What is Incidental Covid and why some see it as a positive

While The wave of Omicron breaks records of infections around the world, the scientific community is quick to understand the real impact of this latest variant of coronavirus.

The evidence gathered to date points to 2 clear questions.

The first, that thanks to the protection of vaccines, natural immunity and changes in the virus, Ómicron appears to be less severe than its predecessors.

The second, which is transmitted so quickly that its progress continues to challenge public health and economic recovery.

The United Kingdom, due to its high number of infections, its extensive program of diagnostic tests and virus sequencing capacity, offers us fast and reliable clues about the behavior of omicron.

And one of the characteristics of this wave in this country seems to be the weight of the so-called “incidental Covid” cases, a phenomenon that could change the way we measure the real impact of the pandemic.

But what do these cases consist of?

Covid as a secondary cause

‘Incidental Covid’ is the term being used by UK health staff and scientists to designate the cases of those who They go to the hospital for an ailment other than that caused by the coronavirus but that, once there, they discover that they are also carriers of the virus.

Scientists in the United Kingdom call incidental covid those patients who enter the hospital for another cause that is not coronavirus but who later test positive. (Photo: GETTY IMAGES)

That is, patients who are supposedly in the hospital “with Covid”, but not “due to Covid”.

Omicron spreads so fast that a considerable percentage of the population, asymptomatic or not, has the virus without knowing it. So it is likely that he will go to the hospital, for example, for appendicitis, and that once admitted he will test positive for coronavirus. In other cases it is possible that they become infected in the hospital itself.

These positives are also included in the daily numbers of infections and hospitalized with the virus.

Data from the past week suggest that a third of those admitted to hospitals in England were in this position.

This, politicians and scientists argue, could be offering a distorted picture of the impact of this wave.

But Is it good or bad news? Does this mean that we are overestimating the infectivity of this new variant?

Positive tests around a phone.
Through its extensive program of diagnostic tests and genetic sequencing, the United Kingdom offers us fast and reliable clues about the behavior of omicron. (Photo: GETTY IMAGES)

It is early to draw conclusions and experts hope that as the weeks go by, the picture will become clearer.

Furthermore, the situation may vary by country due to demographic and epidemiological differences.

Debate increasing

Chris Hopson, CEO of NHS Providers, the membership organization for public health service trusts in England, spoke about the weight of incidental Covid cases in a thread on Twitter in late December.

In this it warned, among other issues, about the higher proportion of “asymptomatic patients admitted to the hospital for other reasons and who later test positive for Covid, which some are describing as ‘incidental Covid’”.

Boris Johnson, Prime Minister of the United Kingdom.
The UK government is closely monitoring Ómicron’s behavior to decide whether to impose further restrictions. (Photo: GETTY IMAGES)

Some received this observation as good news., as further proof of the lesser severity of the Omicron cases.

And several articles published in the British press wondered if the time had come to change the way the impact of the pandemic is measured.

Although the data show that despite the record of infections, hospitalizations due to covid increase at a slower rate than in other waves, the experts consulted by BBC Mundo insist that it is too early to determine the potential impact of omicron.

At the moment, this new variant is generating several challenges.

Less pneumonia, more autoimmune damage

Professor David Strain, from the School of Medicine of the University of Exeter in the United Kingdom, assures BBC Mundo that Ómicron is causing fewer cases of pneumonia and that many of the patients who arrive at the hospital do not enter for Covid as the primary cause.

Pneumonia is one of the most serious complications after coronavirus infection and the ultimate cause of death for many of those infected, especially the elderly and immunosuppressed patients.

Patient on assisted respiration in a UK hospital.
Fewer people admitted by omicron need assisted respiration than those hospitalized in previous waves. (Photo: GETTY IMAGES)

However, “I wouldn’t say this is exactly good news,” says Strain.

A greater probability of being reinfected even if we are vaccinated that this variant implies and the lack of protection of those who are not vaccinated lead to other problems.

“Many patients, especially the youngest, between 20 and 30 years old, continue to arrive very ill. They are patients who avoid pneumonia, but who suffer the second part of the infection, which causes an overload of inflammatory problems such as blood clots or edema ”, explains Strain.

Patients suffering from chronic diseases such as diabetes, cardiovascular problems or ulcerative colitis, for example, are more exposed to these types of autoimmune responses.

“Like the flu, Covid-19 can aggravate these types of medical ailments, as well as problems in the lungs, kidneys and brain,” Julian Tang, a virologist specializing in respiratory diseases from the University of Leicester, also in the UK.

Strain explains that it is these patients who, once they enter the hospital, can also appear as incidental Covid cases.

View of the Parliament of the United Kingdom.

“But even if they enter because their cardiovascular disease has suffered, they do have Covid it is very likely that this infection is the one that has worsened your previous condition“, dice Strain.

As a consequence, it leads to “a longer stay in the hospital, an increase in recurrent admissions and a greater frequency of outpatient visits,” adds Tang.

In summary, although incidental COVID cases seem to exclude complications such as pneumonia, these patients continue to represent a challenge derived from virus for both individuals and health systems.

“It is true that incidental Covid cases are not direct admissions and do not usually have pneumonia, but in the end they are patients whose diseases have definitively deteriorated because of Covid,” explains Strain.

Committed hospitals

Tang lists other problems stemming from Ómicron’s high contagion rate and incidental Covid cases.

“This wave is causing many absences of health personnel in hospitals because vaccines and booster doses offer incomplete protection against the Omicron variant,” explains Tang.

Ambulances in the UK.
Although the proportion of incidental covid is higher, this continues to put great pressure on the health system. (Photo: GETTY IMAGES)

“If there are not enough staff, this indirectly affects and worsenstheperspectives for patients“, Explain.

Therefore, “incidental COVID cases remain important from an infection control and public health point of view,” he adds.

“We are seeing an increase in people who go to hospital, more casualties of health personnel and all this increases the pressure” on the health system, admitted Chris Hopson in an interview on Monday with the BBC.

Meanwhile, the UK government, led by Prime Minister Boris Johnson, has ruled out the application of more restrictive measures, claiming that Ómicron is “clearly milder” than other variants.

However, he has recognized that the pressure on public health services will be “considerable” in the coming weeks and that it would be “nonsense” to think that the pandemic is over.

It may interest you:

* IHU: They discover a new variant of Covid-19 with more mutations than Ómicron
* Covid: The symptoms of Ómicron, Delta and a flu so as not to be confused

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