The theme is back in fashion a regular intervals, usually in conjunction with the threat of a new variant. On the urgency of sequenziare the Sars-CoV-2, at least in words, everyone agrees: politicians, ministers, scientists, health authorities. The numbers, however, tell of an Italy very far from the minimum target set by the ECDC (the European center for the control of infectious diseases) and the World Health Organization, which ask to analyze the genome of at least 5% of positive swabs, to control the proliferation of mutations. The data available on the international platform Gisaid they say that from 10 January 2020 Italy has just filed 76,863 sequences, that is the1,44% of the total of positive tests. A slight increase was seen only this summer, with the establishment of a network of regional laboratories for epidemiological surveillance: considering the window of the last ninety days, the percentage increases to 2,91%. But already in the last month – thanks to the rise in infections that commit the structures – the figure has collapsed again to the1,33%. By turning the premier’s announcement into a dead letter Mario Draghi, which still in June struck on the need to “increase sequencing” to “promptly identify the development of new variants”, such as the Delta (formerly Indian) which at that time worried more than all the others. As well as the promise (dated April 30) of the Undersecretary of Health Andrea Costa to isolate three to four thousand genomes per week, a threshold that, seven months later, still appears very distant.
Sequencing we start talking about fine 2020, when the first of the strains significantly more contagious than that of Wuhan was discovered: the English variant, later renamed Alpha. The ECDC invites countries to “analyze the isolated viruses in a timely manner” and “develop standardized mechanisms to study and evaluate the new variants”. At that moment Italy had just deposited on Gisaid 920 sequences in a year, against 140mila of the United Kingdom: January 27, 2021 to sound the alarm Gianni Rezza, director of prevention of the Ministry of Health, who invokes “a greater firepower to sequence the virus “and” have a surveillance and alert system on the circulation of variants “. On the same day, the president of Aifa (Italian Medicines Agency) Giorgio Palù and the Deputy Minister of Health Pierpaolo Sileri announce the birth of an “Italian Consortium for the genotyping and phenotyping of Sars-CoV-2”, a project that however remains stuck in the quagmire of the government crisis and will be relaunched – in the form of a network of laboratories – only at the gates of summer , with the poor results under the eyes of all.
On February 1, a circular signed by Rezza urges all laboratories in the country to “guarantee the availability of human and material resources to manage the growing number of requests for detection e characterization of SARS-CoV-2 samples and exploit all possible capacity from clinical, diagnostic, academic and commercial laboratories “. Shortly after – on February 7 – the ECDC recommends sequencing “at least five hundred samples randomly selected every week at a national level “, indicating a series of priorities, including vaccinated people who are reinfected, long-term positives and those arriving from countries with a high incidence of variants. But Italy will remain far from that standard for a long time to come. In fact, a few days later the European center raised the alarm: our capacity (but also that of the other Member States) is far below the 5% threshold. On February 17, the Commission launched a “anti-variant strategy“Allocating 75 million euros and on March 9 comes the appeal of the experts of the Technical-Scientific Committee. But the turning point continues not to be seen: “Italy is currently sequencing 1.3 virus samples per thousand and it takes an average time of about two months to load them into Gisaid “, reports the virologist of San Raffaele on February 22 Roberto Burioni, which speaks of “one of the worst performances in the world”. Two months later, on April 26, our score is still stuck at 20.696 sequences, lo 0,52% of the total of positive swabs, against 379.080 of the United Kingdom ranked first.
In the same days, the government, under pressure, sets ambitious targets. “It becomes necessary strengthen activity of sequencing, in order to identify early on the appearance of new viral variants before their rapid spread ”, Undersecretary for Health Costa told the Chamber on 30 April. And it promises a structure with an analytical capacity “equal to three thousand to four thousand genomes a week, for the research and study of variants already known, but, above all, of “new” variants of interest for public health “. An objective that with today’s lenses appears unrealistic, if we consider that in the last 90 days the analyzed sequences have been 13.104 (an average of just over a thousand a week) and just in the last month 2.936 (about seven hundred a week). In the following months the Delta variant comes to rage, and with hindsight the calls for sequencing return daily. “Since January we have made great strides”, reassures Sileri. And on July 14 – answering a question time in Montecitorio – Minister Speranza boasts a success that in hindsight will be ephemeral: “The definitive figure for the month of June is 6% of cases that are sequenced “. “We work so that the network of laboratories has holding capacity even beyond Covid ”, he said. But so far it seems poorly equipped even for the fourth wave.