Covid and flu, for experts Christmas 2022 risks being difficult. And getting the fourth dose of the vaccine becomes more and more fundamental. “The elderly, especially the over 80s, are underestimating the anti-Covid vaccination and also the anti-flu vaccination. This is a mistake and a very high risk in view of Christmas that we cannot afford. We still have a month before the holidays, the elderly those who have not had the vaccinations do them immediately. Christmas will be calm only if they are vaccinated, but I fear that there will be a bad flu mixed with Covid, with a probable peak right at Christmas, and it will also be difficult to make differentiated diagnoses”. So at Adnkronos Salute Matthew Bassetti, director of the Infectious Diseases Clinic of the San Martino Polyclinic in Genoa, on the prediction of the Covid epidemiological trend. According to Bassetti, “it could be a Christmas with many people affected” therefore “if they want to spend a nice holiday in December with their grandchildren and children, especially in the company of the elderly and the frail, the latter need to go and get vaccinated against Sars- CoV-2 and against the flu. We are seeing many people who in 2022 did not have the anti-Covid vaccination – he remarks – we are talking about over 80 who cannot ignore the fourth dose “.
“The data we have today tell us that Covid-19 is regaining strength, the circulation of these variants with large transmission capacities causes the virus to circulate more, so I think it is essential that the Ministry of Health tackle this epidemic trend with an assessment weekly, to be ready to start the necessary measures to counteract circulation where there is a significant increase” in cases. “If necessary, it will be necessary to reconsider the containment measures, including the possible use of masks in certain environments, for example”, he underlines to Adnkronos Salute Massimo Andreoni, head of infectious disease at the Tor Vergata Polyclinic in Rome and scientific director of the Italian Society of Infectious and Tropical Diseases (Simit), on the sidelines of the XXI national congress, underway in Rome. Certainly, “with the viral circulation of Covid on the rise – he adds – I expect a plan for the winter season. Minister Schillaci has already said that he intends to carry out an information campaign to bring the issue of vaccination to the attention of the population, the most effective weapon we have to try to stop the pandemic “, he adds.
“We must acknowledge that the population is tired of the anti-Covid vaccination considered by many to be a nuisance, an element of great psychological fatigue. But we must insist on the campaign for the fourth dose which is going slowly, giving priority to fragile subjects”, underlines Andreoni again who adds: “In general, if the epidemic tends to evolve further we will have to re-advise vaccination to the entire population”.
“We must make every effort to convince fragile people to take the fourth dose and, in some cases, even the fifth dose – he recommends – The more we vaccinate, the more we are able to control the circulation of the virus. This is an incontrovertible fact and abundantly demonstrated by medical science and epidemiology data. In this sense, vaccination should be extended as much as possible”.
The third Christmas spent in the ‘company’ of Covid is a month away and “it would be advisable, before going to buy gifts, to take the fourth dose of the vaccine and the flu shot at the same time”. He suggests it to Adnkronos Salute Massimo Galli, former director of the infectious diseases department of the Sacco hospital in Milan, assuming a forecast of the Covid epidemiological trend for next Christmas. “The more the elderly postpone the second recall, the more they will be discovered for the Christmas holidays which, I imagine, will be without limitations this year – warns Galli – To this risk of contagion from Sars-CoV-2 I would also add that for the flu which, given what has already happened in Australia, will certainly be more dangerous. We don’t know if a simple ‘sneeze’ or a powerful ‘storm’, but we know that the flu will hit at Christmas”.
In view of the Christmas holidays, therefore of family lunches with many people gathered at home, “those who have loved ones in fragile conditions must take care – remarks the infectious disease specialist -. That is, they must not be exposed to the risk of Covid contagion but above all they should be vaccinated at sooner if they haven’t done it. Super crowded situations, at least in theory, with these numbers of the virus we cannot afford. The indication is to be cautious and to be careful of the very elderly, it is a period – he concludes – in which it is easy to incubate an infection without realizing it and therefore it is also easy to infect family members”.
A plan for the winter “is needed”. The virologist points it out Fabrizio Pregliasco, who warns: “There will certainly be a rise in Covid cases, and also a mix of different types of flu, so we will have a clinical impact on the national health service, on hospitals” in the coming weeks. In light of this, he observes to Adnkronos Salute, “there should be planning, in my opinion. Without wanting to be a jinx or think of the worst – he points out – it is necessary to imagine different scenarios and then revise those provisions already used by re-adapting them to our new knowledge” on Sars-CoV-2, “compared, for example, to times of isolation, as has already been thought”. But also “on the use of masks in more stringent terms”, continues the professor of Hygiene at the State University of Milan.
The expert deems it useful to envisage “increasingly growing hypotheses that also take up scenarios from the past, without wanting to think that they must necessarily exist – he specifies – but just to prepare for something that I hope will not happen. Also in terms of department reorganization. At the moment we are no longer managing patients in Covid wards, but with isolation practices or dedicated spaces that weigh down operations a bit, because obviously getting dressed and undressed for assistance to these patients becomes demanding”.
There are still a few fourth doses of the anti-Covid vaccine in Italy, the Gimbe Foundation’s weekly report even underlines a 12% drop in the last seven days, and there is a month left until Christmas which could be difficult with the Covid plus flu. “A communication and awareness campaign should be launched among the population on the importance of getting vaccinated, it seems to me that the Minister of Health has said that he wants to do it but it is important to do it immediately”, he tells Adnkronos Salute Walter Ricciardi, Professor of Hygiene at the Catholic University. But is a month enough to get the second booster for anti-Covid immunizations off to a good start? “We’re already late,” she warns.
“The fourth anti-Covid dose, if there are no comorbidities, the forty-year-old can also not take and manage the situation on his own. For those aged 50, it must be evaluated on a case-by-case basis, based on the characteristics of the person: the last word belongs to the specialist and the family doctor who can give advice on the matter. It is clear that we must not let our guard down against Covid-19, as well as against the flu: vaccination must be recommended, stimulated and carried out in the elderly, at risk, fragile and immunocompromised individuals, including the health professionals who are most in contact with the sick”. So at Adnkronos Salute Claudio Mastroiannifull professor of infectious diseases at the La Sapienza University of Rome and president of the Italian Society of Infectious and Tropical Diseases, on the sidelines of the XXI Simit National Congress underway in Rome.
For Mastroianni, “a new phase is opening in which we must learn to live with this virus”. Today, he recalls, “we have important strategies available, first and foremost the vaccine and the possibility of therapies and approaches that allow us to manage more optimal this infection. It is important to keep our attention high because the virus is circulating, fortunately not with the severity we observed two years ago, and we must know how to manage it”.
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