Galli: it seems to be possible to say that with the new variants there is an increase in symptoms of a certain extent. One reason is that, as the number of infections increases, symptomatic cases are more likely to emerge
With over 730 thousand positives (plus all those not registered) and reinfections rose to 8.4% of the total number of infections (with a higher risk for the unvaccinated, women and younger age groups), it is clear that the new Omicron sub-variants, BA.4 and especially BA.5 (34% in Italy), are driving sustained circulation of the virus. In Italy, 90% of the over 12s have completed the vaccination cycle and another 5% recovered for up to 6 months (according to the estimates of the Ministry of Health). The level of widespread immunity is high, but despite this the cases continue to increase. And in many cases the infection manifests itself with symptoms even in those who have already been vaccinated or cured. How can this be explained?
The factors involved are different, but it is clear that the virus for the umpteenth time has “guessed” the mutation that allows it to continue its run – he reasons Massimo Galli, full professor of Infectious Diseases at the University of Milan -. The quotation marks are a must because the birth of new variants or sub-variants is random. We know that Sars-CoV-2, being relatively large, does not change very much: it does enough to produce strains that are able to be more performing from the point of view of transmissibility. We cannot exclude that after BA.5 other even more widespread variants arrive. We hope that the virus will gradually lose its virulence, but even on this we do not have absolute certainty.
Professor, why are there so many symptoms among the vaccinated / cured?
In the absence of scientific data, we can rely on “sensations”, even clinical ones. Given that the vast majority of people who become infected do not report s to official surveillance, but communicate their condition to relatives and friends, it seems to be possible to say that with the sub-variants of Omicron 4 and 5 there is an increase in symptoms, not serious but nevertheless of a certain importance. One reason undoubtedly is that, by increasing the number of infections, it is statistically more probable that symptomatic cases will emerge. However, we remember that the virus that circulates today has a pathogenicity that is not in the least comparable to that of the first waves, when in Italy we have reached a thousand deaths a day.
Have the symptoms changed with the different variants?
In over two years it has been possible to evaluate the effects of the various loops from a quantitative point of view, the level of pathogenicity in fact, while measuring the qualitative aspect of symptoms is much more difficult and we have no scientific data on this. The feeling that there has been a phase in which the reports of loss of smell and taste have subsided, which are now returning. In other phases, intense pain, muscular and lumbar pain seemed to predominate. What we are seeing now is a fair commitment of the respiratory tract, even without reaching the Covid pneumonia that we have unfortunately learned about.
Is there a risk that hospitalizations and deaths will rise again?
For now, in the face of a growth in infections, hospitalizations have risen, but not dramatically. With a virus that infects many people (it has an R0 of 15, that is, one subject infects another 15) the number of symptomatic people obviously increases and some of them end up in hospital. Vaccines, however, continue to protect us from serious illness, despite a physiological decline in protection: it is therefore very important to complete the vaccination cycle with the third dose, the fourth for people over 80 and immunosuppressed.
What will happen in the next few months?
In July there will probably be the peak of Omicron 5. Unfortunately, the hot season is not much help with such a highly diffuse variant. The elements in our favor are the closure of schools and the fewer opportunities for crowding indoors. In the fall, if we’re okay with it, we’ll have Omicron 5’s tail. But it can also happen that new variants emerge.
Will the fourth dose be needed for everyone after the summer?
With current vaccines it may not be particularly useful, but if specific vaccines against the new variants arrive (as announced by some manufacturers) the hypothesis could make sense. More than a fourth dose, in this case, I would speak of annual vaccination with an always updated product, as is already the case with the flu. Speaking of vaccines, I think the time has come to clarify some details. Let me give you an example: a nurse had Sars-CoV-2 infection, then received two doses of the vaccine and later resumed Covid. Oragli is asked to do the third dose of vaccine, he thinks the suspension from work. Here, I think that in cases like this, an antibody response test could be useful to decide if an additional dose of vaccine is really necessary, especially if the person, as in this case, also suffers from an autoimmune disease although in remission.
June 27, 2022 (change June 27, 2022 | 14:23)
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