The forecasts of the director of the Institute of Pharmacological Research Mario Negri for the coming weeks: «We would not have problems with beds if we were all vaccinated. The reopening of schools? Irrelevant contribution to the growth of infections “
The Omicron variant is unleashing the “perfect storm”: hundreds of thousands of cases, including new infections and re-infections, and glue hospitalsxed. Even in Italy we are witnessing a surge in new positives and today, even if with the new rules, working life and many students are returning to class are resuming completely.
The next two weeks are announced decisive, also to understand if here in Italy the Omicron variant will eventually prevail over the Delta variant.
“In a sense, we have two pandemics: one sustained by Omicron and the other by Delta – explains al Corriere della Sera Giuseppe Remuzzi, director of the Mario Negri Pharmacological Research Institute -. We must not forget that many ICU patients have contracted Delta, which has continued to expand even in recent weeks. ”
Who are the patients who occupy the ICU beds?
«Even within the hospitals there are” two pandemics “: one of the vaccinated and one of the unvaccinated. As can be seen from the charts of the Istituto Superiore di Sanità (see graph below, ed) which measure the incidence of hospitalizations per 100 thousand inhabitants divided by vaccination status and age class, being vaccinated protects in a very important way. With the third dose in general, only elderly people and other types of associated diseases end up in intensive care. The percentage of unvaccinated in hospital is very high, if we were all vaccinated, there would be no problem of saturation of the beds “.
Regarding the next two weeks, what can we expect?
“If the two variants continue to coexist, this could pose a problem. If, on the other hand, Omicron manages to overwhelm Delta, since the disease it causes is less severe, then perhaps we will be able to see the curve descend in a matter of weeks. Omicron’s blazing-fast expansion over Delta would not be bad news in itself. “
Someone speculates that the Omicron variant could also end the pandemic, is that so?
“With such a contagious variant, the peak of the new positives curve would be reached earlier, in the same way, as has already happened in South Africa and Great Britain, the decline will also be faster, but if we want to talk about the end of the pandemic I think we will still have to take some precautions at least for a couple of years ».
Why is herd immunity a chimera with Omicron?
«Yes: even if we reached 95% between vaccinated and cured, the mutations of the virus (which do not stop) and the circulation of people (which continues) would remain to be considered. We could speak of a “way out of the pandemic”, almost a “kind of herd immunity” ».
Will the opening of schools affect the growth of infections in a decisive way?
“The school has been closed for a long time and infections have continued to increase: I believe that the contribution of students is really irrelevant with a variant that spreads with such speed”.
Besides vaccines, what are the other “weapons” at our disposal against Omicron, for example, in home care?
«Two scientific works deriving from our research group show that the use of non-steroidal anti-inflammatory drugs used at the first symptoms of the disease reduces the evolution towards severe forms and hospitalization by 90%. Both studies have limitations and there is still no definitive proof ».
What about paracetamol?
“Paracetamol consumes glutathione which is a very powerful antioxidant. Just in these days a study has been released which shows that patients with Covid have an important oxidative stress, probably responsible for the inflammatory lung damage, associated with glutathione deficiency and it has been seen that this deficit increases with age “.
When are antivirals indicated and what may be the benefits?
«Antiviral drugs prevent the virus from replicating and therefore stop the disease even before it appears. They should be given within 5 days of starting symptoms in those patients who are expected to end up with more severe disease and who need to be reported to general practitioners. The antiviral now available is Merck & Co’s molnupiravir which reduces severe disease with an effectiveness of 30%. Pfizer paxlovid will be available soon, reaching 87% efficacy ».
When are monoclonal antibodies indicated?
«Monoclonal antibodies work against the other variants, against the Omicron variant they are no longer effective. The only one that works for now is Gsk sotrovimab. In perspective there will be others, under study ».
Are chloroquine, colchicine and heparin for treatment or prevention useful? What about ivermectin?
“Heparin appears to work if given in the early stages. A lot of studies have been done on hydroxychloroquine and the conclusion is that it does not give any advantages. Same conclusions for colchicine and ivermectin: there were no differences between the treated patients and the “controls” ».
January 10, 2022 (change January 10, 2022 | 07:52 am)
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