Covid, fourth wave: the situation in Europe and in Italy

Although in Italy the situation is largely under control, the numbers of the epidemic are in ascent throughout the old continent. Many countries are thinking aboutintroduction of restrictive measures, largely intended only for those who have deliberately chosen not to get vaccinated. In Austria The 2G system has been launched from today, which allows access to almost every context of social life only to the recovered or vaccinated: except for work, and in any case molecular, goodbye to tampons for the green pass which will be valid nine months after the second injection and then the third dose will be needed to maintain it. The weekly incidence is 599.6 cases per 100 thousand inhabitants. Also in Germany infections and incidence are growing: yesterday the country was 201.1 cases per 100 thousand inhabitants, the highest since the beginning of the pandemic. The countries of Eastern Europe live in a different situation, the result of poor adherence to vaccination campaigns: Bulgaria e Romania, for example, with very low coverage rates, they are experiencing a critical phase, made even more complex (in the first case) by the upcoming elections, with the policy covering a situation in some cases beyond the collapse of health systems and a very strong take root of fake news on vaccines, often relaunched – as shown by various reports, the latest today on Republic – by local politicians themselves or by Orthodox religious authorities. Of the 51,000 deaths in Romania, one third is counted in the last month. It hasn’t dropped below 400 official newspapers for weeks. On the other hand, among the over 80s only 20% received the first dose: the data speak for themselves and there is little to add.

Also in France admissions are on the rise: there are over 1,100 people in intensive care. President Emmanuel Macron will explain the plan for the next few weeks in a new speech. Pure the Great Britain, for months without any restrictions, has been living in a situation of its own: on Monday there were 32,332 infections and 57 deaths and the government of Boris Johnson, in a somewhat fluctuating way, ended up again under accusation for choices and pandemic management. The Danish government, among the first to introduce and eliminate it, is instead evaluating the restoration of the green pass: in mid-September the daily infections were about 200, in the last few days it has often exceeded 2 thousand. Also there Poland has been in a complex situation for weeks with the doubling of cases, the result of poor containment measures, distrust in the institutions (which flirt with no-vaxes) and low vaccination rates also in this case. Just 52% of the population has completed the vaccination course. Other worlds, compared to Italy which looks carefully but confidently at the cold season. Yet connected worlds, like everything in the EU which for months has reopened to vaccinated and buffered.

In Italy, as we said, intensive care and ordinary wards are well below the thresholds established for the zone changes of the regions. They are actually less than two months ago: on 4 September we counted 4,204 hospitalized, on 3 November they were 3,029 but obviously it’s the progression that matters and now that data is uphill. In fact, cases are growing, not only due to the increase in tampons, and the incidence as well: in the last two weeks the monitoring of the Gimbe Foundation has shown an increase in cases and in the ratio between positive people and tested cases, much more useful than general buffer / positive ratio which is also rising. Contagions, winter season and upcoming holidays suggest in short to continue on the path of prudence, obviously without penalizing those who have responsibly chosen to vaccinate and who in any case must continue to wear a mask indoors and avoid, when possible, situations of extreme promiscuity. As he explained in an interview Alberto Mantovani, one of the most influential Italian immunologists and the one with the highest scientific impact in terms of studies and research, if that of herd is complex to achieve it is necessary to aim for family immunity, securing and protecting all the components of its core.

From laughter moves by the Draghi government, having heard the CTS and the commissioner structure led by General Francesco Paolo Figliuolo, there will be a foregone conclusion extension of the third dose to all over 50s, starting six months after the second administration. Incidentally, the boosters are already proceeding at a good pace. It must be accelerated with the third booster doses, while those who did Johnson & Johnson they can already proceed without age restrictions. “We focus too much on the no vax, which are a minority. Rather, it would be necessary to push the tablet on the third dose, in the fragile population groups, in the over 80s, in health professionals, in those who have relations with the public, and above all to convince those who have not completed the vaccination cycle, still too many “explained Francesco Vaia, director of Spallanzani in Rome. Some regions, such as Piedmont and Campania, are already starting with the third dose for teachers e in Lazio the elderly are called proactively by the local health authorities or general practitioners. In Germany, for example, the third dose is available to everyone six months after the second, regardless of age. Too bad that in that case the latter are still a bit too low, around 67% of the total population against 73% in Italy.

Meantime it is necessary to convince those who have not yet given an injection: difficult, of course, because those who have not yet been vaccinated in November 2021, one year from the start of the campaign, probably have no intention of doing so. Discard the swabs as a requirement to obtain the green pass, or even better more consistently reach the vaccination obligation, it would be the ideal and perhaps, by now, obvious path. However, the government still does not seem willing to take except for some specific categories as well as health workers and RSA workers who are already required to protect themselves: army, brigade, policemen, train staff, supermarket cashiers. On November 8 we administered just over 10 thousand first doses: they are too few, they are even less than the first day of vaccination for health professionals on 31 December 2020, and they are few even for a country in a better condition than many others with 84% of people over 12 fully vaccinated. An example? Out of 16 thousand unvaccinated police officers only 1,500 have decided to immunize themselves after the obligation of the green pass to work: the others go on with the less reliable tampons that the Coisp union would even like to make last 96 hours. That’s not how it works: those are people in close contact with the public. It risks getting infected and infecting much more than those who do less exposed jobs.

Another way is to start quickly, as soon as Ema has approved the Pfizer vaccine for the age group 5-11, with the vaccinations of the little ones that can support the circulation of the virus although he rarely gets seriously ill. Aifa will in all likelihood give a very quick go-ahead, hopefully to leave in December and touch at least 50% of the approximately 4 million children affected.

A further measure, on which the Lazio region is pushing given the presence of the Fiumicino hub and the strong flow from the East, is that of reintroduce a possible quarantine for those arriving from countries with the most delicate situation: «We need quarantine for those arriving from some Eastern European countries where the numbers of new cases are very high and the percentage of vaccinated people low. Italy has intense relations with Romania and Bulgaria, the workers of those nations are engaged in assistance to the elderly, for example. We can’t risk it. And I say this with a spirit of collaboration and with respect for these citizens who carry out important jobs, ”said Alessio D’Amato, Lazio’s councilor for health.

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