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Rapid testing is an important measure in preventing the spread of the virus

Today’s daily press conference on the current situation regarding COVID-19 was attended by Neda Hudopisk, Head of the National Institute of Public Health Ravne na Koroškem unit, Aleš Rozman Director of the Golnik University Clinic for Lung Diseases and Allergy and Borut Štrukelj, full professor at the Faculty of Pharmacy in Ljubljana.

Borut Štrukelj, full professor at the Faculty of Pharmacy in Ljubljana

Borut Štrukelj, full professor at the Faculty of Pharmacy in Ljubljana | Author Nebojša Tejić, STA

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Yesterday, 1,012 patients required hospital care, 20 fewer than on Monday; there were 165 patients in intensive care, three fewer than the day before. Due to technical difficulties at the National Institute of Public Health the previous day, further details were not available.

According to Ms Hudopisk, 6,770 infections had been recorded in Koroška region to 1 February, peaking in the middle of November and again at the end of December. Koroška is home to 3.5 per cent of Slovenia’s population, but on several occasions, the proportion of people testing positive has exceeded more than 10 per cent of cases in the whole country. As the region is small, large shifts in the seven-day average number of cases can quickly occur. Thus, on 31 January, 31 cases were recorded, which indicated the orange phase, but by the following day, they had slipped back into the red phase.

Rapid testing is an extremely important measure in preventing the spread of the virus. Protocols designed for managing various combinations and cases that can occur during rapid and PCR testing must be clearly defined and will enable the management of situations of the type that occurred during the testing of teachers from some Gorenjska region schools and kindergartens.

Mr Štrukelj reported that, as at Tuesday, 2 February, there were 20 vaccines in third phase clinical trials around the world. Eight vaccines have been granted partial, conditional authorisation. Two vaccines – the Russian and Chinese ones – are approved for full use. Conditional authorisation is a technical term used by the European Medicines Agency and the US Food and Drug Administration for new technological medicines or vaccines that require special vigilance, which means that the effects of such vaccines undergo additional monitoring for 24 months. After this period, the vaccine receives full authorisation.

There is a growing recognition that the efficacy of vaccines varies depending on the age of the subjects, the country in which the study was conducted and the amount of the first dose. For example, the 70 per cent efficacy of the Astra Zeneca vaccine means efficacy of 60 to 90 per cent depending on the factors described above. Efficacy of 70 per cent is very good when compared to other vaccines; for example, the vaccine for seasonal flu has an efficacy rate of 50 per cent.

Similarly, varying efficacy was also noted with the Johnson & Johnson vaccine. A clinical study conducted in the USA found 76 per cent efficacy, which is similar to that of the Astra Zeneca vaccine. In South America, efficacy was 66 per cent and in South Africa (RSA), it was 57 per cent. This is very likely a reflection of mutated variants of the virus in a particular area. Data is also known for the Novavax vaccine, which has a high level of efficacy in the UK with 90 per cent, yet only 51 per cent in the RSA. 

Some EU countries have decided to target the under-65 age group for the Astra Zeneca vaccine. As this vaccine is stable, Slovenia has decided to vaccinate people with disabilities with it.

The Astra Zeneca vaccine is very similar to the Russian Sputnik 5 vaccine. The manufacturers of both vaccines have decided to undertake joint development and testing of a combination of the two vaccines in Ukraine.

An individual can become sick after the second dose of the vaccine, but only rarely. This can happen in patients who have immune system deficiency who have not developed sufficient neutralising antibodies or those who undergoing treatment with strong immunosuppressive drugs that impair the functioning of the immune system.  

Vaccines provide a significantly longer period of protection than that conferred by the illness; according to the latest data this period is more than one year.

The period between the first and second doses is defined with a lower and upper limit set by the manufacturer or the competent authority, which for the EU is the European Medicines Agency (EMA).

The clinical response after receiving the second dose of the Pfizer vaccine is much more intense, presenting in the form of a headache, but this is due to a strong immune system response.

Fighting COVID is a long battle 

The huge number of COVID cases around the world means that the impact of the virus will not be contained for some time. There are increasing calls to let the virus simply run unchecked to achieve herd immunity, thereby limiting the spread of the virus.

The example of the Brazilian city of Manaus is well known, where the incidence rate among the population stood between 60 and 70 per cent last April. With such a high level of herd immunity, new outbreaks would not be expected.  However, that is exactly what happened a month ago when there was another major outbreak of disease among the population, this time with a Brazilian mutation of the virus. 

Mr Rozman believes that the virus control strategy requires a reduction in the number of infections, and strict travel restrictions so that various mutations are not freely transmitted from one country to another. However, once the number of daily cases is significantly reduced, it will be imperative to consistently track the virus again in order to keep public life functioning. Therefore, we need a long-term strategy for how we will live with the virus in the long run because society will not be the same as it was before the virus.

As there are many viruses in the community, rapid tests should be used. Of course, false-positives do occur with rapid tests, but not in such numbers that this would have a major impact on the epidemiological picture. However, the Slovenian epidemiological curve is unique and differs from those in many other countries, the reasons for which are something that will, in due course, be the topic of much debate among experts.