When will the peak of the new wave of Omicron 5 arrive? Is Covid a disease to be feared yet? Are masks always necessary? And how to organize between hospitals, fourth doses and antivirals? To clarify the many doubts of this phase of the pandemic, is Professor Francesco Menichetti, former head of Infectious Diseases at the University Hospital of Pisa and now president of Gisa, the Italian Group for Antimicrobial Stewardship.
Is the peak of the wave from Omicron 5 near?
“We do not know. This shifting and elusive virus is proving increasingly unpredictable, starting with the fact that it has now proven not to be as seasonal as flu is. What we know for sure is that in a few weeks in Italy the reservoir of infected has more than doubled, but also that this number underestimates the reality. The real infected are double, perhaps more than double. It is possible that the peak will arrive by the end of July, considering how quickly the infection travels, but a certain forecast is not possible ».
How is the virus fighting in hospitals today?
«Omicron is an upper respiratory infection, very few pneumonia. So, with so many asymptomatic people, you cannot cram those with a heart problem or those with a fracture in a Covid ward, just because they are positive for the virus. Micro-bubbles are needed in the individual departments. The directive of the Tuscany Region goes in the right direction, but it cannot be enough if things remain on paper: if a patient with a complex infectious disease that occurs at the Cisanello di Pisa, is transferred to Livorno, it means that we leave the university specialists to take care of tampons in the Covid ward, is a waste, and a detriment to patients. As for the frail, however, they must be protected to the maximum, with the creation of truly isolated wards, clean from Covid. For this, woe to even think of abolishing the hospital entry tampon ».
Does home isolation of positives still make sense?
«No, because by continuing in this way we end up favoring the undeclared. Those who are positive but asymptomatic should be able to do everything, such as going out and going to work, but always wearing the Ffp2 mask. For those who are symptomatic, go out, always with the mask, three days after the end of the symptoms ».
On masks, the government first lifted the obligation, now it is debating whether to reintroduce it in schools in September. What is the right choice?
«The Ministry of Health and the control room seem to me to be in a moment of weakness. Highest esteem of colleagues, but in the last period there is the feeling that we wanted to submit to the mantra of “Italy reopened”. With the farewell to the obligation of masks, a serious mistake has been made and the reverse gears of these hours increase the feeling of confusion. Vaccinations and masks (and the etiquette of behaviors that come spontaneously when we wear them, such as washing hands or distancing) are the only certain tools we have to control a virus, which in many ways escapes our ability to control “.
There are scientists who wish for a mass infection to develop immunity. It’s right?
‘What immunity are you talking about? Who got infected in January and reinfected today? The virus changes with an impressive speed, on the contrary it is necessary to be extremely careful ».
Is the fourth dose of vaccine for all over 60s a necessary step?
“Vaccines are decisive against Covid, but this new step leaves me very perplexed: an invitation to the fourth dose, identical to the previous ones, I don’t know how convincing it can be. Especially since there is not enough data on its usefulness. Instead, we need more clarity on the updated vaccines that should arrive in the coming months “.
And the antivirals? Are they really a tool that can change the course of the pandemic?
«They are essential, if used promptly. I myself, when I got infected, I recovered from the symptoms and I was negativized in 5 days thanks to the antivirals. Unfortunately we are expiring them, because we don’t use them. On the one hand, the selection grid, by age and by pathology, is very rigid, too few people are allowed to use them. We should not say liberalize them, but make their use more flexible from case to case, even for example when a young person immediately presents strong symptoms. On the other hand, more collaboration on the part of family doctors would be needed. Instead, for the moment, antivirals remain drugs almost always for use only by hospital specialists and this should not be the case “.
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12 July 2022 | 06:58
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