Covid infections grew by 61.4% in a week: an exponential growth, which makes institutions cry for emergency, worries experts and paves the way for an autumn in which the fourth wave no longer seems a possibility. The Gimbe Foundation, in its latest weekly report (relating to the period between 7 and 13 July) speaks of an increase from 5,571 to 8,989 new positives in seven days. The frail are especially concerned: chronic immunosuppressed, cardiopathic, oncological patients. Which, in the face of a fourth wave, would be doubly discovered.
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Baldanti’s alert
To sound the alarm is Fausto Baldanti, head of the Molecular Virology Laboratory of San Matteo. “Today the real issue is who really needs the third dose – he says – we have studies underway on the most fragile patients, people in which total antibody responses are generated, ie neutralizing antibodies and also T-cellular, lower than immunocompetent subjects. So a reflection on the third dose should be made starting from these categories “.
Cases on the rise, but testing drops
So the infections rise. But, according to the Gimbe Foundation, testing does not follow the same parable. The president explains it Nino Cartabellotta. “On the front of the new cases – he specifies – there is a net weekly increase, however underestimated by a testing activity in continuous decline, which makes it impossible to trace the contacts adequately”. Since the beginning of May, the number of people tested weekly has in fact progressively reduced by 56.3%, from 662,549 to 289,869. In the week 7-13 July in all Regions, with the exception of Basilicata and Valle D’Aosta, there was a percentage increase in new cases compared to the previous week due to the progressive spread of the Delta variant. Deaths, on the other hand, continue to decline, settling at 104 in the last week with an average of 15 per day compared to 24 in the previous week.
More than 4 million at risk
Taking into account the progressive increase in positive moves and the spread of the Delta variant, even faster than the previous ones and according to experts destined to prevail in Italy, the Achilles heel continues to be represented by over 4.77 million over 60s at risk of serious illness not covered by the double dose of vaccine: of these, 2.22 million (12.4%) have not yet received even one dose of vaccine with significant regional differences (from 21.8% in Sicily to 7.2% in Puglia) (figure 16), while 2.55 million (14.2%) must complete the cycle after the first dose (1,856,129 with AstraZeneca, 596,190 with Pfizer-BioNTech, 96,503 with Moderna).
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“The leap forward compared to the 5.75 million over 60s not adequately protected last week – points out the Gimbe Foundation – is almost exclusively linked to the completion of vaccination cycles: in other words, the number of over 60s who receive the first dose, a sign of persistent vaccination hesitation in this age group “. Moreover, the trend of administration of the first doses by age group confirms the flattening of the curves of the over 80s and the 70-79 and 60-69 groups and a decline for all the other age groups, with significant differences in coverage between the various registry classes.
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Does the third dose help everyone?
To counter this state of affairs, we are now looking not only at the extension of second doses to those who have not yet taken them, but also at a third dose in the fall. Baldanti again speaks: “Given that the Delta variant circulates among the unvaccinated, therefore young people who are the least covered category, and among those vaccinated with a dose, there is an important fact to consider: Pfizer has made itself available to provide the third dose of vaccine. We at San Matteo had already observed that among our health workers, those vaccinated with two doses but who previously had the disease and developed antibodies against Covid, kept high antibody titers against all variants . It is therefore true that triple exposure strengthens immunity. Even if the United States, the FDA (Federal drug administration), maintains that on the territory they have observed the efficacy of the two doses of vaccine, so as to make them sufficient even against the variant. Delta”.
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“The frail cannot wait”.
“Today the real issue is who necessarily needs the third dose – continues Baldanti -. From our studies, still in progress, on the most fragile patients, such as immuncompromised, transplanted, oncological patients, it appears that their response to the vaccine is lower. in terms of the increase of total antibodies, compared to immunocompetent people (capable of manifesting an immune response, such as the production of antibodies, when the cells of the immune system are exposed to antigens). So the reflection on the third dose should be done starting from these categories of patients, not only in order to better immunize them, but also for a better allocation of vaccine resources “.
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“We need to open a discussion: whether to take the third dose and who to do it – concludes the virologist of San Matteo -. In this case, with reference to the frail, we are talking about people who can certainly be exposed to infection. The scientific criteria are there, they just need to be shared by everyone. Decision-makers need to convene scientific societies to obtain certified opinions through documents: they are called Consensus conferences. What are we waiting for to convene one? “.
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