On March 15, when the plan to alleviate the restrictions imposed to control covid-19 began, mainland Portugal had an incidence rate of new cases of infection per 100,000 inhabitants of 84.2 and a transmissibility rate ( Rt) of the virus of 0.79, today these indicators have already rocketed to 129.6 and at 1.18.

With these values, the country entered the red quadrant of the pandemic control risk matrix, which stipulates a limit of 120 cases per 100,000 inhabitants for 14 days and a lower Rt (number of secondary cases of contagion resulting from an infected person) to 1.

This worsening of the pandemic has been gradual and evident in the last 31 days, with the country going from 241 cases of infection registered on 24 May to 1,497 registered today, which represents an increase of more than 520 percent.

During this period, Portugal had six days with more than a thousand new cases daily: June 16th (1,350), June 17th (1,233), June 18th (1,298), June 19th (1,183), June 22nd (1,020) having reached 1,497 new infections today, the highest number since February 24th.

Worst in Lisbon

The worsening of the pandemic in the Lisbon and Vale do Tejo region has contributed to this situation the country.

On 22 of the last 31 days, Lisbon and Vale do Tejo had more than half of the daily cases verified throughout the country and on two of these days – June 16 and 20 – this represented 68 percent of the total number of registered infections in Portugal.

Experts attribute the growth in this region, above all, to the prevalence of the Delta variant, associated with India and which has a transmission capacity more than 60 percent higher than Alpha, initially identified in the United Kingdom.

Health authorities also admit that Delta may already be responsible for around 70 percent of the cases of infection in Lisbon and Vale do Tejo and that, in the short term, it is the most prevalent strain throughout the country.

With the number of deaths remaining low in the last month - the daily maximum was six deaths on June 10, 16 and 22 -, the worsening of the pandemic is also beginning to be felt with pressure increasing onth health services, despite the number of admissions to wards and intensive care still being far from those recorded at the beginning of the year.

On May 24, Portugal had 239 people in the wards being treated for covid-19 and another 57 in intensive care, but on Wednesday, a total of 100 people were already in the intensive care units of national hospitals, an increase of 75 percent, which has been gradual over the past 31 days.

That 100 patients in intensive care now represent more than 40 percent of the defined critical threshold of 245 beds occupied, when, on May 28, the pandemic “red lines” report added that this figure was still at 22 percent.

The evolution of the pandemic in Lisbon and Tagus Valley is thus reflected in the number of patients who need hospitalisation, which has already led hospitals in this region to move towards a prevention phase for the possible need to increase the number of intensive care beds in the coming days.

During the last week, Lisbon and Vale do Tejo had 65 percent of all patients in the country hospitalised in intensive care, but now with a different profile from previous vacancies: if they had previously been mostly elderly, now the age group that most needs this type of care is from 50 to 59 years old.

Vaccine acceleration

In order to respond to the worsening of the pandemic, the Government's strategy involves strengthening diagnostic testing of covid-19, including for access to sporting, cultural and family events, but also by accelerating vaccination, especially in the Lisbon region, with the Minister of Health, Marta Temido, pointing to the threshold of 130,000 inoculations a day in July.

But today, the coordinator of the vaccine 'task-force' admitted a delay of up to 15 days when trying to reach the goal of having 70 percent of the population vaccinated with the first dose on August 8, because of delays in the delivery of vaccines by pharmaceutical companies.

According to data from the `task force', around 47 percent of the population has been vaccinated with the first dose and 30 percent has already been fully vaccinated, but the pace of vaccination is starting to be affected by the lack of vaccines.

Return to lockdown?

For now, the possibility of the country returning to the state of emergency, which ended on April 30, seems to be ruled out, since the President of the Republic has reiterated that the numbers of covid-19 are "very far" from those that led him to declare this legal framework.

"The situations are diverse, and the explanation is one: it's called vaccination. And the fundamental path is this. The solution to the pandemic, the lasting solution, the definitive solution is called vaccination. The other solutions are solutions that are found occasionally, temporarily, but the only one that truly has longer and more effective effects is vaccination", defended Marcelo Rebelo de Sousa.

On June 17, at the end of the last Council of Ministers, the Minister and Presidency, Mariana Vieira da Silva, admitted that Portugal might have to stop the transition to a new phase of deconfinement, due to the aggravation of the incidence rate of new cases and of the transmissibility index, considering that the country is “at a worrying stage”.

On Tuesday, the Minister of Health, Marta Temido, considered that the worsening of the epidemiological situation of covid-19 in the Lisbon and Vale do Tejo region could lead to new measures to contain the pandemic and a possible brake on the process of relief from measures.

The warnings are contained in the latest risk analysis by health authorities: Lisbon and Vale do Tejo could surpass 240 cases of infection with the new coronavirus per 100,000 inhabitants in 15 days and the Delta variant is expected to overlap in the coming weeks in the country.

The Government's decisions will be made known on Thursday, one hundred days after the beginning of the easing of lockdown first came into forse, which has gradually evolved from the green zone of the risk matrix, up to the orange and red quadrants, where it is now.