Johnson announced a long-term plan to “live with the virus”. The epidemiologist La Vecchia: «An increase in cases is possible, but it will still be limited. Italy is two weeks behind the United Kingdom ”
In England Sars-CoV-2 positive people will no longer be forced into solitary confinement. This was confirmed by the government of Boris Johnson, after the announcement a few days ago: the details of what has been called “a long-term plan to live with the virus” will be discussed in Parliament on Monday. “I’m not saying we have to abandon caution, but now it’s time for everyone to regain confidenceThe prime minister said in an interview with Bbc. According to some experts, however, this is a risky move, which could lead to an increase in infections and to have fewer defenses against any more contagious strains of Omicron.
The rules in Italy
In Italy such a decision is not planned shortly. Currently positives must be isolated for 10 days with final negative buffer
, regardless of their vaccination status. The asymptomatic with third dose, vaccinated with two doses for less than 4 months or recovered for less than 4 months, for which isolation lasts 7 days and ends with negative buffer. In England isolation has recently been reduced to 5 days (without symptoms and in the presence of two rapid negative tests on days 6 and 7), as in the USA, where the final negative test is not even required. A month ago in England some restrictions were removed, such as the green pass (introduced in December and only for discos and large events) and the obligation to wear a mask in shops and on public transport.
How long does the infectious period last
The doubts of the British experts arise from what we know so far of Omicron, the dominant variant all over the world. It is believed that the infectious period may begin one or two days before the onset of symptoms (in asymptomatic patients 48 hours prior to the positive swab are calculated) and that last from 8 to 10 days in moderate cases and on average up to two weeks in severe cases; infectivity generally decreases 7 days after the onset of symptoms. In vaccinated with 2 or 3 doses, a shorter duration of the disorders is observed and therefore, it is assumed, also the ability to infect other people. The variables, however, depend on the level of immunity of an individual and the properties of the variant in play. Some people remain contagious longer than others, and evidence from rapid tests suggests there are still infectious patients after 5 days.
Limited increase in infections
Could the Johnson government plan therefore turn out to be a boomerang? And could it be implemented in Italy? “Here, the situation is two weeks behind the English one,” he says Carlo La Vecchia, Professor of Epidemiology at the State University of Milan -. Around 5-10 March we will have the numbers we see now in GB (34 thousand new positives with 128 deaths in England, 50 thousand positives and 252 deaths in Italy, data as of February 19, ed). In any case, with us the state of emergency will end at the end of March: eliminating the isolation for the positives in two or six weeks will not entail major differences. More than anything else, the decision concerns the cost-benefit ratio, between the health situation and the need to resume activities 100%. I believe that in England there will be an increase in infections, but limited, because Omicron is estimated to have already infected 60% of the world’s population. If we add the vaccinated to this number, it is clear that at this moment we see the effects of widespread immunity. The hospitals are emptying and will be able to cope with slightly growing numbers ». In Italy there are just over 13 thousand hospitalized and less than a thousand patients in intensive care.
BA.2 variant and seasonality
«The Omicron cases are much more than those recorded – continues La Vecchia -, because in many cases they manifest themselves with moderate symptoms that last a couple of days, thus escaping the testing systems. But we must emphasize once again that vaccinations saved us. In Italy, heavier measures have been decided than in other countries, such as the reinforced green pass and the vaccination obligation from 50 years upwards (in force until June 15), on which my opinion is positive. After a winter in which there have been 20 thousand dead from Covid (compared to 90 thousand last winter) I think we can reasonably think of removing all restrictions. However, two reasons for uncertainty remain: the Omicron BA.2 variant (more contagious than the “sister” BA.1), very widespread for example in Denmark, and then the seasonality of the virus. Until autumn we can rule out the emergence of emergency situations, but then we don’t know for sure what will happen. Certainly it is unlikely that there will appear a more contagious variant of Omicron, which has a very high Rt (about 12) ».
Will we need another dose of the vaccine?
For now, the fourth dose of the vaccine has been approved in Italy only for frail subjects and healthcare professionals. But it is not excluded that it can be extended to the entire population. “The third dose should give you a longer lasting immunity than the first two, even if there was a drop in antibodies after the booster – explains the epidemiologist -. However, our defenses are also linked to the activity of T lymphocytes, the so-called “memory cells”. At the moment we do not know if another booster will be needed or if it will be decided to use new vaccines. Pfizer, Moderna and AstraZeneca have developed formulations against Omicron, but from the first results there do not seem to be great advantages over the Wuhan vaccine, the one built on the original strain still used today. We know that current vaccines do not protect against contagion, but against disease: only fragile subjects went to hospital with Omicron ».
The fifth coronavirus
It is now clear, however, that Sars-CoV-2 will not disappear. “It will likely become the fifth seasonal coronavirus that causes colds – La Vecchia explains -: three are very ancient, they have been around for hundreds of years, and the fourth caused an epidemic in Russia at the end of the 19th century and then became endemic ». What if a new pandemic breaks out? “We will certainly be better prepared than in 2020, when we were faced with a completely unknown virus – concludes the expert -. Italy also did well on the sequencing front, with ISS reports on a representative sample. It must be said that no variant was born in Italy, but if it were to happen in the future we would see a rapid increase in cases (as happened in South Africa with Omicron): in that case it makes sense to increase and concentrate the sequencing activity to identify the cause of the contagions “.
February 20, 2022 (change February 20, 2022 | 16:14)
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