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Has the pandemic passed? Guys, don’t rush

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Has the pandemic passed?  Guys, don’t rush

It starts from Bergamo, the city most dramatically affected by Covid. Where it is no coincidence that the fourteenth edition of the Icar congress is also taking place, the Italian Conference on AIDS and research against viruses with over a thousand specialists and hospitals from all over the country. And finally they: four of the most important protagonists who in the last two and a half years – it was March 11, 2020 when WHO, the World Health Organization, decreed the planetary emergency for Sars-Cov 2 – have helped journalists and Italians to extricate themselves from viral replications, natural and induced immunities, virus biology.

With the pandemic closed, can we move on to endemic?

Are we already over? Ready to talk about post Covid? Of an endemic and no more of a pandemic? The answer is an invitation to be cautious, not to be too hasty to dismiss two years that have brought the national health system to its knees and changed our social habits forever. Even if a virus has changed to the point of being much more contagious, and therefore more infectious, but that makes you sick less is a good starting point. Pier Luigi Lopalcofull professor of Hygiene at the University of Salento, Carlo Federico Pernodirector of Microbiology and Diagnostics of Immunology to the Infant Jesus of Rome, Massimo AndreoniProfessor of Infectious Diseases in Rome Tor Vergata e Matteo Bassetti, director of the Infectious Diseases Clinic at the San Martino Polyclinic in Genoa talk about vaccines, protection, the mysterious origin of the coronavirus, antiviral drugs that should be given to patients most at risk of progression to a more severe disease but which are not used as it would be useful for protect them. And if it is true that vaccines in the first place, with monoclonal antibodies and antiviral drugs, have managed to tame a coronavirus that in just over two years has infected 531 million people worldwide, killing over six million, singing victory today makes little sense. . And maybe really – like he wrote about Science the American scientist Jennie Lavine – we must enter into the perspective of a long coexistence with the Coronavirus Sars-Cov2.

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No, the virus is no longer good

Also because – underlines Lopalco – “it is not that the virus has become better, but we are stronger thanks to vaccination. The bad news is that the protection drops, the good one is that it triggers an immune protection that also protects against variants: there it becomes infected but we rarely get sick, because the second row of immunity comes into play. We will no longer have pandemic waves but seasonal peaks, probably in autumn, like other respiratory viruses “.

The perfect virus does not mutate

Also because if the feeling we have is that this coronavirus does nothing but change, in reality the opposite is true. “The virus changes to escape something – specifies Perno – but the perfect virus is the one that does not change, like smallpox: when the vaccine arrives it does not escape and disappears. When, on the other hand, a coronavirus changes, even if not all mutations are an advantage , completely replaces the previous one, which is killed, destroyed “.

Prevention also from disease not only from infection

Another chapter, in addition to that of vaccines (“we were lucky with the extraordinary effectiveness of those based on mRNA”, recalls Lopalco), that of drugs, both monoclonals and antivirals. The former have so far been prescribed to 60,000 patients, the latter to 45,000, with the clear advantage of MSD’s molnupiravir, prescribed to over 27,300 people. Few, according to Massimo Andreoni, who is also scientific director of Simit, and who appeals to patients at very high risk of developing a serious disease, namely obese, elderly with comorbidities, immunosuppressed, with HIV: “Prevention must also be prevention of disease – it gets hot – not just the infection. We treat fewer patients than they should be treated with antivirals, effective drugs with very modest side effects, we keep them in the drawer and this for a short circuit for which patients cannot reach the medication within a few days of diagnosis for reasons of communication with the general practitioner, and with specialist centers. And instead at least part of the deaths in recent days could be avoided with timely treatment “.

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The Liguria model

A model that works is that of the Liguria region, one of the leading prescribers of antivirals. “We are a small region – reasons Bassetti – and therefore it has certainly been easier, but we have managed to establish a path that has brought the median time in which we administer molnupiravir to patients at risk to 2.3 days. 7 days a week between general practitioner and hospital. The prescription of these drugs cannot be delegated to general practitioners without specific skills. Infectious diseases in Medicine, huh … “

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