Super Green pass, the epidemiologist Panella: “With this load of unvaccinated it is impossible to wait any longer. Administrative and non-health measures? It is a non-existent border”

The Covid epidemic begins to run also in Italy, even if the contagion spreads much less than in the rest of Europe. There Germany, overwhelmed by the peak of infections, has the worst scenario and one wonders if the measures adopted by the government – the reinforced Green pass and mandatory vaccination for some categories – can keep Italy out of that situation. We asked Massimiliano Panella, epidemiologist and professor of Hygiene at the Eastern University of Piedmont, what do you think of the measures and how useful they can be to face the upcoming holidays in serenity.

Professor Panella, do we “save” Christmas?
I sincerely hope so. Those taken by the government are logical measures, appropriate to the current risk. However, we have a load of unvaccinated people, an amount that is important. There are so many people who have to take the first dose, only now we are accelerating significantly on the third. So the risk is always around the corner. There are 6.7 million unvaccinated, others now poorly immunized. If the disease begins to turn, we could suddenly have a very large number of cases and therefore the risk of going towards closure is there. But I expect to have a nice Christmas. Next to us we have Germany, Austria and Belgium who will not have a Christmas like ours.

Do the measures adopted by the government therefore have a real possibility of limiting infections?
Generally speaking, I agree with the government’s action. Overall, it seems to me a balanced initiative that responds to the need to curb the epidemic which unfortunately, as widely expected, started again with the autumn and the cold. At the same time, it allows us to fully protect our ability to lead a normal life. It is a balanced, reasoned and timely intervention, but it could not have waited any longer.

Would it have been too much to introduce the obligation of Fpp2 masks on public transport and facilitate the return to smartworking?
On public transport and in crowded places it is clearly important and effective. With greater circulation of the virus it makes sense to increase social distancing even with smartworking. As for the templates, it is not so easy to guarantee the correct use, while for smartworking the cost-benefit ratio must always be considered. In theoretical terms it is better to stay at home, but we have to consider the impact in social and economic terms. These can be important additional measures. So I think they are potential measures for a later stage if the virus were to circulate more intensively.

Are there any overseas measures that we could copy instead?
Italy’s is a good result. Spain and Portugal have also experienced some upsurge in the past. Vaccination was the turning point of the pandemic.

Some cities have made it compulsory to wear masks outdoors.
It seems to me a correct measure. In a lower circulation phase, such as ours still is, the probability of getting infected is not high but with greater circulation it is absolutely necessary. Keeping your distance is always helpful.

On the controls front, some possible criticalities have already emerged. Critics argue that the enhanced Green Pass may be an administrative measure rather than a health measure.
The biggest public health measure taken to contain chronic diseases has been a ban on smoking in public places. This has produced far more public health than tons of health campaigns. When we talk about public health the boundary between administrative and operational-health is extremely blurred, in truth for me it does not exist. The measures taken by the government have an important scope with respect to the potential impact: the mandatory vaccination for some categories and the booster which are important from a medical point of view because evidently they reduce the circulation of the virus. The three categories in question (military, law enforcement and school personnel, ed) are in contact with people and have an essential role: they must be protected at the highest level. Teachers must be protected from a technical point of view, but also from a social point of view precisely because of the value of the school. They are not administrative measures, but important from a public health point of view.

Is it therefore in favor of compulsory vaccination for all?
From my point of view, the concept of obligation is not very relevant. The relationship between the risk and the benefit of the vaccine compared to the risks associated with the disease is so disproportionate … I speak as a doctor and epidemiologist: for me it is mandatory to protect people and I would feel like protecting everyone. But I am not the legislator, nor do I know the related legislative aspects that also take into account other parameters. As a doctor, I would like the entire world population to be vaccinated.

The European Medicines Agency has given the green light to vaccination for the age group 5-11. Various concerns have already been raised in the past and there are those who remember that there is an audience of over 50 who is not yet vaccinated. Vaccinating the little ones seems easier than convincing adults.
The reasoning is not appropriate. Covid severely affects the elderly and other age groups like mine. But even in children, there are many infections and we still don’t know the long-term consequences they can have. This virus affects the nervous system: it takes away our taste, smell for example. It is important to protect children: they are not soldiers to be put on the front line. The latest studies also tell us children are also harmed. At the beginning the studies were dynamic and we only saw the striking cases. In the face of a catastrophic emergency, we did not see some cases. Now new and additional data have emerged and the frequency and severity of the disease has emerged. The international agencies have done well to authorize the vaccine. Those who do not get vaccinated have made their choices but should not be abandoned.

There are many no vaxes and those who get sick are increasingly occupying the beds in intensive care.
If we count the number of people who go to the streets and those who have been vaccinated, we realize that Italy is a cohesive country and that it is going in the right direction. I only say this, I am a doctor and I rely on science. Which is not perfect, but probabilistic and tells us what the right thing is. On the other hand there is superstition, they are beliefs. It is sad to see that these beliefs can make people sick and spread disease. It is sad to see what happens in Trieste and Bolzano. I am a doctor, when a person is sick, he is sick: it doesn’t matter how sick he got. And it applies to all of my colleagues. The health system makes no difference and if someone got sick while going to the streets, when they feel bad for me they are the same as the others. Intensive care has been boosted and we are not in that dramatic suffering of last year. The maximum possible will be done for everyone, possibly without taking anything away from others.

Is there anything you want to add?
I am happy with how the country is reacting overall and I am proud of Italy which has been cohesive in rowing in the same direction, in protecting health. Our country in its small way has given a great test. The Spanish epidemic has produced at least 20 million deaths, Covid has reached 4.5. I tell everyone to get vaccinated and protect themselves. We must stop this dangerous disease. A Japanese study speculates that the Delta variant is self-destructing, I hope so. Mutations can go in various directions. We must be firm in our response and with the right approach.

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