Back-to-school and return to work triggers a spike in Covid infections in Spain

Covid-19 never really went away, and during the summer infections increased, but the return to school and work seems to have meant a significant return of the disease, in Spain and throughout the northern hemisphere, as the World Health Organization (WHO) has already warned.

The increase in indoor activities is the perfect breeding ground for an upturn in infections that is being noticed in the reports of the Ministry of Health and also in the street. Experts say that SARS-CoV-2 is a cyclical virus that will continue to cause waves, but point out that the latest increase in cases has had no impact on hospitalisations, the real measure of the health situation.

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At their meeting last week, experts from the national Ministry of Health and the regions noted that “an increase (in infections) has been detected, which is stabilising”. The department continues to publish the report of the Acute Respiratory Infection Surveillance System (Sivira) every week, which in its latest update, published on Thursday, reported a cumulative incidence rate of Covid-19 in primary care of 114.5 cases per 100,000 inhabitants, which represented a decrease from the previous week, when it was 137.3, but is still well above the 30 cases recorded in the last week of June.

By age, the highest rates are seen in the under-four age group (253.62 cases), a fact that is explained by the start of the school year and by variants, the XBB.1.5 family (a subvariant of Omicron) being the predominant one. However, the increase in infections has not had a significant impact, at least not yet, on admissions. The hospitalisation rate stands at just 3 cases per 100,000 inhabitants, which although far from collapse, does represent a significant increase compared to the beginning of the summer, when it stood at 0.52.

The good news is that the increase in Covid cases coincides with low numbers of people infected by the other two most important respiratory viruses, influenza and respiratory syncytial virus (RSV), but even so, the Public Health Commission has decided to take an important step: the Covid and influenza vaccination campaign, which is being carried out simultaneously, is being brought forward to the last week of September. The target population for this campaign is the over-60s, pregnant women and vulnerable people. In addition, the Vaccines Committee has asked parents to immunise babies against RSV as soon as possible to try to avoid an explosion of cases similar to the one that occurred last autumn and winter.

“This is a disease that comes in waves, some smaller and some larger. It is very important that people keep getting tested and continue with the prevention measures we know about, especially if they are in at-risk environments or live with vulnerable people, which is the population that needs to protect itself the most,” said epidemiologist and paediatrician Quique Bassat, who advised the government on the back-to-school protocol two years ago.

Low impact

Bassat pointed out that the end of prevention measures, such as the elimination of the obligatory use of masks, has had “little impact” on infections, and suggested that the expected increase in infections among children and adolescents at the start of the school and university year will not have a “clinically relevant impact”, i.e. it will not increase the number of hospital admissions, “because we have already seen that younger age groups do not suffer from serious illnesses”.

Although the accounting of cases became more flexible in April last year, when the ‘influenza’ process began, people in Spain are very aware of the need for self-diagnosis. The sale of rapid test kits continues to increase for the ninth consecutive week and represents 556% more than in June, according to the consultancy firm IQVIA, and the use of masks has increased in hospitals and on public transport, although the Ministry of Health is not considering making their use compulsory for the moment. Meanwhile, in many classrooms and offices, ventilation or the installation of air purifiers and HEPA filters, which continue to be supplied by companies such as Mitsubishi Electric, is a preventive measure that began during the pandemic and has been maintained.