Former Obama administration adviser Dr. Bengoa on the coronavirus pandemic and the Omicron variant

Covid-19 has been spreading around the world for just over two years and governments and health experts have been doing their best to combat the continuously evolving virus. Likewise, their efforts have adapted to an ever-changing situation, juggling policies, solutions and restrictions.

Recently, Dr. Rafael Bengoa spoke with Mario Espinosa of AS to answer questions about the future of the covid-19 pandemic, the policies implemented by governments and the spread of the Omicron variant. here are excerpts interview.

Dr. Rafael Bengoa, Caracas 1952, is an expert in management and public health. He is former Minister of Health of the Basque Country in Spain, former Director of Health Systems for the World Health Organization (WHO) and former adviser to President Obama on the implementation of the Affordable Care Act.

You don’t stop a virus with a bombardment, it gradually slows down

Dr Raphael Bergoa

Will the coronavirus become endemic?

There are many people who suddenly think, on a specific date, we will be in the endemic phase. Viruses don’t do that. We are still in the pandemic. You don’t stop a virus with a bombardment, it gradually slows down, with epidemics that will have to continue to be controlled. Epidemics will be more controllable because there will be a lot of immunity in [Spain], but we must not think that endemicity means the disappearance or eradication of the virus, but that it stays with us.

Its evolution and its adaptation to us are not finished

Dr Raphael Bergoa

Is it possible that a new, more aggressive variant will appear and replace Omicron?

I have to say that not all more transmissible viruses are less virulent. In this case, we were lucky because the virus was more interested in the transmission aspect, but it is not automatic. We were lucky with this scenario and it is positive, but the virus has still not finished defining itself. Its evolution and its adaptation to us are not finished. Since the start of the pandemic, we’ve had four or five variants that hit us hard and others that seemed to but ultimately didn’t. We have to wait and see if the virus will keep trying to evolve to be more and more contagious.

It’s unpredictable even the virus does not know if it will manage to create another more successful variant. We have to do what we haven’t done in this sixth wave, which is to create the capacity to deal with the unexpected. If I were to use a football analogy, coaches have [players] on the bench to cause the unexpected. If the first half goes badly, they change things. And that’s what matters. We didn’t have that against Omicron. Therefore, since we don’t know if there will be another variant, what we need to do is prepare for that eventuality.

Primary health care is the bench of our team. We need to register more players

Dr Raphael Bergoa

How does a country prepare for the unexpected?

First, make sure we have a plan B. We didn’t have one for Omicron and we’re constantly improvising schools, hospitals, primary healthcare, etc. The most obvious measure is to ensure that the primary health care system, which is the bench of our team, is reinforced in a very, very strong way. Therefore, we need to register players.

it makes sense to create the necessary infrastructure… where children do not infect other children

Dr Raphael Bergoa

Are we constantly improvising with schools, especially now that in-school learning is back?

With the schools, we see an example of a certain improvisation. It is not necessary to speak in terms of restrictions. That is to say, once you have decided to resume learning in the classroom, which is correct, knowing that many students are going to be infected, it makes sense to create the necessary infrastructure, such as the ventilation, CO2 monitors, provision of masks and numerous tests.

In the USA, they will do eight tests a month for free. In England, there have been free tests for months so people can return to work. Some countries require a test to exit quarantine. It makes sense to provide them for free. In the majority of schools across Europe, the tests are free. It is therefore not necessary to debate strategic restrictions in schools, but to create the conditions in which children do not infect other children and people can be tested for free.

even the virus does not know if it will manage to create another more successful variant.

Dr Raphael Bergoa

With such high contagion rates, can we say that vaccination efforts have been a success?

The vaccination was a spectacular success. For the majority of infected Spaniards, [vaccination] kept them from being hospitalized, being in an intensive care unit and dying. That is to say the neutralizing aspect of the vaccine. There is one thing that has not been well understood in Spain, the vaccine is not a shield in the sense that you will not be infected with Omicron, because the variant can partially overcome this barrier. But once infected, vaccination neutralizes the effects of the virus.

When we have it, we hope that this year the [coid-19] sterilizing vaccine, we will be able to say that we have a shield against the infection and, thus, a neutralization. This is very important because many people in Spain and other parts of the world have not understood this separation and believe that being vaccinated means not being infected. No, Omicron manages to pass certain barriers but it is less severe [when it does].

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