The medical director and head of the intensive care unit at the Clínico Virgen de la Victoria hospital, María Antonia Estecha, stresses in this interview that the Covid vaccine saved many lives this summer, when the rate of contagion was high. "If we had not been vaccinated, I don't know what this fifth wave would have been like," she says, before adding: "Most people who have been vaccinated and get Covid are asymptomatic. Many of those who have become infected had not had the vaccine".
What has been the profile of patients who have needed hospital treatment during the fifth wave of the virus?
In general terms, they were younger people who were not fully vaccinated. They had received the first dose, but not the second. They were in their thirties and forties. There were also younger people who had not been vaccinated at all, and elderly people who had been vaccinated early on in the campaign and had then caught the virus again. Some died, but others were not very ill, not like they were at the start of the pandemic.
So although there has been a great deal of contagion and a large number of deaths, the vaccine has meant that fewer people have had to be admitted to hospital for treatment, or have died.
Yes, that's right. Some people did still become seriously ill and some did die. Nevertheless, many others did not become very ill, especially those who were already vaccinated. On the other hand, the patients who weren't vaccinated, either because they had not yet had the two doses or because they had decided not to have the vaccine, were as sick as during the first wave.
Did most of those who were vaccinated but caught the virus anyway have underlying health conditions?
Yes, but the vast majority of vaccinated people who caught the virus were asymptomatic. Most of those who became infected had not been vaccinated. Very few vaccinated people were seriously ill with the virus. The vaccine has been a really important shield. If we hadn't been vaccinated, I don't know what would have happened in this fifth wave.
What message do you have for people who are reluctant to have the vaccine against Covid?
These people need to know that very few people who are vaccinated have been seriously ill; it's a very small percentage. The people who are still getting sick are those who have not yet had time to have both doses of the vaccine or haven't wanted it. That happens in about 95 per cent of the cases. There are very few vaccine failures. In the intensive care unit at the Clínico hospital, out of the more than 60 patients we had during the fifth wave, only two of them had been vaccinated.
Some people refuse to be vaccinated because they claim that the vaccine doesn't stop contagion. What's your response to that?
The vaccine stops you becoming very ill, but it doesn't stop you catching the virus, up to a certain extent. We have had medical professionals who have caught Covid outside the hospital and have not had any symptoms.
They are now giving a third dose to people whose immune systems are suppressed.
Yes, these are patients who have a tumor and are undergoing chemotherapy or who, for example, suffer from a rheumatic illness and take powerful anti-inflammatories such as corticosteroids.
And they have now started to give a third dose to elderly people in care homes, too.
What they're trying to do there is increase the number of antibodies in older people so they are better protected. There have been cases of elderly people who had Covid in the first wave and have become reinfected despite being vaccinated, which must be because their level of antibodies dropped and they did not have sufficient response to stand up to the virus.
One of the effects of the fifth wave was to delay operations. Are things more normal now?
Yes. The number of operations has increased significantly in September, after a month of August in which we did everything we could. Nobody was expecting what happened with Covid this summer. And it has been very hard, because so many professionals were on holiday. Everyone is very tired, and we have to look after them. You can't allow yourself the luxury of cancelling their holidays. So, it was a difficult time, and those of us who were working were doing double shifts. I hope all this is over soon, because the staff are so tired.
I know that with this virus it is difficult to make predictions, but are you expecting more cases this autumn?
I hope that we will reach a high enough level of immunity through vaccination so there will be no more waves of the virus. It is possible that there may be small outbreaks, but not like the situation this summer with the fifth wave. What we need now is 90 per cent herd immunity. For that to happen, people need to be aware of the situation, and those who are not yet vaccinated need to have the vaccine. Apart from that, it is very important to continue using face masks, because there are still people who have not been vaccinated.