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Memorias del Instituto de Investigaciones en Ciencias de la Salud

On-line version ISSN 1812-9528

Mem. Inst. Investig. Cienc. Salud vol.19 no.2 Asunción Aug. 2021 


COVID-19: Are we close to returning to “normal”?

Mario Fabián Martínez Mora1

1Universidad Nacional de Asunción, Instituto de Investigaciones en Ciencias de la Salud. San Lorenzo, Paraguay.

The COVID-19 pandemic, a public health emergency of international concern, is caused by infection by SARS-CoV-2, a virus belonging to the Coronaviridae family, which develops an infectious disease of the respiratory tract1-3. Since its detection in December 2019 in Wuhan (China)4, there have been more than 225 million cases worldwide and around 5 million associated deaths in 236 countries5. In Paraguay, the first case of COVID-19 was confirmed on March 7, 2020 in a 32-year-old patient from Ecuador6. Later, on the 20th of the same month, community circulation was confirmed, declaring total quarantine in all the country7. Before these events and the imminent entry of the virus into the country, the Ministry of Public Health and other institutions such as the Institute for Research in Health Sciences of the National University of Asunción (IICS-UNA), have been fine-tuning molecular techniques molecular recommended by the World Health Organization for the detection of the virus, managing to install these capabilities in their laboratories8. By the end of that year, more than 105,000 cases were confirmed with more than 2,000 deaths and a weekly average of 750 new cases per day9. But it was just the takeoff; in mid-2021 these numbers quadrupled, reaching a weekly average of 2,850 new cases per day in June9 (on June 4, 3,481 new cases were confirmed, the peak number in the entire pandemic). This triggering of cases was related to the appearance of variants of the virus and mainly due to the entry and circulation of one of them: the variant of concern Gamma (P.1), introduced to the country mainly from Brazil and confirmed by the Ministry of Health in March 202110, one year after the confirmation of the first case in the country. Also in March 2021, vaccination against SARS-CoV-2 was started for health personnel11. After reaching the peak, a gradual and sustained decrease in new cases was observed, reaching less than half of those 3,481 new cases per day in June in the month of July9. Another threat and later reality was the introduction of the fearsome Delta variant, which was confirmed on July 23, 2021 by the sequencing of the entire genome carried out by the IICS-UNA, this institution being the first in Paraguay to carry out this analysis with the SARS-CoV-212. Even with the confirmation of the transmission and community circulation of the Delta variant in the country, the number of new cases continues declining, a scenario little thought about a year ago and very encouraging, thus being able to perceive the effect of vaccination in the population.

Today, a year and a half after the introduction of the virus in the country, about 500 thousand people have suffered COVID-19, leaving more than 16 thousand dead9, figures that surely do not reflect the real number of those affected.

With this new scenario, with less than 3% positivity of samples currently tested9, it seems that we are at the end of the tunnel. But we are not there yet. Historically, microorganisms have almost always marked the roadmap: will we have a new wave of cases? Is it necessary to reinforce doses of vaccines? Will variants of great consequence appear that can effectively evade our natural or acquired defenses either by the infection itself or by vaccination?

The exact moment that indicates a return to a normality similar to how we lived before is not yet visible. However, if mainly 2 conditions are met, we could achieve the pre-pandemic normality in the short term: first, vaccination of a large percentage of the population, a clearly necessary condition to continue advancing in containing the virus and second, sustained compliance of the sanitary measures already known to all.

It is too premature to talk about returning to pre-pandemic normality. We should continue to readjust to this "new normal", which unfortunately is still restrictive, but less restrictive than a year ago.


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