“No alternatives to closures, the risk of variants must be reduced”


In Italy covid and variants are circulating in a widespread way, so there are not many alternatives to “targeted and determined closures”. This is the reflection of Ranieri Guerra, an Italian expert from the World Health Organization (WHO), while the government has approved a new decree with measures valid from Monday 15 March until 6 April. Measures that foresee Italy in the red zone at Easter.

“In Italy today the situation is of fairly widespread circulation of Sars-CoV-2 and its variants that are worrying, and there is still a vaccination rate that varies according to the system in which one is found. I believe that the Government is is orienting on the basis of these assessments towards the road of targeted closures determined by the epidemiological situation and by the evolution trend of the infections, but it does not seem to me to have big alternatives, precisely because the diffusion of the variants is quite extensive and it is difficult to propose a vaccination to carpet in localized areas, also given the porosity of regional borders, evident beyond the fact that by rule the movements between regions should be stopped, but I think it is a little respected stop “, said Guerra.

“Obviously, having at this moment the anti-Covid vaccines available to a limited extent, we must resort to the option of putting up further barriers”, he explains to time.news Salute, looking at the phase that the country is going through and at the debate on a tightening of anti-contagion measures at national level. “The logic is very clear: there are variants that also emerge due to evolutionary pressure. It is evident that, if you are unable to contain the epidemic and the virus circulates, this gives rise to variants that compete with the wild strain, evolve and damage a competitive advantage that makes the contagion spread even more quickly. So it is an obvious logic: either vaccination coverage is increased if you have vaccines, or movement is blocked and restrictions are adopted to slow down the spread of the virus and the vaccination campaign continues on the basis of availability. The variants are quick, probably more harmful in some cases, there is not much to have imagination “.

“We see it in Germany – observes Guerra – which relaxed the restrictions for a couple of days and the infections started again; we see it in Italy where, after a month-a month and a half of relative stability, the numbers of Covid-19 are restarting in an important way; and we also see it in other countries. But we don’t see it in the UK, where the vaccination action has been so powerful that they have managed to act on the coverage factor “.

As for the campaign put in place in Italy, “to get it off the ground we need to tackle the logistical problem, but I believe that now we are seeing a big improvement – says the WHO expert – I have seen the latest numbers and it seems to me that the I pass in the last days “.

Returning to the strategy that lies ahead in this phase of the fight against Covid-19, “the problem is therefore that: if we, in this phase in which we do not have abundant doses of vaccines, but still numbered, let the virus run, we will find ourselves tomorrow – when the doses become sufficient – with a high spread of the contagion and the risk that further variants emerge that could cause problems “, continues Guerra in his reasoning. “We have two factors: the blocking factor and the vaccine factor. They must be played together according to the location in which we are operating. About a month ago I strongly recommended to use also the reserve doses to carry out reactive vaccination actions, which it is itself a containment measure: that is to go and vaccinate everyone in those areas where the most dangerous variants emerge. As should also have been done in the province of Perugia, where the Brazilian variant, which is among the most dangerous, circulated a lot “.

The combination of the two factors once again “is crucial. This vaccination strategy that ‘surrounds’ the risk area can be done where there is a variant that emerges in still manageable numbers. In this context, vaccination must not only be intensified of the frail, but also of people who can become carriers of the virus, so you have to be immunized in schools, in the workplace, everywhere. This is a bit like what is done with the most dangerous viruses, as happened with Ebola . The containment vaccination strategy is effective – he concludes – when the localization of certain viruses and variants is concentrated in limited geographical areas “.

And now that the anti-Covid vaccination has begun, the question of when will it return to normal, when we can say goodbye to masks and distances between people, becomes more and more pressing. “After the vaccination is completed, we will have a few months in which we will have to verify that the transmission chains are interrupted.” But the return to life as usual “will not be something that will happen all together. I foresee that it will be a gradual return to normal activities, by sectors and geographical areas”. Try to look to the future that awaits us Ranieri Guerra, Italian expert of the World Health Organization (WHO).

“Part of the norm is to resume travel and interconnection – highlights time.news Salute – This will happen before” the end of the vaccination campaigns, “with the necessary precautions and risk reduction actions. There will also be differences”. For Guerra, however, rather than wondering when we will return to how we were before, the perspective should be reversed. “I turn the question: for me it is not worth going back to exactly how we were before. It would be a missed opportunity. Let me explain: we should instead seize what happened to rethink some aspects at a micro and macro level. Rethink the importance of managing with a unified vision of human, animal and environmental health, moving towards ‘Planetary health’, which is fundamental to blocking new epidemic risks in the future. Another issue that has emerged strongly is that of inequalities. So, if they told me that the world will return to the way it was before, I would say that in this way we lose an opportunity “.

As for the gradual resumption of contacts and activities, Guerra observes: “One cannot fail to look at the whole problem of border healthcare; certainly one cannot ‘shoot’ at everything that approaches the borders. The EU faces the problem, it cannot hide from this. The cross-border problem will have to be faced by Europe as a whole, as well as by the rest of the world. In this situation, the national logic is secondary to the European one, it must be supranational “.

On this front, Europe seems to want to try to put the lessons of the pandemic into practice, with a funding program (worth over 9 billion euros) to be put in place for 2021-2027, ‘EU4Health’. This is the line designed to achieve the goal of a healthier and safer EU. Among the key issues being addressed are the need to build resilient health systems to the need to ensure prevention, preparedness, surveillance and response to cross-border health threats.

From this pandemic, concludes the WHO expert, “we do not save ourselves, but together, in a solidarity and participatory logic, of sharing the vaccine as a global public good, as very rightly said not only by my director general”, Tedros Adhanom Ghebreyesus, “but also and above all by the Pope”.


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