In an interview on RAC1 radio, Dr Magda Campins, head of Barcelona’s Vall d'Hebron Hospital’s preventive medicine and epidemiology service, stated that the figures provided by various administrations show that "there has been a slowdown in the number of new cases". She went on to say that "the lockdown has been in place for 15 days and this shows that it is bearing fruit". However, she warned that "ICUs are now admitting new patients who have already been in hospital for several days". She added that "there are patients who need delayed intensive care, which is why the number of cases in ICUs is rising". As a result, she foresees that next week Catalan ICUs may be overwhelmed. "I predict that the intensive care units will be on the brink of collapse, while general wards will be spared mostly".
Dr Campins said that so far only patients who are admitted to hospital and then tested are being chalked up as confirmed COVID-19 cases. According to Dr Campins, "patients who remain at home or who are treated in primary care centres do not count as confirmed cases. If we obtain rapid test kits over the next few days and more tests are carried out, it will undoubtedly lead to an artificial increase in confirmed cases". She added that "we may well have to change the graph, since the number of cases will go up, but that won’t reflect what’s really going on".
The effect on pregnant women
From a clinical standpoint, Dr Campins said that "important lessons" have been learnt in recent days: "The virus spreads much more easily than we expected and the way it affects different age groups is also different from what we originally thought". She went on to say that "based on the data that came from China, we thought that it affected the elderly, but now with our own data we can see that 35% of hospital admissions are for individuals between the ages of 45 and 55. And as for pregnant women, we are seeing that it affects them, too”.
Without wishing to cause alarm, the epidemiologist from Vall d'Hebron Hospital declared that "according to data from China and Italy, few pregnant women had severe COVID-19 infections". "But here at the hospital we’ve had some serious cases and we’re worried about the situation because we weren’t expecting it. I don’t want to alarm anybody, but we need to keep an eye on pregnant women in particular". In fact, Dr Campins said that the Vall d'Hebron Hospital is the reference hospital for COVID-19 positive pregnant women. "Pregnant women who have tested positive ought to deliver their baby here, and the others too, because they are divided into separate wards", she said.
When asked about the number of people who may have passed on the disease unwittingly, Dr Campins stated that the figure could be determined later on with the use of "serological tests". "Serology will show us whether or not a person has passed on COVID-19. We’ll need to do population-level studies in which the antibodies can show us if a person has had the virus", she added.
A hypothetical second wave
Dr Campins stated that it is not yet known whether people who have had the virus become immune. "Immunity ought to exist, but we don't know how long it lasts. Six months? A year? For life, like measles?". As for a hypothetical second wave, she said: "It might happen when these strict confinement measures are lifted, if people who haven’t had the virus become infected. The scenario which is being studied is gradually easing the confinement measures. The second wave might come when the measures are lifted or if it’s seasonal, like the flu, when the right conditions return next winter".
Campins declared that she does not believe the virus has mutated. "As far as we know, it’s the same one. But all that’s been published is partial data from each hospital. We lack global and comparative data between hospitals, we only have them from individual hospitals. The situation in one country is very different from another. Here we have a more elderly population than in China, there has been more community transmission ... and all these factors make the contagion and behaviour of the virus unique".