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COVID-19 incidence, positive and occupancy of beds, the criteria that will mark the alert level of a community

The project that the Ministry of Health will present this afternoon to the Interterritorial Health Council at CCAA defines a series of main indicators to decide the level of epidemiological risk in which each community is found, and therefore the measures to be adopted. It will mainly focus on the cumulative incidence, positivity rate and occupancy level of COVID-19 beds in hospitals.

This latest project, to which laSexta had access, modifies some criteria compared to the one published last week, and establishes ranges for each of these criteria, also identified on a color scale.

The criteria to be taken into account are divided into two blocks:

Block 1. Level of transmission of the epidemic. Here, the data of six indicators will be examined: cumulative incidence of cases diagnosed in 14 and 7 days, incidence of cases over 65 years in 14 days and 7 days, number of tests with a positive result in 7 days and percentage of cases with traceability. . , that is, positives collected as contacts of confirmed cases.

Block 2. Hospital pressure. This block will take into account the percentage of occupancy of hospital beds by COVID-19 patients, and the percentage of occupancy of ICUs also by coronavirus patients.

For example, a cumulative incidence over the last 14 days of more than 250 cases per 100,000 population would be “extreme”. Spain would be at an extreme level in this case, since it has 332 cases per 100,000 inhabitants, according to the latest Health report.

Another determining criterion will be the positivity rate (the percentage of positives that come out of the PCR or antigenic tests), which will be at an extreme level if it is greater than 15%. The latest data for Spain as a whole is 12.4%, which would be a high level, but some communities have much higher figures, such as 19% in Aragon. Ceuta and Melilla are particularly concerned, with 28% and 26% of positive cases respectively.

Positivity is a very important data because it indicates the level of control of the epidemic. Typically, in an area where few diagnostic tests are done, the number of positives is high. And this is the case of Ceuta and Melilla, the autonomous regions with the lowest level of tests carried out per hundred thousand inhabitants.

The appropriate WHO recommended level of positivity is a maximum of 5%. In this case, only the Canary Islands comply. In fact, the epidemiological situation of the archipelago has improved a lot, and that is why Germany has taken this Community out of risk areas for travel due to the COVID-19 pandemic.

The following table reflects all the ranges described by the draft remediation plan.

How will the alert level be determined?

Once the table of risk levels has been defined, the health project establishes the indicators and their degree of severity to determine one of the four alert levels specified in the project. The combination is complex, but in summary, at least two indicators of the first block (level of contagion) and one of the second (hospital pressure) will be observed.

Let’s take a real example to understand it. Castilla y León has a cumulative 14-day incidence of 517 cases per 100,000 inhabitants, 17.9% of positive cases and its ICUs are at a worrying level of 35%. It is only with these three indicators, which are at an extreme level, that Castilla y León would be at an alert level 4, the highest of those defined in the project.

Therefore, alert levels will be determined as follows:

Level 4: if you have at least two indicators from block 1 (transmission) and one from block 2 (hospital pressure), at the extreme level. With the latest data published by Health, Castilla y León, Navarra, Aragon, the Community of Madrid, Catalonia and La Rioja, in addition to the two autonomous cities, would be at this level. Level 3: at least two indicators of transmission and one of hospital pressure at high level, and the rest at lower levels. Castile-La Mancha, Andalusia, the Basque Country, Asturias and Murcia would be in this situation at that time Level 2: at least two indicators of transmission and one of hospital pressure at an average level, and the rest at lower levels. The Balearic Islands, the Canary Islands, Cantabria, the Valencian Community and Extremadura could be at this level Level 1: at least two indicators of transmission and one for hospital pressure at low level, and the rest at the new normal level. Only Galicia would be at this level, with current data.

In the following table, we indicate what the rest would look like, depending on the interpretation of the data for this Wednesday, October 21.

Finally, the alert level will determine the measures adopted to stop the spread of the epidemic, such as reducing capacity or closing facilities. From the aforementioned project, Health will also recommend “leaving home if necessary”, limiting social contact or closing shops at 10 p.m. At level 4, the possibility of applying the state of alarm is considered, at the request of the president of the autonomous community.

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