There are now 100 thousand Italians treated at home with antivirals for Covid. The figure was calculated yesterday by Aifa, the Italian drug agency. Yet these pills, which taken immediately after the infection help reduce severe symptoms, are now at the center of controversy. If antivirals – several experts ask – cut the number of deaths by 70%, why does the daily bulletin show us an average of 100 deaths a day? Nicola Magriniwho has been general manager of Aifa just before the start of the pandemic, underlines that in reality Italy is the first country in Europe for the use of these treatments.
The infections have dropped for a month and a half in a row, the deaths have dropped much less and there are about a hundred a day. Because?
“To answer one would have to understand what the reason for death is. An important number of deaths attributed to Covid do not actually have Sars-Cov2 as the main cause. It has changed a lot compared to 2020 when pneumonia was the main cause of death: now it is not I am more. If a person dies of a stroke or a tumor, but it is incidentally positive, the viral infection is not the reason for his death. More information would be needed on this, but it makes no sense now to open controversy: I have verified the data of a couple of regions and in the last week, among the deaths of positive people in hospital, there is not even one Covid pneumonia in the main diagnosis. There are instead patients in whom the infection appears as a complication in secondary diagnoses “.
But do we know if they had been treated with antivirals?
“We do not have this information for each individual, but for over three months we have been the European country with the largest number of treatments with the antiviral drug Paxlovid. We have expanded the ability to prescribe antivirals to family doctors. We have given the possibility to find them in pharmacy and the criterion of age alone (at least 65 years) is sufficient to obtain the drug. Israel is above us for the number of treatments, but it had the product available about a month and a half earlier than in Italy. concerns Paxlovid by Pfizer, the most widely used antiviral, our country now has 56 thousand treatments. In Europe it is the highest number. South Korea and the United States surpass us, and I do not deny that we too have room for improvement, but Paxlovid has also some important contraindications. I believe that the right goal is to get to treat around 10% of the positives “.
If you don’t die of pneumonia, then why do you die so much from Covid?
“I would go and look for the answer in the medical records first of all, because there it is explained what are the main and secondary causes of death. ‘azithromycin or other antibiotics or with old remedies like chloroquine or with drugs that don’t work like ivermectin. Like Aifa we also have comparative studies between monoclonal antibodies and Paxlovid to understand which treatment works best “.
Meanwhile, we are waiting for the updated vaccines. What are the stages?
“On September 1, the EMA, the European Medicines Agency, should approve the new vaccine from Pfizer and Moderna. It is called bivalent or double because it contains both the spike of the Wuhan virus and that of Omicron 1. The technical scientific commission di Aifa will probably give its opinion on 5 September, and a few days later we could have the vials of the new dual vaccines available ”.
Who should get vaccinated?
“Surely those who are over 60 and have not been infected in the last four months, as well as the youngest with important pathologies and risk factors such as obesity”.
But in the meantime, even newer vaccines will arrive, those updated to the Omicron 4 and 5 variants. Won’t it become difficult to find your way around?
“We have vaccines that can be updated every 3 months, we have to get used to it. Pfizer has just submitted the request to the EMA, Moderna will do it by September. The further updated vaccines should arrive starting in mid-November for Pfizer and in December for Moderna. At that point. it will remain to be seen if Omicron 4 and 5 will still be in circulation. “
Vaccines give you a headache.
“The acceleration of development allows us to have new vaccines in just three months, this should be seen as a good opportunity that goes well with the need to revaccinate those at risk every 5-6 months. Pfizer is also trying to accelerate the times, at least in the United States. And it could also try in Europe “.
In short, what should we do?
“If there is an indication to get vaccinated, it is better to do it with what is there at the moment. Even now, for example, we are recommending to do the fourth dose with the vaccine available. Immune response tests conducted on a small group of volunteers with the vaccine updated to Omicron 1 they certainly show an improvement over current vaccines, not dramatic but still a step forward “.