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Vaccination no longer limited to priority groups

The press conference on the current situation regarding COVID-19 was attended by the State Secretary at the Ministry of Health Franc Vindišar and the head of the vaccine advisory group Dr Bojana Beovič. Maja Bratuša of the Ministry of Foreign Affairs presented the current epidemiological picture.

Maja Bratuša, Ministry of Foreign Affairs

Maja Bratuša, Ministry of Foreign Affairs | Author Ukom

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On Sunday, 10 May, 1,310 molecular tests were carried out and 147 new cases of infection were confirmed. 6,794 rapid antigen tests were also carried out yesterday, and the National Institute of Public Health (NIPH) estimates that the number of active cases in the country dropped below nine thousand. Since less new cases of infection were confirmed in the last days, the seven-day average number of positive cases also dropped and stands at 606 (yesterday 614, one week ago 661) according to NIPH data published today.

Bratuša pointed out that despite the slowly improving epidemiological situation, the fact that half of the regions are currently orange and the other half are yellow indicates that we cannot speak about a significant improvement in the epidemiological conditions at the country level. The situation in hospitals also remains serious. After less than 500 COVID patients were hospitalized yesterday for the first time since 28 March, today’s number is unfortunately higher. 508 people are in hospital due to COVID today. Maja Bratuša added that despite this, we still came close to fulfilling both criteria for the transition to the next phase, i.e. the yellow phase of the plan regarding the easing of measures.

Beovič: Slovenia ensures a safe and effective method of vaccination

The head of the vaccine advisory group Dr Bojana Beovič initially pointed out that new developments are constantly changing approaches to vaccination against COVID-19. She added that Slovenia reasonably takes into account the new findings and thus provides its inhabitants with the safest and most effective method of vaccination.

She went on to explain some of the most common vaccination dilemmas.

– AstraZeneca vaccine dose interval: according to the provisions of EMA, the second dose of this vaccine should be administered between 4 and 12 weeks after the first dose. Subsequent studies showed that vaccination with this vaccine is more effective if a person receives the second dose after 12 weeks than if they receive it six weeks after the first dose. It is therefore recommended for the second dose to be administered twelve weeks after the first dose. Beovič emphasized that AstraZeneca vaccine is very effective after the first dose, and the European Medicines Agency also states that protection starts from approximately three weeks after the first dose. The protection persists for at least 3 months, i.e. until the second dose, which we recommend to be administered after 12 weeks.

– Vaccination of the persons who have recovered from COVID: When a person recovers from COVID-19, they are immune to this disease for at least some time. Vaccination of such persons makes sense only when it is expected that their immunity has already decreased. This is currently estimated to take place after 6 to 8 months. It is therefore reasonable to vaccinate an individual with only one dose when the immunity after the disease is still present, since the disease itself acted as the first dose and its effect is only boosted with vaccination. Beovič gave an example of an individual who must be regularly tested at the workplace: If regular testing is the issue, we can get vaccinated as early as the 6th month after the infection, and if there is no rush, one dose of vaccination can be administered up to the 8th month after having recovered from the disease. Experts are not sure about the presence of immunity after this period, so two doses are recommended if the vaccination takes place more than 8 months after the disease (when administering a two-dose vaccine). Beovič also pointed out that recovered persons with severe immune disorders are always vaccinated with two doses.

– Cancellation of AZ deliveries: Beovič expects that the suspended contracts and AstraZeneca deliveries will not pose any problems. She pointed out that the production of Pfizer BionTech is being accelerated and that two interesting new vaccines, the protein vaccine Novavax and the mRNA vaccine Curevac, are in sight, as well as registration of the Russian Sputnik V single-dose vaccine. She also said that the so-called vector vaccines are expected to be less interesting for the third doses, because immunity to the vector, i.e. the carrier virus, is developed, which reduces the response to the vaccine. According to NIPH data, another 49,000 doses of AZ vaccine are available in Slovenia, and a delivery of 490,000 doses is planned in May and June, so there clearly won’t be any problems with second doses. Currently, 133,000 people in Slovenia should get the second dose of Vaxzevria.

