic.

Scientists knew from the beginning that vaccines would mark a turning point in the health crisis, which forced millions of people to stay at home and put health systems in emergency. Today, with several vaccines approved in the world, the different vaccination programs in the world show that immunization is the most effective health intervention available to face the coronavirus. In the world, 53.8% of the world’s population has received at least one dose of the vaccine COVID-19, according to the One world in Data platform of the University of Oxford.

The countries that made the most progress in immunization soon showed that the number of hospitalized and deceased fell dramatically. This is the case of Israel, the United Kingdom and Chile, for example. Although access is uneven, the data shows how efficient they can be. A report the CDC found that a vaccinated person was 11 times less likely to die and it is 10 times less likely to be hospitalized, even compared to the Delta variant, the most contagious to date.

Vaccine Efficacy for hospitalization
Modern 95%
Pfizer 80%
Johnson & Johnson 60%

[Fuente: CDC]

Although their protection against contagion decreased due to the variants, reports from entities such as the World Health Organization and the US Food and Drug Administration (FDA) have reiterated that currently available vaccines continue to be effective in what it matters most in a pandemic: preventing deaths and hospitalizations. Why? Because in this way hospitals and people are not saturated, if they have symptoms, they can cope with the disease at home or with non-intensive medical care.

There is data generated in the country

But Peru already has local data that demonstrate the effectiveness of vaccines. Studies carried out in health personnel, who were first immunized with the Sinopharm vaccines, show that they had 94% effective in preventing deaths. This when the dominant variants were Lambda and Alpha, also more contagious than the original.

Other studies carried out by the Ministry of Health, not yet published in detail, place the effectiveness of the vaccines used in the country above 90%, both to prevent hospitalizations and deaths.

A study published in early October in the journal The New England Journal of Medicine reported the results of the Oxford / AstraZeneca vaccine clinical trials, which were also conducted in Peru and enrolled 1,400 compatriots. The researchers reported that the viral vector vaccine has an overall efficacy of 74%.

The experts consulted by El Comercio highlight that, in the face of a third wave, it must be taken into account that more than 60% of the population is immunized, especially the population at greater risk of severe COVID-19, and that many of they are already receiving an additional dose. Also, there are people who have natural immunity (those who had the disease), which leaves a smaller space for the virus to circulate. However, as we explained in a previous report, this does not mean that there will be no groups at risk. It is possible that what happened in other countries will happen: the new waves will be unvaccinated. Furthermore, as we have shown in other reports, it is young people who are currently occupying more and more intensive care units.

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Knowledge of physicians

A COVID-19 patient at the Sabogal Sologuren Hospital in July 2020. (Photo: ERNESTO BENAVIDES / AFP)
A COVID-19 patient at the Sabogal Sologuren Hospital in July 2020. (Photo: ERNESTO BENAVIDES / AFP)

When the coronavirus emerged in late 2019, the disease it caused didn’t even have a name. Then the WHO called it COVID-19. Doctors used the tools that were available at the time to try to care for people who were aggravating. There were no treatments. Knowledge about hospital management of patients was under construction.

Now, after several waves of epidemics, doctors have a better understanding of what works and what doesn’t. Very popular options early in the pandemic, such as ivermectin and hydroxyloquine, have been ruled out. It is known that the monitoring and early detection of the decrease in blood oxygen saturation is key. Too it is known that access to medicinal oxygen is essential, as well as the correct administration of drugs that have proven their efficacy such as corticosteroids, which should only be applied when the patient is in a hospital environment.

Treatment alternatives

Roche is testing a monoclonal antibody-based COVID-19 treatment.  (Photo: Getty Images)
Roche is testing a monoclonal antibody-based COVID-19 treatment. (Photo: Getty Images)

Recently, countries such as the United Kingdom and the United States have approved emergency therapies. On the one hand, there are monoclonal antibodies for mild or moderate patients at risk of getting worse, which reduce the chances of hospitalization and death by up to 70%; and, on the other hand, interleukin 6 antagonists for serious or critical patients, which reduce death and the need for mechanical ventilation.

Some alternatives are in clinical trials that seek to prevent a person from getting worse. It is possible, scientists say, that by the end of this year new treatment alternatives will be available, among them the therapies developed by Pfizer and AstraZeneca. The fundamental thing, say the experts consulted by this newspaper, is that the country also have access to these new treatments.

Recently, the first pill against COVID-19, the antiviral Lagevrio (molnupiravir), an oral drug for adult patients, has already been approved in the US and the EMA is considering granting it the European license.

Clarification: This report was originally published on September 19, 2021 and has been updated with recent information regarding the statements of the Minister of Health.

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