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35 cases of UK variant confirmed

A press conference on the current situation regarding the COVID-19 virus was held by Director of the National Laboratory for Health, Environment and Food Tjaša Žohar Čretnik and Ada Hočevar Grom of the National Institute of Public Health.

Ada Hočevar Grom of the National Institute of Public Health

Ada Hočevar Grom of the National Institute of Public Health | Author Tamino Petelinšek, STA

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5,316 PCR tests were conducted yesterday, with 1,089 positive results (20.5%). This is close to the number of positives recorded last Tuesday. 22,631 rapid antigen tests were performed. The country currently lists 11,298 active cases of novel coronavirus, while the seven-day average number of new positives is 766 cases per day. Both figures have seen a slight drop in the last week.

A total of 546 patients were hospitalised yesterday, of whom 105 are in intensive care. There were 10 deaths, 9 in hospitals and one in a nursing home.

The municipalities with the highest number of confirmed cases were: Ajdovščina and Sežana (13), Nova Gorica (19), Celje (30), Ilirska Bistrica (16), Rogaška Slatina (19), Velenje (15), Domžale (32), Jesenice (16), Kranj (33), Šenčur (12), Škofja Loka (14), Ljubljana (136), Maribor (34), Koper (70), Piran (25) and Izola (17).

National strategy for tracking known and new SARS-CoV-2 variants

The National Laboratory for Health, Environment and Food (NLZOH) and various institutions have developed a national strategy for tracking known and new variants of SARS-CoV-2, which was presented by Žohar Čretnik.The National Institute of Public Health will cover the epidemiological aspects and monitoring the epidemic, while the NLZOH, the Institute of Microbiology and Immunology (IMI) at the Faculty of Medicine in Ljubljana and the Institute of Specialised Laboratory Diagnostics at the Paediatrics Division of the Ljubljana University Medical Centre will cover tracking in human samples.The National Institute of Biology and the NLZOH will cover tracking in wastewater at treatment plants and hospitals.The National Veterinary Institute will cover tracking in animals. 

The purpose of tracking is the rapid detection of new, more contagious variants of the virus, and to monitor their spread patterns. Genetic mutations of the virus can affect the effectiveness of diagnostics, treatment methods and the choice of vaccines. When they appear, the response has to be immediate, and both the national and international press must be notified of the findings.

The strategy for monitoring the onset and spread of new variants of the SARS-CoV-2 virus includes five parts.

The first part is designed to monitor the spread of new variants among people who test positive for the virus by sequencing the entire genome of the virus. It will be conducted on a continuous basis by taking 5-10% of the positive PCR samples from the entire population in line with European Commission recommendations, and particularly from specific target groups.

The second part is designed to monitor new variants among people by using additional testing through PCR screening. This part will also involve the testing of every tenth positive PCR sample from basic diagnostics. This approach allows the rapid detection of the likelihood of the presence of significant known variants. 

The third part will include tracking using wastewater samples, which allows the inclusion of the entire population, including e.g. asymptomatic carriers who are not referred for swab tests. Another advantage of this approach is that it can be used to detect numerous potential new mutations.  

The fourth part will involve tracking SARS-CoV-2 variants in hospital wastewater and hospital environments, and establishing whether unknown cases of the disease are appearing in those environments.

The fifth part is tracking variants of SARS-CoV-2 in animal reservoirs. The key element to controlling zoonosis is identifying animal reservoirs that could cause infections in humans. It is also important to determine the susceptibility of various animal species to infection with SARS-CoV-2 and their roles in COVID-19 epidemiology. These findings can serves as the basis for the medical and veterinary decisions needed to control the pandemic.  

Results of sequencing from 1 January to 22 February

According to Žohar Čretnik, 1,475 samples have been processed using this method. For 379 samples, the presence of new variants was monitored by tracking significant mutations on a small section of the genome, while for 1,096 samples the NLZOH together with the Institute of Specialised Laboratory Diagnostics at the Paediatrics Division of the Ljubljana University Medical Centre will sequence the entire genome. 

The UK variant was identified in 6 of the total of 1,096 samples. One case was confirmed as early as January in a traveller who returned from England in December, and five were confirmed through the national tracking strategy in January and February. There are two cases from the South-Eastern region of Slovenia, one from the Savinja region and two from the Podravje region. The South African and Brazilian variants were not detected. In the samples at the NLZOH’s diagnostic microbiological laboratories all over Slovenia, the B 1.258.17 variant is strongly prevalent, and represents 78.5% of all sequenced genomes in Slovenia. This variant is also present in other countries around the world (e.g. the Czech Republic, Slovakia, Denmark, Austria, Switzerland, etc.). 

