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TURIN. Paolo Vineis, an epidemiologist at Imperial College London and vice president of the Higher Council for Health, was called in the spring by President Cirio to lead the area of support for strategic planning of the Crisis Unit of the Region. Today he analyzes the second wave of Covid based on an assumption: «The relationship between symptomatic and asymptomatic has been reversed in favor of the latter. Approximately 30% of cases are detected with follow-up and another 30 with examinations. But the symptomatic, like the sick in intensive care, are unfortunately growing rapidly.
Are the current measures sufficient or will we be forced to close?
“The blockade was effective, but now we have contact tracing that didn’t exist before. However, the problems cannot be hidden. The monitoring fails to cope with a growing number of cases and the limit is prevention services overwhelmed by phone calls and organizational problems. All this could have been better prepared, considering that a second wave was expected from June.
We are witnessing an escalation of measures and announcements. What makes sense to do?
“Normally my answer would be that the job of researchers is to find the best scientific evidence and entrust it to the policy that deals with the organizational effort. We now have the double disadvantage of having little evidence of the effectiveness of different measures and a proven organizational machine. It seems to me, however, that it is very reasonable to avoid closure at all costs and to protect production and schools.
What are the most dangerous contagion occasions?
“The main sources of contagion seem to be transport, social and recreational activities, and here we must intervene. The productive world has given rise to few outbreaks, thanks to the restrictive measures that entrepreneurs have an interest in enforcing ”.
Why the contagion has become exponential?
‘Mobility has returned to almost normal levels and Professor Pedreschi from the University of Pisa has shown how decisive it was in the first phase infection, and it still is. With the difference that contact tracing works a bit. “
What are the regions most at risk and what data is good to take into account to understand them?
«In general, the regions at risk are those with the greatest mobility linked to the productive fabric. It is necessary to study the cases per 100,000 people, rather than the absolute numbers, the ratio between positive swabs and total swabs, which is an indicator of the suffering of the monitoring system, and how many asymptomatic become symptomatic. And above all, be attentive to hospitalizations and intensive care. But it doesn’t make sense for each region to take its own measures. I understand the local modulations, but both the scientific evidence and the measures recommended by international agencies are the same for everyone.
How are you doing in Piedmont?
“You can’t say it’s okay. The accumulated cases in the last seven days were 100 per 100,000 inhabitants, more or less like Campania and Lombardy. Admissions to the ICU increase by 7-10 units per day. In July, I submitted a report to the Crisis Unit whose last sentence said that we could not afford to be unprepared for a second wave, and included among the recommendations a strong organizational structure for follow-up contacts and staff training. Unfortunately, it was only partially done. ‘
In the first wave, Piedmont got worse at a later time, could it happen again?
“On the one hand there has been progress, such as the creation of the Department of Infectious Diseases of the Region, on the other I see the same problems of the first phase, especially the lack of a clear general direction, for example on the part of Councilor Icardi”.
If you were to make a prediction, what Christmas do you imagine?
“Me a Christmas lockdown seems unlikely, because the closure is effective if timely and the damage to the economy would be enormous. Rapid tests should be initiated to isolate those contagious, strengthen prevention services to telephone contacts and information systems. It would also be an opportunity to create a digital health record for each citizen and use the data to plan rational elections.». –
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