Covid cases rise, death toll grows. The bulletin for the week of August 22-28 paints a clear picture in Italy and fuels a debate among experts. Is this a situation to monitor or is it business as usual?
Andreoni: “A change of direction is needed for the fall”
“Certainly the growing numbers of Covid, including deaths which in the last week have reached 135, are a cause for concern because we are in a period of the year in which the circulation of the virus has never been particularly significant”, Massimo Andreoni, scientific director of Simit, the Italian Society of Infectious and Tropical Diseases and full professor at the University of Tor Vergata in Rome, tells Adnkronos Salute.
“A change of direction is needed in view of autumnthe circulation of the virus will be more significant and the epidemiological situation is worrying because the vaccination campaign for Covid has not yet taken off”, he adds, commenting on the data from the weekly update on Covid-19: both cases are increasing (15,221 from 22 to 28 August, approximately +11% compared to the 13,690 of the previous week) and deaths, 135 in the last week, 36% more than the 99 of the previous survey.
“In light of these numbers, it becomes essential that the Ministry of Health promote and organize a robust vaccination campaign to vaccinate the greatest number of high-risk subjects,” adds Andreoni.
Ciccozzi: “It’s all normal, we have to get used to it”
For epidemiologist Massimo Ciccozzi, “everything is normal, this is the trend we have to get used to. The growing numbers are based on the increased movements of Italians and tourists in transit in our country. Those who leave or return from vacation do so by plane or train, consequently there is greater circulation of the virus. The only protection against contagion is the mask that, unfortunately, no one wears anymore”.
“Fortunately the symptoms are less severe but – warns Ciccozzi – not for the elderly and frail who are more vulnerable and severely weakened by the heat and who must be protected”. The epidemiologist has no doubts: “In October it will be necessary to get a booster vaccination for Covid and influenza, especially for over 70s and frail people”, he concludes.
Pregliasco: “Rising perhaps due to Xec variant”
“Unfortunately, Covid is still among us, with an undulating trend also depending on the onset and presence of variants. This increase” that is observed in the numbers of the virus in Italy “could be the effect of the latest Xec variant“, a new entry that is on the rise globally, “and has a diffusion and immunoevasion capacity that appears to be high”, the analysis of virologist Fabrizio Pregliasco.
The data, at least as far as the number of cases is concerned, “are certainly underestimated”. Many of these “are trivial, and there are perhaps also many asymptomatic people who maintain the chain of contagion”.
“It is true – underlines the director of the School of Specialization in Hygiene and Preventive Medicine of the State University of Milan – that this is a pathology in most cases is trivial, that for a young person can be approached with anti-inflammatories. But we see it from the rising numbers of deaths, it is a problem for fragile people. The message is therefore for them and for the elderly: in the presence of respiratory forms, even dubious or non-specific, do a swab anyway, at least for them, to be able to take antivirals. Today there is Paxlovid which avoids the most severe effects for fragile categories”.
These growing data, concludes Pregliasco, “also serve to remind us of the importance of the vaccination booster in the fall, always and above all for the elderly and the frail, both for the anti-Covid and the flu vaccine. Today, in short, is still the time for attention with respect to what may be risk situations. And, above all, let’s protect the frail”.
Professor Matteo Bassetti, director of Infectious Diseases at the San Martino Polyclinic in Genoa, has a different point of view: “I am an infectious disease specialist and it has been over a year since a Covid patient died in my department. Over 85-90% of those who are hospitalized today with Covid – he analyzes – are patients who do not have pneumonia, but who have other problems and since they are swabbed – partly during the screening upon arrival at the hospital and partly also at home for any colds or flu – they end up entering the hospital” as positive for Covid, but “for heart failure, for kidney problems, for neurological problems, for other types of problems. What happens when we take a 90-95 year old man or woman to the hospital who tests positive for Covid? What happens is that, even if they had no problems”, when you are so fragile at such an advanced age, “you risk dying from other causes, or from hospitalization”.
Therefore, Bassetti continues, looking at the data from the latest bulletin, “the truth is that doing so many swabs increases mortality, because it ends up taking people who could easily stay in their healthcare facilities, in their RSAs, in their homes, to inappropriate places. This is the problem that I continue to underline: we see a number that is not the number of Covid deaths, but the number of people who die with a positive Covid swab, perhaps a previous one, and are still classified as Covid deaths, which do not exist today”.
“The count of these deaths should unfortunately be asked of those who continue undaunted, without listening to the experts, to do swabs on people for whom the swab is of no use, except to put them in a position to be treated worse than others. Because, when a 90-year-old arrives at the hospital with a positive swab, he is put in a particular ward, he can no longer return to his facility, the time he spends in facilities that are not good for him increases. So this is the reason for that number of deaths. And the more we do useless swabs on people who perhaps have a cold, the more we will continue with this situation. The truth is that people don’t want to listen to what the experts say, these numbers don’t surprise me”.
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