To date, 2,018 samples have been screened using the rTEST COVID 19 (the so-called Slovakian test). The potential presence of the UK variant was indicated in 38 samples. Of these 38, the UK variant was confirmed in 5 samples using genome sequencing. The presence of other variants was confirmed in 18 samples using sequencing, while 15 samples are still in the confirmation process.

In addition to the NZLOH, the IMI has confirmed 28 samples of the UK variant, bringing the total number of confirmed samples in Slovenia to 35. The IMI notes that 21 of these samples do not involve a travel anamnesis, which means that these people became positive through contacts inside the country. The reasons for the spread of the UK variant of the virus are failure to abide by protective measures and the virus’s own highly contagious character. It is impossible to determine which of these factors contributes more to the spread.

The NLZOH will monitor the presence of the UK variant of the virus particularly in the Coastal-Karst region, and has therefore increased the share of positive PCR tests that it will monitor there to 30%.

Research on the impact of the COVID-19 pandemic on lifestyles (SI-PANDA 2020/21)

The purpose of the research is to take measurements in order to better understand human behaviour in relation to COVID-19, and to assess the level of pandemic fatigue during the COVID-19 epidemic in Slovenia. This will also allow them to identify groups at high risk for serious forms of consequences of the epidemic within society. The results will be used to try to change people’s behaviour in order to (i) reduce the transmission and spread of the SARS-CoV-2 virus, (ii) reduce fatigue and distress, and increase the quality of life, (iii) maintain a functioning healthcare system, (iv) provide for the normalisation of all segments of society, and (v) reduce inequality, said Hočevar Grom.

Pandemic fatigue is a natural and expected response to a long-lasting public health crisis that requires the imposition of measures that significantly affect people’s everyday lives. It manifests in a gradually increasing lack of motivation to adhere to the recommended self-protective behaviours, which affects people’s emotions, experiences and perspectives. Demotivation is also reflected in reduced awareness of the risks associated with COVID-19, unwillingness to receive information and failure to engage in self-protective behaviours. This threatens the effectiveness of measures to prevent the spread of the SARS-CoV-2 virus.

The research is being conducted among people between 18 and 74 years of age in an online panel survey in twelve (12) iterations, starting on 4 December 2020. The survey is being carried out every two weeks, with six (6) iterations having been conducted so far. The research is based on a survey from the World Health Organization (WHO), which the NIJZ adapted to the conditions in Slovenia, and which also allows an international comparison.

Certain key findings have been published following the sixth round of research, which was conducted between 12 and 15 February.

People’s attitudes towards the measures The easing of the restriction against travel across municipal boundaries received the highest level of support in the most recent, i.e. sixth, round of the survey. In past rounds of research, this restriction on movement was most disruptive to people who live alone, as they are unable to engage in recreation, etc. The opening of schools received strong support. The lowest level of support was received for the night-time curfew.

Trust in people and institutions regarding the epidemic control In all of the rounds, respondents indicated a high level of trust in personal physicians, hospitals and employers.

Vaccination 55% of respondents believe that vaccines can help contain the spread of the pandemic, and therefore intend to get vaccinated. Younger people are more sceptical of vaccines than older people. 48% of young people between the ages of 18 and 29 stated that they do not intend to get vaccinated, while 40% of them are willing to do so. Support for vaccination is increasing from survey to survey.

Lifestyle changes Nearly half of respondents were less active in the last two weeks than they were prior to the pandemic, and 34% avoided going to the doctor for problems that are not associated with the coronavirus. One quarter report less-healthy eating habits, 18% more people are smoking, and alcohol consumption has also increased. Due to these changes in lifestyle and delaying visits to the doctor, increased incidence of diseases and medical issues can be expected in the wake of the pandemic.

Increased mental health issues 22% of respondents are having more issues with mental health than before the pandemic, and 11% are manifesting symptoms of depression. The percentage of people who list mental health issues has remained constant throughout the survey period. The largest share of issues is found amongst the youngest respondents, a full 32% of whom report that they are having issues with their mental health, and 11% of whom report symptoms of depression.

Financial circumstances in the last 3 months One quarter of respondents believe that their financial situation is worse than prior to the pandemic, although the percentage in the sixth round of the survey was slightly lower than in the first round. The youngest group of respondents (age 18 to 29) report the largest deterioration of their financial circumstances. These respondents estimate that their financial status has deteriorated by 35%.

The NIJZ are aware that the pandemic has affected many people. But it has not affected everyone equally, and some people are having much bigger problems than others.