Insights for COVID-19 in 2023 / Perspectivas de COVID-19 para 2023

Predictions for a near end of the pandemic by the World Health Organization should be interpreted with caution. Current evidence indicates that the efficacy of a fourth dose of classical mRNA vaccines (BT162b2 or mRNA-1273) is low and short-lived in preventing SARS-CoV-2 infection in its predominant variant (Omicron). However, its efficacy is high against severe symptomatic infection, hospitalization and death. The new vaccines being introduced are bivalent and active against the Omicron variants. Potential new vaccines to be introduced in the coming year include a vaccine based on a recombinant protein that emulates the receptor binding domain of the Spike protein under development by the Spanish company Hipra, as well as vaccines for nasal or oral administration. Available information suggests that vaccines against COVID-19 can be administered in association with influenza vaccination without particular complications. New drugs against COVID-19, both antiviral and anti-inflammatory, are under investigation, but this does not seem to be the case with monoclonal antibodies. The indication to use masks in some circumstances will be maintained next year in view of the accumulation of scientific data on their efficacy. Finally, the long COVID or Post-COVID syndrome may continue to affect a very high proportion of patients who have had the disease, requiring combined diagnostic and therapeutic resources. (AU)

Las predicciones para un próximo fin de la pandemia de la Organización Mundial de la Salud deben interpretarse con precaución. La evidencia actual indica que la eficacia de una cuarta dosis de las vacunas clásicas ARNm (BNT162b2 o mRNA-1273) es baja y de corta duración para prevenir la infección de SARS-CoV-2 en su variante predominante (Omicron). No obstante, su eficacia es alta frente a la infección sintomática grave, hospitalización y muerte. Las nuevas vacunas que están siendo introducidas son bivalentes y activas frente a las variantes Omicron. Entre las potenciales nuevas vacunas que se introducirán en el próximo año, se encuentra una vacuna basada en una proteína recombinante que emula el dominio de unión al receptor de la proteína Spike en desarrollo por la compañía española Hipra, así como vacunas de administración nasal u oral. La información disponible apunta a que las vacunas frente al COVID-19 podrán administrarse asociadas a la vacunación antigripal sin particulares complicaciones. Se encuentran en investigación nuevos fármacos frente a COVID-19 tanto antivirales como anti-inflamatorios pero no parece ocurrir lo mismo con los anticuerpos monoclonales. La indicación de utilizar mascarillas en algunas circunstancias se mantendrá el próximo año en vista a la acumulación de datos científicos sobre su eficacia. Finalmente, el síndrome del COVID largo o Post-COVID puede que siga afectando a una proporción muy elevada de los pacientes que sufrieron la enfermedad, requiriendo recursos diagnósticos y terapéuticos combinados. (AU)

Insights for COVID-19 in 2023.

Predictions for a near end of the pandemic by the World Health Organization should be interpreted with caution. Current evidence indicates that the efficacy of a fourth dose of classical mRNA vaccines (BT162b2 or mRNA-1273) is low and short-lived in preventing SARS-CoV-2 infection in its predominant variant (Omicron). However, its efficacy is high against severe symptomatic infection, hospitalization and death. The new vaccines being introduced are bivalent and active against the Omicron variants. Potential new vaccines to be introduced in the coming year include a vaccine based on a recombinant protein that emulates the receptor binding domain of the Spike protein under development by the Spanish company Hipra, as well as vaccines for nasal or oral administration. Available information suggests that vaccines against COVID-19 can be administered in association with influenza vaccination without particular complications. New drugs against COVID-19, both antiviral and anti-inflammatory, are under investigation, but this does not seem to be the case with monoclonal antibodies. The indication to use masks in some circumstances will be maintained next year in view of the accumulation of scientific data on their efficacy. Finally, the long COVID or Post-COVID syndrome may continue to affect a very high proportion of patients who have had the disease, requiring combined diagnostic and therapeutic resources.

Mask use during the COVID-19 pandemic: A descriptive survey in South Korea.

Extensive research on the coronavirus disease 2019 (COVID-19) is underway. However, there are not many studies on the use of masks, which are essential for infection prevention. This descriptive study aimed to understand the factors influencing the use of masks by Korean adults during COVID-19. We conducted an online survey with 280 adults in South Korea between August and September 2020, analyzing the data using SPSS version 24.0. Multiple regression analyses were performed to understand the factors that influence individuals' use of masks. The participants' perceived susceptibility, perceived barriers, other people's dignity, compliance with public order, reasonable decision making, and subjective norms explained 21.6% of mask use. Mask use is expected to increase further if people perceive a personal need to wear masks, if their peers perceive the importance of mask use, and if they possess civic consciousness that considers society as a whole. This paper makes a significant contribution to the field of public health, with evidence-based recommendations for increasing mask use, going beyond simply attributing mask use to individual preferences.

