It’s not over until it’s over, but maybe we’re not doing enough to get out of the coronavirus emergency. Nino Cartabellotta, president of the Gimbe Foundation, is convinced of this, since since the beginning of the pandemic has been monitoring the progress of the anti Covid plan set up by the government.
In this phase of decreased circulation of the virus and easing of pressure on hospitals, two critical issues are identified: on the one hand, the reduction in testing activity which, according to Gimbe, attests to the renunciation of case tracking, on the other hand, a significant regional heterogeneity in the activity of sequencing that leaves openings to the uncontrolled circulation of variants of the coronavirus in our country.
In fact, according to the foundation’s monitoring, the number of people tested weekly, stable until the first ten days of May, has decreased in the last 3 weeks from 662,549 to 439,467 (-33.7%). And in the same period, an average of 120 people / day per 100,000 inhabitants were tested, with molecular or antigenic swabs, with clear regional differences: from 199 in Lazio to 49 in Puglia. “Unfortunately – explains Cartabellotta – the criteria for conquering and maintaining the white zone, introduced with Legislative Decree no. 65 of 18 May 2021, discourage the Regions to enhance testing activities and resume tracing, just when the numbers of the contagion would allow the use of a weapon that has never been properly used “.
As for sequencing, from February 2021 over 1,000 cases per week have been sequenced with very heterogeneous regional performances: from 6.05% in Abruzzo to 0.09% in Piedmont.
“Insufficient sequencing – specifies Cartabellotta – does not allow to identify the most contagious variants until after the increase in cases, nor to adapt vaccination strategies if necessary. For example, on the most contagious delta (Indian) variant of 20- 60%, the efficacy of a single dose of vaccine on symptomatic disease is around 33% for both the Pfizer and AstraZeneca vaccines, while after the complete cycle it rises to 88% and 60% respectively “.
Another advanced criticality is that of vaccination coverage: if 40.3% of the population has received at least one dose of vaccine and 20.7% has completed the vaccination cycle, among the groups most at risk only 30% of the seventy-year-olds have obtained the double dose, while 28% of 60-year-olds have not yet even gotten the first dose and over three million are still waiting for the second.
Considering that the Regions – which from today open vaccinations without age groups – are using almost all the doses available,
The non-take-off of deliveries still affects the number of administrations: now stable for a couple of weeks with the 7-day moving average reaching 500,000 inoculations / day. 81.5% of the over 60s received at least the first dose of the vaccine, with some regional differences: if Puglia, Umbria, Lazio, Lombardy, Veneto and Molise exceed 85%, Sicily still remains below 70%. In detail: – Over 80 group: of the over 4.4 million, 3,736,001 (83.4%) completed the vaccination cycle and 386,742 (8.6%) received the first dose only. – Age range 70-79: of the over 5.9 million, 2,109,513 (35.4%) completed the vaccination cycle and 2,884,265 (48.4%) received the first dose only. – Age range 60-69: of the over 7.3 million, 2,136,231 (28.7%) completed the vaccination course and 3,325,680 (44.7%) received the first dose only.
The clear improvement of the pandemic situation – concludes Cartabellotta – if on the one hand certifies the success of the “reasoned risk”, on the other it requires that prudent optimism be accompanied by a shared strategy between the Government and the Regions to guarantee the irreversibility of the reopening. The proposals of the GIMBE Foundation go in this direction:
- Make the necessary corrections to the new system for assigning colors to the Regions (eg standard of swabs per 100 thousand inhabitants) to encourage testing and resume tracing, without fear of not conquering or losing the white area.
- Define a unique way to promptly identify and stem any outbreaks.
- Enhance the sequencing of the variants, in particular in some Regions, and in case of spread of the Indian variant, administer the second dose to the elderly and frail according to the optimal range of clinical trials.
- Implement new strategies to vaccinate over 3.3 million over 60s without coverage and at high risk of hospitalization: eg. active call, dedicated open days, dedicated institutional communication.