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Limited resources must be rationed and this will be the case for vaccines, at least throughout the first half of 2021. They arrive in Italy as of December 27 like the rest of Europe, but not immediately for everyone, also for logistical reasons . Choose the strategy for vaccination campaigntherefore, it is not taken for granted or without consequences. Starting since Old people – It is the criterion of Italy as of other EU countries – the objective is, above all, to contain mortality. If we immunize the Young people and intermediate groups of the population with a vaccine that reduces the ability to infect will, on the other hand, have a lower spread of the virus. It’s good to be clear: you can’t have it all.
The good news is that a mediation between the two objectives is now possible, thanks to the study of some Italian scientists who have developed a mathematical model able to evaluate the vaccine distribution criteria, anticipate the consequences and optimize their effectiveness. A precious opportunity, especially if the mass vaccination campaign coincided with the third wave, where once again, to limit deaths it will also be essential to contain infections. But there is a but: models must be implemented with i data that we can collect. “The percentages of the Immune application remain low and the amount of tampons is also decreasing instead of increasing,” he warns. Giovanni sebastian, CNR mathematician among the study authors.
The first doses of the vaccine will go to the staff of the hospitals and in retirement homes, including guests. Then to those who act essential services, from police to school, from public transport to prisons. Only then will the true mass vaccination campaign begin. When? Soon to count. Not even the extraordinary commissioner for the Covid emergency sets a date, Domenico Arcuri: “We do not know, perhaps for the first quarter of 2021,” he declared a few days ago, when we still did not know about the delay in vaccines Sanofi: 40 million doses, a fifth of the vaccines planned for this year, postponed until 2022. What we know instead is the chosen criterion to distribute them to the population: “We will start with the 11 million Italians who are over sixty years old, starting with the oldest down,” Arcuri explained, declining the first guidelines approved by Parliament on December 2. A strategy to implement, writes the Ministry of Health itself, waiting to test the effectiveness of vaccines in the field.
Comparison with other countries helps to get an idea of possible developments. “It is planned to start the nursing homes for the elderly and people over 80 years, as of December 27,” announced the Federal Minister of Health of Germany. Jens spahn, by presenting a vaccination plan that divides the population into four priority categories. Net of Rsa, health workers and patients at risk, those over eighty years old belong to the former, those over 70 to the latter, while in the third we find people of different ages selected for previous pathologies or particular professional activities. All those under 60 who do not have special conditions fall into the fourth category. the UK, which has already started with the Pfizer-Biontech vaccine, has divided a quarter of the population into nine priority groups, the oldest and at risk. And so on France, where those over 75 and those over 65 with other diseases at risk are at the forefront of the vaccination plan, and large-scale vaccination is scheduled between April and June.
In short, everyone agrees. But is it the best solution? “It also depends on many factors how the epidemic evolves, of the phase in which we are now ”, explains Giovanni Sebastiani, mathematician of CNR at the ‘Mauro Picone’ Calculus Applications Institute and author of a study on the distribution of vaccines together with Giorgio Palù, virologist from the University of Padua and new president of Aifa, the Italian pharmaceutical agency. Just published online by the international magazine ‘Vaccinations‘, the study used data collected from Veneto in the first wave and developed a mathematical model. “A vaccination plan is a political option,” Sebastiani said. “Our algorithm offers the decision maker the ability to optimize that choice.” Let’s try to explain: “Once the criterion has been defined, such as the priority of the elderly to reduce mortality, the model will show me the best balance with respect to other needs, such as reducing diffusion, which is still linked to the most important groups. young, of working age and socially active “. Ultimately, it is not enough to say “let’s start with the oldest.” Not if the objective is to operate options consistent with the data epidemics at our disposal, the only way to limit risks.
Sebastiani starts from the comparison between the last sixty days and the two central months of the closing of spring, from March 8 to May 6. the the death toll is identical: 29,430 deaths for the second wave, 29,451 for the first. “Only 21 fewer deaths, can we say that we have improved in the fight against the virus?” Sebastiani asks. Better than an answer is to ask other questions: which elderly to vaccinate first? What pathologies at risk should be prioritized? What strategy allows us relieve hospital structures more? Which to maximize the containment of infections at the same time and to the extent possible? The answers can be given by the developed model, already online and available to those who want to program and implement it. “When entering the data, starting from the epidemiological ones, the decision maker can interrogate the model based on the chosen criteria.” Adopt what the CNR researcher defines “quantitative approach”It means being willing to recalibrate the strategy according to the moment.
A hypothesis that the executive takes into account. “Italy is in the phase of sustained transmission, so the initial indications refer to this epidemiological situation,” reads the government’s strategic plan, which for now focuses on the “direct reduction of morbidity and mortality, as well as in maintenance of the most critical essential services “. But immediately afterwards, he specified: “If one or more vaccines prove capable of preventing infection, the focus will also be on reducing transmission, in order to further reduce the burden of the disease and the social and economic consequences.” A challenge that puts our poor at the center ability to collect and use data epidemiological. Far from the tens of millions of downloads that would have determined its effectiveness, the Immune application struggled to reach ten million users. Meanwhile, the number of gods also falls. tampons, which went from an average of 215 thousand daily in the week of November 12 to 18 to 155 thousand in the second week of December. “We have to regain control of monitoring increasing the number of swabs, periodically testing classes of subjects at high risk of contagion on a sample basis ”, says Sebastiani. “Together with the use of timely but more sustainable intermittent protection devices and closures, where between 7 and 10 days of strict measures are interspersed with 2 or 3 months of significant release, monitoring will be the best ally of an effective vaccination campaign”
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