Covid, influenza and respiratory syncytial virus (RSV) are growing in Europe and the ECDC returns to “recommend the use of masks in crowded public spaces to people at high risk of serious diseases“. In an epidemiological update published today, the European Center for Disease Control addresses a series of advice to the Member States of the European Union and the European Economic Area (EU/EEA) to mitigate the impact of Covid, influenza and viruses respiratory syncytial (RSV), but also other pathogens such as Mycoplasma pneumoniae.
“In recent weeks – says the director of the centre, Andrea Ammon – we have found signs of an increase in community transmission of respiratory viruses, typical of the winter season. There are several steps to take that can save human lives and avoid overloading health systems”. Actions which include “vaccination, strengthening hospital capacity, strengthening training and awareness, infection control measures, rapid tests and use of antiviral drugs”.
Among respiratory viruses, “Sars-CoV-2 is currently predominant – the ECDC notes – while Rsv, seasonal flu and other viruses co-circulate at lower levels, but with an increasing trend. At the moment “Severe Covid-19 mainly affects people aged 65 and over“, while “the increase in RSV activity has led to an increase in hospital admissions, particularly among young children. Although currently at low levels, influenza activity is expected to increase further during the winter months,” the agency warns. “Even seasonal epidemics of various other pathogens causing respiratory symptoms that occur every few years (such as Mycoplasma pneumoniae ) contribute to the increase in the number of patients presenting to primary and secondary care”.
Ciccozzi appeal
“Today we should put the mask back on when traveling on the train, subway or bus. Other than avoiding kisses! What is the probability that I could get infected with a kiss to a friend who I know and I know does not have Covid why does he have no symptoms, and how much is it when traveling on the subway in close contact with people, perhaps touching the various chairs, and on the train? The latter is extremely higher. So the suggestion is precisely this: to put Ffp2 absolutely in metro, train and plane. Then it is clear that it is also good to wear it in hospitals, in RSAs, but – especially in big cities – on the metro and train they are essential when traveling for Christmas”, says Massimo Ciccozzi to Adnkronos Salute, head of the Medical Statistics and Epidemiology Unit of the Faculty of Medicine and Surgery of the Bio-Medico Campus of Rome, launching an appeal for the return of the Ffp2 mask on means of transport in view of Christmas.
ECDC recommendations
Here, in detail, ECDC recommendations against winter respiratory viruses. In addition to the mask chapter, the European agency urges us to “vaccinate the most vulnerable against Sars-CoV-2 and influenza, as well as against RSV in the countries that are introducing this Vaccine, in order to prevent the progression of the infection towards a serious disease; increase the capacity of emergency rooms and intensive care units (as needed, in terms of staff and beds) in both adult and pediatric hospitals; ensure that healthcare personnel are trained to implement adequate infection prevention and control measures, so as to help reduce the burden on healthcare facilities and avoid outbreaks within them, including long-term care facilities; raise awareness among healthcare workers to ensure a timely diagnosis of cases and improve hospital preparedness in managing the increase in patients in emergency and intensive care units, both in pediatric and adult hospitals”.
Again, the ECDC invites “performing rapid tests to facilitate early diagnosis and organizational decisions, appropriate treatment and implementation of public health measures when necessary”. It is then recommended to “remind doctors that, when indicated, the early use of antiviral treatments for Covid-19 and influenza can prevent progression to severe disease in vulnerable groups and that Rsv prophylaxis for newborns may be considered, in accordance with national guidelines. The use of antibiotics for bacterial respiratory infections should follow a medical evaluation – experts point out – since antibiotics do not treat viral infections”.
The ECDC urges countries to “implement risk communication activities for the public, including strengthening vaccination promotion against seasonal influenza, Covid-19 and RSV according to national recommendations. Messaging should also promote good hand hygiene and of the respiratory tract, encourage people to stay at home when they are ill and ensure adequate ventilation of indoor spaces”. Finally, “consider the use of the ECDC's '5C diagnostic model for vaccination', for more effective promotion of recommended vaccines”. The 5Cs stand for Confidence, Complacency, Constraints, Collective Responsibility and Calculation: trust, satisfaction, limiting conditions, collective responsibility and calculation through risk communication activities.
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