Vice Admiral Henrique Gouveia e Melo, coordinator of the task force responsible for the implementation of the national vaccination plan against Covid-19, this Wednesday the Assembly of the Republic answered the questions of the deputies about the course of the vaccination process. In Parliament, Gouveia e Melo gave figures, envisioned the next steps in vaccination, answered questions about AstraZeneca and assumed that the country was not prepared for a large-scale operation – so failures will be inevitable.
According to Gouveia e Melo, Portugal reached last Sunday the barrier of half a million people already vaccinated with the two doses. “Last Sunday, 500,275 second doses administered in Portugal were reached”, explained Gouveia e Melo. Although the DGS bulletin this morning still accounts for 472 thousand people vaccinated with the second dose, the vice admiral clarified that the DGS data refer exclusively to mainland Portugal and that the task force gathers the numbers of the continent and the islands. The first to receive the vaccines were health professionals, still in December, followed by elderly people living in nursing homes and then the entire elderly population.
Also last Sunday, the milestone was reached 80% of elderly people over 80 years old already vaccinated with the two doses, added Gouveia e Melo.
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At the same time, members of another priority group are also being vaccinated – people aged between 50 and 80 and with a number of associated serious diseases – as well as members of the educational community. Responding to criticisms about the inclusion of teachers and school staff in the priorities before all the elderly were vaccinated, Gouveia e Melo clarified that this is not the case. task force which defines the priorities, but pointed out that the vaccination of the educational community is serving as a test of the country’s ability to vaccinate several thousand people in one day – an essential test for the summer challenge.
Gouveia e Melo left a specific date: until April 11, must be vaccinated, with the two doses of the vaccine, all elderly people over 80 years old, all residents in nursing homes and all people between 50 and 80 years old who have a set of comorbidities considered as factors of great risk for Covid-19. “Of course, there may be small bags that we are unable to contact, but the vast majority will be closed, in principle, until April 11.”, Observed Gouveia e Melo.
The following weekend will accelerate mass vaccination among the educational community. About 200 thousand people will be vaccinated “already in the transition from the first to the second phase“, At a time when the priority ones will be practically all vaccinated, and the process will also serve“ to test our methodologies of vaccinating 100 thousand people at once, which we have to test before May, before we start with these vaccination rates ” in the general population.
According to the vice admiral, the vaccination plan is now focused on increasing the scale. With the vaccination of the two main priority groups of the most vulnerable people practically ended by April 11, the task force vaccination will focus on ensuring that no one is left out.
First of all, it is necessary to arrive at such “small bags”Of priorities that may have been left out of mass vaccination. Municipalities and GNR will help health authorities to identify info-excluded or isolated elderly people, confirmed Gouveia e Melo in Parliament. “We are creating mechanisms to reach these grants, through the municipalities and through the GNR, to prevent elderly info-excluded or isolated from escaping us from the vaccination network”, said the military.
“The mesh is made for the majority, to reach 90 or 95% of the people. The remaining 5% are more complex processes, which cannot be done in the massive process ”, he added. “In fact, there was a gap between 65 and 80 years of age, while we have not released the AstraZeneca vaccine over the age of 65. We are trying to close that gap.”
Gouveia e Melo also estimates that there are about 40 thousand people bedridden or isolated in the country that need to be identified through partnerships between health authorities and local authorities, parishes and GNR. To the deputies, Gouveia and Melo underlined that the five health regions of the continent are already making efforts to identify all these people and detailed that the project of the Calouste Gulbenkian Foundation, which made available half a hundred vans to vaccinate people in the homes, will be an important element of this effort.
“No one can be excluded from the vaccination process”, Explained Gouveia e Melo. “This effort consumes a lot of human resources and requires a lot of organizational capacity to help these people.”
But the big challenge for the next phase will be large-scale vaccination. While, for now, people are being vaccinated by health centers – either in their own medical facilities or in local vaccination centers established in partnership with local authorities -, in the next phase, mass vaccination should take place, essentially, in 150 rapid vaccination posts installed throughout the country and which should be fully operational from May.
Starting in April, at a time when the mass vaccination of 200 thousand members of the educational community will simultaneously mark the transition between phases and serve as a test of the capacity of the national system to vaccinate thousands of people in a single day, these posts will begin to be reinforced so that they can be fully operational in May. The arrival of more vaccines in Portugal will allow, in April, an average of 60 thousand vaccines per day to be administered in the country – but the goal is to reach a average of 100 thousand inoculations daily, between first and second doses. On peak days, the number of vaccines administered can reach 150 thousand.
