Beyond the regulations and limits still in force (such as that of indoor masks) how to behave personally to protect yourself from Covid, especially if you are part of a risk category? The answers of the immunologist Viola
Italy reopens and the April 1st the state of emergency due to the Covid-19 epidemic that lasted more than two years will have ended. There are many restrictive measures that see the end (we have talked about them in detail WHO
), such as the color Regions system. A second step towards the total return to normal is expected on May 1st with the fine del green pass.
Among the decisions taken by the control room of the government is that of remove the quarantine it imposes positives on close contacts even for those who are not vaccinated. Meanwhile, even if the state of emergency is over, the pandemic is not over, which in Italy, as in the world, is regaining strength. According to the newly released weekly monitoring data, theRt rising to 0.94 and the incidence continues to increase (we talk about it WHO
) reaching 725 new cases per 100 thousand inhabitants. The new positives on weekly change have grown by an average of 41%, although the rate of climb of the curve is slowing down.
In this context, with the abandonment of most of the restrictions and beyond the prescriptions that remain, we asked Antonella Viola, immunologist at the University of Padua, what should the citizen who wants to protect himself against the virus do?
The only recommendation we have to give people to always wear the Ffp2 masks when they are indoors or full of people. proved to be the only tool that truly protects us from contagion. The government maintains the obligation to wear masks indoors until April 30, even if the Ffp2 are foreseen only in some contexts. Obviously, vaccinating yourself is the key means of protecting yourself from disease and the severe consequences of Covid: those who have not done so must take the third dose to complete the vaccination cycle, also because only two doses are not enough against the variant in circulation.
Without quarantines, can we think of greater protection according to personal risk?
If there are no more quarantines, there will be many more positives around and the only way to defend ourselves is to wear masks indoors. The alternative to stay at home. The point that young people vaccinated feel rightly safe from the disease (they hardly go into severe disease, unless they are “fragile” for other reasons) to remember that they can bring the virus home to their parents or grandparents. the reason why I insist on keeping the mask indoors: not so much because the boy has to protect himself, but because it is a source of contagion. If we all make this sacrifice again at this time we will protect the people most at risk.
Are the elderly still in danger?
Many have done the third doses in November, December: the protection is decreasing and in the coming weeks it will decrease a lot. Already now we are seeing many people who, despite the third dose, have become infected. In some cases they even make the disease, although in most people it will not be severe because the vaccine protects against hospitalization and death. The main problem in the coming months will be protecting the most vulnerable elderly.
What does this new generalized rise in cases tell us about the future of the virus?
This queue due to the Omicron BA.2 variant (WHO the article on the variant with the questions and answers), which is now prevalent in Europe, Africa and Asia and is growing in America. In Europe there are countries that already have very high peaks now. This variant is much more transmissible than the “first” version of Omicron and is immunoevasive (i.e. able to partially evade the protection offered by vaccines or healing, ed). What does it tell us about the future? That the virus keeps changing in a very clear direction, that of having a Spike (the protein that attaches to human cells, ed) which infects a lot; there is now also evidence of a mix between Omicron and Delta (therefore a reorganization of the virus) in which Omicron’s Spike is still maintained. This too is telling us that the path that the virus has chosen is to maintain this Spike which has a very strong affinity for the ACE2 receptor of human cells and therefore is able to infect very efficiently (the current BA.2 is thought to be the most contagious airborne virus ever to appear on the planet, ed).
Are we at risk of catching Covid every three months? a seasonal virus, or do behaviors matter more?
The seasonality of Covid depends above all on our behavior: it is obvious that with schools closed, offices closed and everyone at the seaside, the risk of contagion is much lower. I know that the sun and temperatures also have a certain influence, but the data says that the behavior factor is the main discriminating factor, so yes, we risk getting Covid every 4-5 months, despite protection from serious illness.
How many months do the vaccines in use with the three doses protect against severe disease?
The studies are still in progress, but what has been seen in any case, even with regard to the severe disease, after four months there is a decline, for this reason Israel has made the fourth doses.
Will the fourth dose have to be done? Not a risk?
The data clearly show that there is no problem of anergy (it was feared that the immune system subjected to close vaccination would no longer react, ed): the immune system responds by producing antibodies. There is for a low efficacy of the protection, that is the advantage that the fourth dose offers minimum and, above all, we do not know if it lasts only a few weeks or is maintained, so at this moment there is a skepticism in the scientific community towards the fourth dose. From an operational point of view, it is unthinkable to vaccinate people every three to four months.
Pfizer and Moderna are asking for authorization for the fourth dose, what is the orientation in Italy?
The idea is to eventually administer it to the over 65s and not to the entire population. Even those over 65 cannot be vaccinated every four months, so in Italy we will probably offer the fourth dose in September. For this reason, from now until autumn you have to be careful: if the curve remains low, the situation is acceptable, if it begins to rise too much you have to run for cover.
Will we never get rid of SARS-CoV-2?
Not for now: another scientific work has just come out that has demonstrated the passage of the virus from the white-tailed deer to humans. It is now evident that animals are a natural reservoir of SARS-CoV-2 and the species that can host the jump of the virus from man to animal and propose it backwards to man are many. This is why it is said that we will not be able to eliminate Covid: it will be a global health problem with which we will have to deal. These vaccines have saved us from a catastrophic situation, but they are not the final solution.
Would it be more useful to study a pan coronavirus vaccine or a vaccine that also curbs contagion?
Both aspects: we need the pan coronavirus vaccine because there are so many other coronaviruses that are ready to make the leap of species and therefore would protect us from future problems; now we need a vaccine that is able to protect us from contagion, but also to last over time. Relying only on one Spike to build vaccines is not the right way, we have to think about something else: there are several working groups that are carrying out vaccination strategies with a different approach, based on other SARS-CoV-2 proteins for it some more time, in the meantime we have to use the masks.
Could the end of the restrictions, but also the dismantling of the CTS (Technical Scientific Committee) and the commissioner structure, somehow hinder the studies that are necessary to monitor the progress of the virus?
The structures should now be consolidated both at the regional and at the state level, furthermore the Istituto Superiore di Sanit (ISS) does this work by definition. I agree with the end of the state of emergency because two years have passed, we have concluded the vaccination campaign and we must move to a state of vigilant coexistence. The wrong message that, once the emergency is over, Covid is also over.
March 18, 2022 (change March 18, 2022 | 13:47)
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