The European Medicines Agency monitors the side effects of all vaccines, and, following the reports from foreign media, it is currently analysing the nervous system disorders after receiving the AZ vaccine and heart inflammation after receiving the PB vaccine. Nervous system disorders are side effects that also occur with other vaccines, but they are really extremely rare.

With the measures in force, a vaccination rate of 50 percent is likely to be sufficient

Vaccination against COVID-19 has already proved to be efficient in Slovenia, as the incidence of the disease is decreasing, especially among the elderly. With the measures currently in place – similar to the Israeli data – a vaccination rate of 50 percent is likely to be sufficient. As Bojana Beović pointed out, we obviously want to ease the measures, therefore a greater vaccination rate is necessary to ensure the so-called collective immunity. Until this, we can safely ensure almost normal activities in culture, sports, hospitality and tourism, and more, by following the recommendation of Dr Zdenko Šalda from Trebnje: to socialize with other people, a person needs to either recover from COVID-19, be vaccinated or have an up-to-date negative test.

Vindišar: The number of COVID hospitals may be reduced this week

State Secretary at the Ministry of Health Franc Vindišar presented the situation in Slovenian hospitals with COVID departments and coordination to ensure the necessary capacities.

In autumn 2020, the Ministry of Health prepared a web application with data on current conditions in all hospitals categorized as COVID hospitals. Any changes in numbers of patients in hospitals are entered into this application, and the numbers of patients in intensive care beds and regular beds are recorded separately. The capacities for both types of beds are also indicated for each hospital. This application is accessible to all hospital managers, medical dispatch service, some of the representatives of the Ministry of Health and the coordinator for hospital beds Robert Carotta.

Unlike the second wave, when the average rate of occupied intensive care beds was approximately 17 percent of all hospitalised patients, this rate increased to 25 percent in the third wave. Vinndišar explained that because of this, the strategy developed to ensure the necessary capacities and define COVID hospitals had to be adapted accordingly.

The Jožef Štefan Institute’s prediction models have proven to be a welcome tool that helps us coordinate our work. We have established weekly audio-video conferences with medical directors of 13 COVID hospitals, where we check the situation in individual hospitals, coordinate emergency corrections and arrange work in the coming week.

According to Vindišar, this coordinated operation enabled us to ensure the necessary capacities at all times along with optimal accommodation for all patients depending on their state of health.

The State Secretary said that the current situation is favourable, because the trends in the number of hospitalized patients indicate a decline in both regular and intensive care beds. Based on the number of hospitalised patients, the total number of capacities and the number of COVID hospitals may be further reduced this week, said Vindišar.

He added that this will enable greater staff capacities for other non-COVID programmes. According to the data of individual hospitals, regular programmes are significantly reduced, especially in the field of operational activities and slightly less in the field of internal medicine. We all realize that it is important to ensure all the programmes, because this is the only way to provide proper access to all health services.

In addition to these hospitals, 10 hospital beds are available in Hospital Sežana for eventual transfers in case of nursing home infections, and 10 beds are available in the University Psychiatric Clinic Ljubljana. We also have separate capacities in the Division of Paediatrics in Ljubljana and separate zones for COVID treatment in all maternity units. Women with scheduled deliveries that are infected with COVID are usually redirected to the maternity hospital of the University Medical Centre Ljubljana.

At the end, Vindišar thanked all health care workers. He pointed out that workload in recent months has been exceptional for the vast majority, regular work schedules that were in place before the pandemic have generally been changed, and working conditions are much more difficult, because the use of personal protective equipment presents an additional burden. He highlighted the high level of solidarity and the willingness of all stakeholders to provide mutual assistance between hospitals. State Secretary Vindišar concluded the press conference by saying that these events have definitely re-confirmed the importance of the public health system.