The epidemiological picture of Covid in Campania and in the other Italian regions is stationary. Pneumonia with the classic serious profiles that were seen in the first waves are instead increasingly rare although still present in some patients who have never been vaccinated. Alessandro Perrella head of infectious disease of Cotugno, warns «The cases are decreasing but the pandemic is not over. The variant BQ1 and its sub-variant BQ1.1 will become the dominant strains from mid-November to the beginning of December ».
Are you sure there will be a new epidemic wave?
«The presence of Cerberus in Europe is consolidated and rapidly growing. Betting that it will cause a new wave is like playing a horse race with only one quadruped in the race. The virus has the same doubling trends as the cases we have seen in all previous waves. It will become predominant in a month or so. The only difference is the climate, today it is warmer than in previous years ».
What should we expect?
«The virus is less harmful and penetrates less into the population partly due to the type of variant and partly due to the vaccination coverage we have achieved with vaccines and infections. But Cerberus also has a tendency to bypass the immune defenses ».
Who are the subjects at risk?
“Frail people, the sick, the elderly, patients with immune deficiencies, oncohematological, transplanted, dialysis patients, diabetics, heart patients and so on”.
Should the fourth doses be done?
«Yes, in frail patients and in the over 50s who have an onset of immune senescence. In children if they have chronic oncological diseases. Healthy adults can wait. ‘
Will periodic vaccination be achieved?
«The current variants are not a last step of the virus, they represent one of the possible evolutions. The virus is dynamic, it mutates and it is not static. It evolves to improve itself ».
What changes now that the Civil Protection bulletin on cases will become weekly by government decision?
«From a medical statistical point of view it changes little. With mathematical models we are able to evaluate the incidence trend and above all the impact that on the hospital network. Clearly we still know little about the new variant ».
So what?
“So beyond any consideration of merit, the use of the mask – in some healthcare contexts and when staying in crowded environments, particularly in a hospital setting, in contact with the frail and sick or with the elderly in the family – still represents a tool valid for prevention and protection also in accordance with the WHO standard procedures for the prevention of airborne diseases “.
Who are your patients?
«At the moment patients with complex pictures from plutipathologies who also have positive swab. The prevalence is for those over 75 with haematological or oncological disease under treatment and with primary or secondary immunosuppression. They arrive after several days of positivity at home due to persistent fever and tend to have a greater involvement of the deep respiratory tract. After a careful evaluation and therapy, they return home. In summary, the frail and elderly who are also those at greatest risk of a fatal outcome due to systemic involvement and sometimes worsening of the underlying pathology “.
All unvaccinated health workers will be back in service: what does an unvaccinated doctor risk and what does his patients risk?
“You risk contracting the virus if in good health to be asymptomatic and therefore to carry the infection for many days.”
Doesn’t this also apply to the vaccinated and recovered?
“Yes, but to a lesser extent: an unvaccinated person is more symptomatic and in the phase immediately preceding the full-blown disease is much more infectious than a vaccinated or immunized. In my opinion we shouldn’t let our guard down too much in surveillance ».
How long does the immunity of the vaccinated and the recovered last?
“In Campania we made a study and published the data: the maximum protection occurs in the first month, after 4 in fact the surveillance begins to decrease and the protective capacity is reduced. The severe disease shield lasts longer, for about a year ».
Current treatments for the disease?
«Antivirals, latest generation monoclonals, non-steroidal anti-inflammatories that can also be used at home. Carbocysteine inhibits the Spike protein activator and cortisone in the hospital setting in severe inflammation. The evaluation of recovered patients suffering from genetic tombophilia at risk of thrombosis is also useful ».