For these rapid vaccination posts, 2,500 nurses, 400 doctors and 2,300 assistants will be needed for the process. The professionals essentially come from the NHS and “the idea is to use up to 20% of nurses who are in primary health care, which are 9 thousand, therefore 1,800 nurses ”. To these will be added health professionals hired.
At national rapid vaccination stations, national standards will be implemented in order to be able to vaccinate the largest number of people per day. “The fact that only nurses can register a vaccination on the portal is a limitation, it is a waste of resources in my opinion”, said Gouveia e Melo. “We are trying to remove that limitation.” In addition, “phone calls are a huge administrative burden that often fall on nurses”, and hence the inclusion of the possibility of self-scheduling. “As we move from a more info-excluded and older population, the process accelerates“, it says.
With the second phase of vaccination taking place at the expected rate – and the vaccines arriving in Portugal in the expected quantity -, Vice Admiral Gouveia e Melo says that the country will have “certainly more than 70% of the population vaccinated with the first dose”Until the end of the summer.
Responding to questions from deputies about the AstraZeneca vaccine, Vice Admiral Gouveia e Melo explained that the total universe of vaccines that Portugal plans to receive is situated at 35.8 million doses. Of these, about 6.5 million will be from AstraZeneca – the vaccine which, after being suspended for a week in Portugal and in almost the entire EU due to suspicions of causing blood clots and thrombosis in some people, is back under fire after Canada and Germany suspended its administration to people below 55 and 60 years of age.
Gouveia e Melo also ruled out, for now, any change of position in Portugal regarding the AstraZeneca vaccine. “The European Medicines Agency (EMEA) has not changed its position on AstraZeneca. There are a number of movements around AstraZeneca, which are often not perceived if they are only of a clinical nature, a clinical concern, or if they are of another nature, ”said Gouveia e Melo.
“What we have decided to do is to follow the AEM’s strict recommendations. Therefore, the European regulator. At the moment, the European regulator does not create any restrictions on the use of this vaccine, continuing to affirm that the advantages far outweigh any inconvenience that may appear“, finished.
This week, Canada decided to suspend the administration of the AstraZeneca vaccine to people under 55. Two Berlin hospitals later announced that they would not administer it to people under 60, opening the door to a decision along the same lines across Germany. After being suspended for a week in practically the entire European Union due to suspicion of a causal relationship with episodes of blood clots and thrombosis, the AstraZeneca vaccine again received a vote of confidence from the AEM and WHO. However, the registration of those adverse effects in younger people is taking several countries and suspending the vaccine in people under 60 years of age.
Vice-Admiral Gouveia e Melo recognized in Parliament that the organization of the calls and the scheduling of an average of 100 thousand vaccines per day in the summer is “one of the biggest concerns” gives task force vaccination.
“Scheduling and invitations are a high concern in organizational terms. If anyone thinks that everything was prepared, they were not. The country was not prepared to give 20 million vaccines in about six months”, Said Gouveia e Melo to the deputies.
“There are a number of adaptations that are being made at an accelerated pace. There are also flaws, we have to live with the flaws. If anyone thinks that this process is going to be flawless, he is demanding things that are impossible to do. The country was caught by a pandemic, which forced quick solutions. We didn’t have much time to do infrastructure planning, ”added the military.
The self-scheduling system will be one of the mechanisms to mitigate this difficulty, explained the coordinator.
At the same time, the coordinator of the task force of vaccination defends that, after the priority of the first phase – which ends with the educational community – is vaccinated, the criterion should be exclusively age.
“All groups are important, everyone has justifications for prioritizing,” acknowledged Gouveia e Melo. However, there are no vaccines for everyone in the priority phase, he added, answering a round of questions from deputies in which questions related to one or another specific professional group have arisen several times. “If not, we vaccinated all of Portugal in the first phase by the priority groups”, Said Gouveia e Melo. “The fairest criterion from the second phase onwards is the age criterion.”
The vice-admiral pointed out that there is a correlation between many diseases that aggravate a clinical picture of Covid-19 and age, advocating vaccination “for decreasing age groups”. The exception is serious illnesses that affect “very young” patients, who force them to be “pulled forward”.
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