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What is the second wave?
the resumption of the epidemic after a certain period of time from the first wave. The epidemic peak is the highest point on the curve and corresponds to the phase with the highest incidence of cases. The distance between one wave and another (and the next) is not predictable. Influenza viruses, for example, have an annual peak. The waves are divided by an inter-pandemic period which, as regards Covid 19 in Italy, corresponds to June-September 2020.
When will the peak come?
Some signs suggest that the peak of the second wave has been reached and that a slight dip is likely. In general, the upper part of the curve is reached in each epidemic between 60 and 70 days from the beginning, in this case in mid-September. A second sign suggests the slowdown: in many regions the growth in the number of clinical cases seems contained compared to the previous days, even in heavily affected regions such as Lombardy. Still too early to predict the start of the decline, the outlook will be clearer next week. It must also be taken into account that in this phase the communication of data by the services overwhelmed by the emergency may not always be timely and complete.
What are the characteristics of this curve?
The curve of positives diagnosed with molecular tests shows a trend according to the manual. The virus seems to go its way undisturbed by following the classic rise of the bell with a doubling time of weekly cases. If the traditional two-month duration is respected, the wave will last until Christmas 2020, moving towards a progressive decline. The doctors’ concern that this phase is not a storm, but a tsunami, capable of overwhelming the health system. This was stated by Filippo Anelli, president of the Federation of Medical Orders, which asks the government for aggressive measures. On Monday the same call came from the Milanese doctors who are convinced that the closure is urgent
Is the second wave of Covid different from the first?
The lethality of the current epidemic peak is much lower than that observed in spring, although the risk factors that determine the success of the treatments have remained the same: the average age of the deceased is around 80 years, other diseases are present in 95% of the cases . The time between initial symptoms and hospitalization was significantly reduced and diagnostic and therapeutic skills improved. The clinical severity of patients with symptoms ranges from 5% of severe cases, 20% with significant symptoms, and the remaining 75% with mild symptoms.
Will we have achieved herd immunity at the end of the second wave?
Even this epidemic peak will not be enough to develop the so-called herd immunity necessary to protect the entire population: a large part will remain susceptible, exposed to a further increase. National seroprevalence investigations (conducted in April with serological tests and then in various local contexts) indicate that less than 5% of Italians have antibodies against this virus. So 95% of Italians can get infected.
Have international technical agencies (WHO, CDC, ECDC) provided incorrect guidelines?
All agencies have always admitted the uncertainty of knowledge about the pandemic (the new virus, the world population has never encountered coronaviruses similar to the current one, therefore the body’s protective memory to counteract this infection is lacking) and the weakness of the scientific evidence. on the effectiveness of containment measures. In addition, these organizations are directed to the whole world and must necessarily consider the most extreme scenarios to offer indications to be disseminated globally.
Vaccines will change the situation
Safe and effective Covid vaccines will be available in 2021. Their effect will not be immediate. They will act to contain the clinical impact of the disease and reduce its severity, not to control the incidence of cases, avoiding infection. Furthermore, most vaccines in development appear to require a double dose to achieve a significant level of efficacy. Therefore, it will take months to achieve a real massive barrier through repeated vaccination campaigns.
(He collaborated with Corriere Donato Greco, former director general of Prevention at the Ministry of Health, WHO consultant).
November 4, 2020 (change November 4, 2020 | 08:43)
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