The director of the Mario Negri Institute for Pharmacological Research: «We need to know if there are variants other than Omicron»
Ua very heavy wave of infections in China, the fear of new variants (non-Omicron) that “escape” from vaccines, the concern for Gryphon (Xbb), whose diffusion is rapidly increasing in the United States. What’s going on?
“We are in a delicate phase, but let’s not be alarmed ahead of time,” he replies Joseph Remuzzi, director of the Mario Negri Institute for Pharmacological Research and full professor of Nephrology at the University of Milan -. What is happening in China, with one million new infections a day (which according to estimates could increase to 3-4 million between January and March), is due to the ill-considered “zero Covid” strategy: everything has been staked on isolation, the vaccination campaign has slowed down significantly and the virus has circulated little. From “all closed” we have suddenly moved to “all open”: in this way the virus has free ground because it encounters a poorly immunized population. It is an unacceptable mistake almost three years after the start of the pandemic ».
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What is the situation today in Italy?
«90% of the over 12 population has completed the vaccination cycle and we enjoy widespread immunity. We know that the hybrid one, given by infection plus vaccine, is the most effective immunity. According to the Higher Institute of Health, the risk of severe disease is 80 times higher in those who are not vaccinated or have not had a recent diagnosis of Covid. Now it is extremely urgent to administer the fourth dose (and then the fifth, after 120 days) to the over 60s, then to the rest of the population. The flu vaccination is also important. Children from 6 months onwards should be vaccinated for both Covid and the flu, according to the indications of the most important pediatric societies, while, as the British Medical Journal, in adolescents the fourth dose could be avoided. For recalls, any mRna vaccine is fine, perhaps better the bivalent adapted to Omicron Ba.4 and 5, but it is not an essential condition ».
What could we risk in the near future?
«It is correct to test passengers from China for Covid with the aim of sequencing the variants (a few hundred sequencings are sufficient), to have a precise idea of what is arriving from the Asian country. If the variants all belong to the Omicron family, as it would seem so far, we can be relatively calm because vaccines protect 80% from serious disease and, to a lesser extent, also from infection. The situation would be more worrying if a variant other than Omicron appeared or began to spread massively Gryphon (Xbb), and in particular its subvariant Xbb.1.5, which from the first data seems to give a high risk of reinfection. At the moment, however, there is nothing to worry about because Xbb is 6% globally and 1.8% in Italy. The United States is an exception, where it reached 13%. The indication of the American Centers for disease control and prevention is interesting, which asked airlines to embark only passengers with a negative swab carried out no later than the previous 48 hours: it is the simplest and most immediate strategy to implement ».
Are we ready for a possible new wave?
«Yes, but in Italy we need to start investing again in the health service, especially at the local level. The “Health Houses” have been announced, built with funds from the Pnrr, but public health must be governed: the new structures should not be entrusted to private cooperatives, but to family doctors who depend on the National Health Service. A study recently published in the journal Nature shows that the excess mortality during the pandemic (estimated at 13-15 million deaths) mainly concerned countries with weak public health (such as India) or entrusted to private insurance (such as the United States). Italy has not done badly, but has been overtaken by Germany which guarantees treatment to all citizens and has a strong territorial network. The pandemic has taught us two things: the first is, precisely, the importance of well-organized public health and the second is that medium and long-term forecasts are better not to be made”.
December 30, 2022 (change December 30, 2022 | 11:27 am)
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