2023-09-04 15:36:47
Covid cases are increasing in Italy, mostly due to the almost total absence of restrictions and the spread of new variants, including Pirola. This week a new circular from the Prevention Directorate of the Ministry of Health will regulate the execution of swabs upon arrival at the hospital and in the emergency room. The objective is the protection of the frail hospitalized and – according to what time.news Salute learns, but the definitive text is still being worked on – great importance should be given to the differential diagnosis, in symptomatic patients, with the other circulating respiratory pathologies. Not only Covid tests in hospital and Rsa, therefore, but also for other respiratory viruses. There could also be an indication for greater attention in residences for the elderly.
ANDREONI: “PROGRESSIVE INCREASE OF CASES WITH RETURN TO WORK AND SCHOOL”
“In the next few days we will see a progressive increase in the number of Covid cases, an inevitable scenario linked, as happened in previous years, to the full recovery of work activities and the reopening of schools in the various Regions. The variant that is circulating has a certain capacity to evade immunity and has a high transmissibility, the hope is that things hold up as we’re looking.” Thus at time.news Salute Massimo Andreoni, scientific director of the Italian Society of Infectious and Tropical Diseases (Simit), takes stock of the situation. “The important point will be vaccination for the over 60s and the frail, as indicated by the Ministry of Health and the scientific societies Siti and Simit, with 12 million vaccine doses expected for the candidate audience for vaccination”, concludes the infectious disease specialist.
BASSETTI: “IT’S NO LONGER A HOSPITAL PROBLEM”
“I am baffled by all the hype we are making in Italy about this alleged return of Covid, because they are false data that are not representing anything of what is happening: an increase in tests and positives but in hospital. Today, after a long time, I have zero Covid patients hospitalized in my ward So Covid is no longer a hospital problem or even a health-organisational one, it is a virus like the flu, like the respiratory syncytial virus or the common cold, they compete with each other in attacking the streets upper and lower respiratory tracts and give a picture that goes from bronchitis to pneumonia”, Matteo Bassetti, director of infectious diseases at the San Martino Polyclinic in Genoa, told time.news Salute.
“Let’s go back to teaching that if a student has a sore throat in the morning and has had a little fever, maybe he goes to school but with a mask. He also puts it on the bus and in class. And so do the workers. The line must be respect for others, without imposing anything. But the idea that the mask should return to supermarkets is wrong. While those who go to the hospital to visit a relative don’t hurt to wear it, not only for Covid but for any other microorganism. Washing your hands before going to school and on returning, as well as those who go to work, is a good hygiene rule. There are no other rules to follow in this period”.
THE NEW PIROLA VARIANT: WHAT WE KNOW
The BA.2.86 variant of Sars-CoV-2, aka Pirola, as it has been dubbed by experts on social media, “is antigenically distinct from XBB.1.5”, i.e. the Kraken variant, “and can escape the neutralizing antibodies induced by XBB. The effectiveness of the updated vaccine should be closely monitored” against this new variant. “However, BA.2.86 may not prevail very quickly due to its lower infectivity.” This is in summary what emerges from the tests conducted in the laboratory of Yunlong Cao, a group that was at the forefront during the Covid pandemic precisely in the evaluation of new variants.
The expert – in force at the Biomedical Pioneering Innovation Center (Biopic), Peking University in Beijing, China – also put the latest new entry in the Sars-CoV-2 family under his lens: Pirola. Internationally, the health authorities as well as the World Health Organization are closely monitoring it due to the high number of mutations it carries, in particular on the Spike protein (which is used by the virus to hook human cells). One of the biggest fears is that it may escape the antibodies induced by the new vaccines. And it could be to some extent like that, but there’s something else too and it seems to be more reassuring.
The tests conducted in Yunlong Cao’s laboratory actually suggest that Pirola “can significantly escape the antibodies induced by infection/vaccination with XBB”, the most widespread family of variants among those currently circulating, but its infectivity “may be much lower to that of XBB.1.5”, i.e. the Kraken variant, “and EG.5”, i.e. Eris, says the expert, explaining via X (Twitter) the new experimental data collected. The group, the scientist goes into detail, used “the pseudovirus neutralization test and antigenic cartography (based on mouse serum immunized with mRna)” and “discovered that BA.2.86 is antigenically distinct” from the original virus and from the Omicron variants “BA.2, BA.5 and XBB.1.5. This means that XBB-induced antibodies cannot recognize and neutralize BA.2.86 well”.
Pirola, therefore observes the expert, “can induce a significant antibody evasion of plasma isolated from convalescents who have suffered an XBB infection. The immune evasion capacity of BA.2.86 even exceeds that of EG.5”, Eris, “and it is comparable to the so-called ‘FLip’ variants”, versions of the virus with a particular combination of mutations that are making their way in particular in some areas of the world and on which the beacon of international health authorities has already turned on.
“As for drugs with neutralizing monoclonal antibodies, all approved antibodies cannot neutralize BA.2.86 well,” continues the scientist, but one (SA55), currently in clinical phase 2-3, “remains effective.” Yunlong Cao explains that his team also identified the “key mutations responsible” for BA.2.86’s increased immune evasion compared to Kraken. But at the same time the team noticed another not insignificant aspect. Through tests on pseudoviruses, explains the expert, “we found that BA.2.86 shows lower cellular infectivity than XBB.1.5 and EG.5, and this could influence its transmission”.
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