WHO Europe director Hans Kluge sees a “
plausible
“Final game”
»In the fight against the epidemic. The prerequisites can be seen but caution is needed
In the long battle against Covid, the director of WHO Europe Hans Kluge glimpses a “plausible “final game” ; the possibility of a long period of tranquility and a much higher level of defense against any resurgence of the contagion “. Therefore, always in the words of Kluge to a “ceasefire” that could lead us to a lasting peace. But will it really be like this? On what elements are the statements of the WHO Europe director based? We asked Paolo Bonanni epidemiologist, full professor of Hygiene at the University of Florence.
Why is it possible to be optimistic about the advent of a better time?
«It is an optimism to always be taken with a certain margin of insecurity, but it is quite reasonable in the sense that we we cannot expect to continue to have a circulation of viruses and variants as we have had in the last two years fundamentally for one aspect: the advent of Omicron with the very high contagiousness it had, and therefore with all the cases it caused, resulted in a natural immunity that was combined with the immunity determined by vaccination.
“Certain claiming that vaccines lead us to make the Sars-Cov-2 coronavirus disappear completely is quite unlikely. But there are grounds for thinking that slowly this virus can transform itself from a pandemic virus to a winter epidemic virus, like the flu. Because I repeat we now have an immunity – albeit not lasting, albeit partial, towards some variants more and towards others less – against these viruses which could then allow us to review them only periodically in the winter seasons. So then we should go towards that evolution ».
Besides vaccination and natural immunity, are there any other factors at play?
“The exit from winter. The cold disfavors us towards respiratory viruses basically for a couple of reasons: one, the fact that we live more indoors and therefore we have a greater tendency to stay in environments where the virus does not disperse as outdoors but remains present with the higher concentrations. If, on the other hand, we live more outdoors, that is, we eat in restaurants outside because it is hot, we stay with the windows open in the offices and therefore there is a significant change of air or we have air conditioning systems, we have a life less in contact with each other. That is, there is a question of dilution of viral loads. The second element is the issue of cooling: however, the cooling of the mucous membranes is always a factor that favors the engraftment of viruses, as also happens with the flu. So even cooling is a factor that somehow weakens our natural defenses, our barriers in the face of the presence of viruses and their attack. Going towards the heat, these two factors are lacking ».
Less serious than Omicron: is it now a fact?
«I would say yes, because there are now so many jobs, so much scientific evidence that Omicron tends to affect the upper airways more compared to what hit the lower airways more the Alpha variants and especially the Delta which was quite naughty. Here, too, we do not have the absolute certainty that an equally contagious and worse variant cannot reappear. However in evolutionary biology usually everything goes towards a situation where viruses tend to adapt to the host. We are their host, it is not convenient for them to kill us but it is better for them to be able to transmit more and more efficiently from one element of the species to another ».
Are we sure that there will be no outbreaks of infections?
“We can be reasonably safe. If I were to sign that nothing will ever happen again, that there is no chance of a more contagious and badder variant coming out, this in the biological field can never be excluded in absolutely certain terms. It is quite reasonable to think that if we have constituted an underlying immunity, it is also reasonable to think that it is difficult to come up with a variant so different that you find us completely uncovered. In other words, we would have some degree of cross-protection anyway. So maybe it could be those who have had a single dose of the vaccine, or have had infections from variants further away from those that appear so those who have had an infection from Wuhan for example, maybe they can be a little more sensitive and then maybe they will do the his infection and then at that point we will have infections as for the winter, seasonal flu ».
Will we be able to give up some of the measures implemented in recent years?
«Give up all of a sudden, absolutely not. That is d
we have to adjust the shot if anything, and mitigate some of these measures in situations where they have less significance. Let me give you an example: I think in a month or two continuing to keep the masks outdoors will not make much sense in conditions where there is no crowding. So certain things that are also from a certain point of view difficult to continue to maintain, I think that there may be a relaxation on that. We need to see how to monitor vaccine doses. For now, none of us are saying that an immediate fourth dose is needed now because after the three doses a certain level of immunity is reached and should be maintained with a little longer time. But in short, if it takes the fourth dose we will see it over time. For now we do not say it yet ».
Above all, how to convince the almost 2 million Italians over 50 to get vaccinated?
«I can’t imagine the strategies anymore, because I think these people have a sociological cultural imprint completely different from the rest of the population. They think that the scientific truth is different from what is said and supported by 99.9% of scientists in the world, they think that like saying that vaccinations are something of little use or in any case misrepresented. In short, I don’t think they are questions of conviction through irrefutable proofs, which have always existed, but the problem is that how to say if a person does not want to understand a certain type of reasoning and does not have a logic based on scientific data “.
Technically what are the elements that determine the declaration of a disease as a pandemic?
“A disease becomes pandemic when an infectious agent appears that is substantially new to that species at least. That is or whatever it is an infectious agent or that had been present in the past but then disappeared or that was present in another species as in this case and it appears in a population and therefore is totally susceptible. The problem is that the spread of infections happens so dramatically fast when none of our species had any kind of protection against that virus because they had never seen it before. So when a new effective agent appears for that species that has a great spreading capacity and to which no one is immune, when this disease spreads and is present in a certain number of countries, at that point the pandemic is declared ” .
What about becoming an endemic instead?
“We will arrive at the moment when the pandemic will be declared over because we will have reached the situation in which the virus becomes constantly present with a small number of cases but which manifests itself in an epidemic form, perhaps only in the winter season. So it becomes something that looks a lot like the flu: that is, it becomes endemic with epidemic ignitions. Some cases of flu, maybe if one went to look for him, he would also find it in August but hardly. So there are very few cases, but then from October onwards it starts again, very very low. Maybe in some cases until December we don’t see any cases of flu or in any case we can’t isolate them. Then the seasonality starts, usually between December and March then from April it goes back down and then maybe for the whole summer it remains at such low levels that they are not seen or it just disappears. So we will go towards a situation of this kind, always presumptively ».
And the unknown factor of countries with low vaccination levels?
“This is the real sore point. In the sense that we say these things by looking only at our advanced Western world, which has always been able to vaccinate practically the entire population with even three doses. The real problem – which is also the problem that this question mark leaves us about the possible emergence of unexpected variants – is that as long as we let the coronavirus circulate freely there is always the risk that the more it circulates, the more it reproduces, the more it multiplies, the more it gives rise to variantsAnd maybe the one hundred and fiftieth is a contagious variant, maybe even a bad one, and then at that point we start over. For selfish altruismif we want a bit of an oxymoron, we should instead help the diffusion of vaccination because we too would have a return in terms of reducing the risk of returning to the situation we have experienced for two years “.
February 3, 2022 (change February 3, 2022 | 18:07)
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