Actions and attitudes on the immunized patients against SARS-CoV-2 / Acciones y actitudes ante el paciente inmunizado contra el SARS-CoV-2

The access to COVID vaccines by millions of human beings and their high level of protection against the disease, both in its mild and severe forms, together with a plausible decrease in the transmission of the infection from vaccinated patients, has prompted a series of questions from the members of the College of Physicians of Madrid (ICOMEM) and the society. The ICOMEM Scientific Committee on this subject has tried to answer these questions after discussion and consensus among its members. The main answers can be summarized as follows:The occurrence of new SARS-CoV-2 infections in both vaccinated and previously infected patients is very low, in the observation time we already have. When breakthrough infections do occur, they are usually asymptomatic or mild and, purportedly, should have a lower capacity for transmission to other persons.Vaccinated subjects who have contact with a SARSCoV-2 infected patient can avoid quarantine as long as they are asymptomatic, although this decision depends on variables such as age, occupation, circulating variants, degree of contact and time since vaccination. In countries with a high proportion of the population vaccinated, it is already suggested that fully vaccinated persons could avoid the use of masks and social distancing in most circumstances.Systematic use of diagnostic tests to assess the immune response or the degree of protection against reinfection after natural infection or vaccination is discouraged, since their practical consequences are not known at this time. The existing information precludes any precision regarding a possible need for future revaccination. (AU)

El acceso a las vacunas frente a COVID-19 de millones de seres humanos y su alto nivel de protección frente a la enfermedad, tanto en sus formas leves como graves, junto a una verosímil disminución de la transmisión de la infección desde pacientes vacunados, ha motivado una serie de preguntas de los colegiados y de la sociedad. El Comité Científico del ICOMEM sobre esta materia ha tratado de responder a dichas preguntas tras discusión y consenso entre sus miembros. Las respuestas principales pueden resumirse así: La aparición de nuevas infecciones por SARS-CoV-2 tanto en vacunados como en previamente infectados, es muy escasa, en el tiempo de observación del que ya disponemos. Cuando ocurren infecciones de brecha, suelen ser asintomáticas o paucisintomáticas y, en principio, tendrían una menor capacidad de trasmisión a otras personas.Los sujetos vacunados que tienen contacto con un paciente infectado por SARS-CoV-2 pueden evitar la cuarentena, mientras se encuentren asintomáticos, si bien esta decisión depende de la edad, la profesión, las variantes circulantes, el grado de contacto y el tiempo pasado desde la vacunación. En países con una alta proporción de la población vacunada se sugiere ya la posibilidad de que las personas plenamente vacunadas prescindan del uso de las mascarillas y el distanciamiento social en la mayoría de las circunstancias.Se desaconseja la utilización de pruebas diagnósticas de manera sistemática para evaluar la respuesta inmune o el grado de protección frente a la reinfección tras la infección natural o la vacunación, dado que en este momento se ignoran sus consecuencias prácticas. La información existente hasta este momento, impide hacer cualquier precisión frente a una posible necesidad de revacunación futura. (AU)

Actions and attitudes on the immunized patients against SARS-CoV-2.

The access to COVID vaccines by millions of human beings and their high level of protection against the disease, both in its mild and severe forms, together with a plausible decrease in the transmission of the infection from vaccinated patients, has prompted a series of questions from the members of the College of Physicians of Madrid (ICOMEM) and the society. The ICOMEM Scientific Committee on this subject has tried to answer these questions after discussion and consensus among its members. The main answers can be summarized as follows: The occurrence of new SARS-CoV-2 infections in both vaccinated and previously infected patients is very low, in the observation time we already have. When breakthrough infections do occur, they are usually asymptomatic or mild and, purportedly, should have a lower capacity for transmission to other persons. Vaccinated subjects who have contact with a SARS-CoV-2 infected patient can avoid quarantine as long as they are asymptomatic, although this decision depends on variables such as age, occupation, circulating variants, degree of contact and time since vaccination. In countries with a high proportion of the population vaccinated, it is already suggested that fully vaccinated persons could avoid the use of masks and social distancing in most circumstances. Systematic use of diagnostic tests to assess the immune response or the degree of protection against reinfection after natural infection or vaccination is discouraged, since their practical consequences are not known at this time. The existing information precludes any precision regarding a possible need for future revaccination. This Committee considers that when mass vaccination of health care workers and the general population is achieved, SARS-CoV-2 screening tests could be avoided at least in outpatient care and in the case of exploratory procedures that do not require hospitalization.