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Pneumology experts warn that, despite recommended prevention measures during de-escalation , Spain could face a second "significant" outbreak of coronavirus infection . According to the figures offered by the Ministry of Health, Consumption and Social Welfare , from June 22 to July 5 there has been a rebound of at least 3,081 infected.

The rebound in cases in Spain is due to a SARS-CoV-2 subtype similar to the one that already caused the tragedy in March. However, it has joined a new lineage or strain of coronavirus probably imported from Latin America . However, so far there is no scientific evidence that it is a more aggressive version of the virus or with a higher contagion power. Regardless of the virus subtype, the symptoms appear to be similar and primarily affect the respiratory system.

And, as the president of the Catalan Society of Pneumology (SOCAP) , Enric Barbeta , points out, the virus has been mutating since its appearance and has different lineages. "What we know so far is that the virus imported from Latin America shows genetic differences compared to the virus in the March outbreak, but we cannot venture to say that it is clinically different. In part, we cannot assess its aggressiveness, since the health systems of the countries that have faced it are very different from ours, "said the pulmonologist.

The scientific community is currently studying a mutation that has occurred at position 23.403 of the coronavirus genome and that could perhaps be related to an increased contagion capacity. However, this is an unconfirmed first hypothesis by the research teams. Yes, it has been proven that this new variety of coronavirus, called G614 , has replaced almost all of the world the previous version of the virus, called D614 .

"The virus changes (mutates) with a more or less constant rate and generates variability every so often," says Antonio Salas , from the GenPoB group (Population Genetics and Biomedicine) of the Santiago Research Institute (IDIS) , "the half-life of a strain does not exceed 30 days on average ". However, it qualifies: "The mutation rate of the virus is lower than the influenza virus, but given the ease with which it has spread throughout the world, it is the circumstance that it has had the possibility of generating a lot of genetic diversity "

"First we must recognize that this mutation arises from an Asian strain for the first time in Europe at the beginning of the pandemic (and I say for the first time because it has arisen more independently, but without much success)," explains Salas, "and it is the one that becomes predominant in this continent constituting up to 81% of all the existing strains, but also in South America (86%) and Africa (85%). From this strain, which we call A2, many others have emerged sub-strains with additional mutational characteristics, the A2a sub-strain is by far the most common, and not other A2 sub-strains that also have the G614D mutation. "

"In Spain this mutation is not very frequent (56%) if we take into account the continental context, he clarifies," in my opinion, the evidence that exists regarding greater transmissibility of the virus carrying this mutation is very scarce, and for at the moment I keep this result in my private quarantine waiting for other evidence to emerge. "

New scenario

"We are facing a very different scenario regarding the first significant outbreak of coronavirus in March. The positive change in scenario is very clear both at the clinical and epidemiological level, and from the point of view of the organization of the health system or the knowledge about treatments, "says the head of the Pneumology Service at Hospital del Mar in Barcelona and president of the BRN Foundation , Joaquim Gea .

"The preparation of professionals is much better regarding the health crisis in March. The experience regarding something that has happened to you always involves learning. Training in this type of coronavirus has been very intense in recent months. Now we are more and better prepared than we were then and we will be able to better manage the disease, "emphasizes Gea.

Also, experts point out that the treatments used to fight Covid-19 have not changed much compared to March, although knowledge about how the disease responds to them has.

"The treatments currently available to treat Covid-19 are very similar to those of March; there is a drug already approved for this specific indication, although its use was already allowed in the previous outbreak for very specific cases. In this sense, the biggest difference is marked by the advances and findings made in the management of the ventilatory and blocking aspects of the inflammatory storm that the disease entails on the part of health professionals ", ditch Gea.

According to the criteria of The Trust Project

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