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No one would have ever imagined that, on Christmas Eve, instead of receiving friends and family at home to exchange greetings, the first message received would come from the press conference of two doctors. However, for a year, everything has changed. Also listening to Gianni Rezza, director of the department of infectious diseases at the Higher Institute of Health, and Silvio Brusaferro, president of the institution, on December 24, is part of the new normal.
Brusaferro: “In Europe, the virus circulates with different intensity in individual regions”
In the update on the epidemiological situation of the Coronavirus in Italy, after entering the red zone, Brusaferro began by describing “the European panorama: in all countries the virus circulates with different intensity in individual regions.” An analogy with the Italian situation. The ISS president then underlined how in some neighboring states the epidemic curve has begun to grow again, while “the incidence figure continues to decline throughout Italy, except in the Veneto region.”
Today in our country the epidemic has very different incidents, so it is necessary to continue with mitigation measures ”. The additional data, commented by Brusaferro, is relative to the median age of infections, “which is decreasing slightly over time.” Basically, the epidemiological picture of those affected is constant ”. Most patients are asymptomatic or paucisymptomatic, almost the 75%. Instead, “the number of people who develop serious illnesses is decreasing, slightly.”
“There is an upward trend in RT this week in 0.90Ironbrush added. The good news is that the number of inpatient medical and intensive care beds is declining. “At the country level, we are beginning to fall below the employment threshold of 30% of intensive care and 40% of places in the medical area. “The projection to 30 days of bed saturation tells us that the pressure on regional health services “will continue to decrease.”
The risks of intensive care
In the focus on intensive care, Brusaferro confirmed that the average age of hospitalized patients remains high. The patients who need the most important care are predominantly men. Another element, now known, is that mechanical ventilation is especially required “by the elderly and those with multiple pathologies require intensive care”. The average age of the deceased also remains constant, around 80 years.
Rezza, for his part, highlighted the presence of a situation of instability at the territorial level: “It is as if we were in a transition phase. Now we have a kind of tendency to stabilize the incidence of contagion. Intensive care, he points out, still arouses concern: “The beds are still quite full, for the moment we remain above the critical threshold.” The increase in RT has also been taking place, “although slightly”, for two weeks. “All this means that we must continue to keep care high and we will have to try to further reduce the incidence rate of the infection, to get below the fifty positive for 100,000 inhabitants, while now we are a 300».
The Covid variant
“Yesterday I attended a WHO webinar attended by my English colleagues,” Rezza said. They gave us a lot of information about the Covid variant. First, there are two that have raised particular concern, one isolated in England and one in South Africa. English seems to have arisen in Kent and then spread to the southeast and to London. ‘ It is a variant composed of several mutations of the peak protein “that seems to confer an increase in transmissibility, some models estimate that it is higher than 70% ».
However, “it is not clear whether it is an increase in transmission related to the characteristics of the viral strain or not.” According to mathematical modelers at Imperial College, the parameter R is greater than 0.4 compared to that of the more common strain. “But these are estimates – Rezza adds -, yet to be confirmed: perhaps in that place, for some reason the virus is running more. England has a consortium that does a lot of genomic analysis, British model makers are among the best in the world, in this case these estimates make me believe.
Hence the increased transmissibility. “Fortunately – the ISS Director of Infectious Diseases closed the matter – there is no increase in clinical severity. And there appears to be no potential effect on the efficacy of the vaccine. Within a week, biological studies will confirm or not these hypotheses. Translated? In seven days we will have more reliable information on the possible increase in transmissibility and on the change, which seems to be avoided, in the aggressiveness of the virus.
The Christmas List
“I am always ashamed to be the one who produces data that is used to make political decisions. Embarrassed because it seems that you want to tighten your freedoms during an important period like Christmas – Rezza said, highlighting the correct behavior to follow on the holidays. “It is clear that loving people means protecting them. It is neither rhetorical nor banal to repeat to protect the elderly ».
The doctor knows that the night of December 24 will meet for Christmas Eve dinner and that tomorrow, December 25, many families will do the same. “But limiting the number of people is important. Everything is based on probabilistic calculations: the more the size of the aggregations increases, the more likely it is that a person is infected and constitutes a danger to others.
“The thresholds,” Rezza concluded, “which seem arbitrary, are based on risk. It is important to limit aggregations to reduce that risk. Then he appealed to the public: “Everything must be returned to a base of tranquility and serenity, I would not see these government recommendations as something authoritarian, repressive. I would see them more as a reminder of common sense.
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