Corona virus disease. Walter Ricciardi speaks: “It was decided not to fight the virus anymore. Without interventions in hospitals, schools and transportation, we will have a disastrous autumn.” And about the fourth dose, he has no doubts: “Extend it to over 70 years and health care workers.”

by Giovanni Rodriquez

“This would be the time to put in place a great plan expressed in several points: immediately protect the most vulnerable with the vaccine, provide schools with proper ventilation systems, strengthen public transportation, and require them to use masks. Immediately expand the public for the fourth dose up to 70 and health workers. If we do not do these things, we will surely face a disastrous autumn.” For new vaccines, “Moderna is farthest in the licensing process”

July 06

“Any strategy that is not focused on fighting this virus will cause us serious problems.” He is convinced of that Walter RicciardiAdviser to the Minister of Health Roberto Speranza.

And it seems that Italy, as well as the rest of the West, has now decided not to fight Covid anymore. Hence the outbreak of cases in the middle of summer and the failure of the vaccination campaign to give the fourth doses to the most vulnerable. Without immediate planning intervention for hospitals, schools, transportation and the safety of those most at risk, Ricciardi warns, we will head toward a “catastrophic fall” that may see not only a marked increase in mortality among the most vulnerable, but also a strong strain on health services.

Professor Ricciardi, the impression is that with the abolition of the restrictive measures, the interest in the importance of the vaccination campaign has also decreased, particularly with regard to the administration of the fourth dose. Is that correct?
As for the fourth doses, but also for the measures to combat the virus, I have already given references to the Ministry of Health since April, suggesting how to intervene. However, there were some difficulties given that all European countries had already started paths back to normal life. In Italy, we have only been able to maintain the obligation to use masks on trains, transports and hospitals. Too small. The impression is that at present it has been decided to stop the fight against the virus almost everywhere. Even overcoming the emergency did not help, we returned to a normal state in which decisions are fragmented, and above all lagging behind. In the face of very tired public opinion, it was decided to concede all. We have stopped fighting the virus by allowing behaviors that, as we see today, have contributed to the explosion in the number of infections. Another component that has been making a comeback for operational fragmentation is vaccination.

Is that why less than 30% of the audience of eligible people gets their fourth dose today?

Operational fragmentation certainly contributed to this finding. Whereas before the Figliuolo commissioner structure ensured rapid supply and management through hubs, today we are back to normal. And we know how this normalcy is not enough to achieve vaccination goals, except for children for whom vaccinations are mandatory to go to school. This normality thus translates into poor coverage that will only set the stage for a disastrous fall.

Many people today prefer not to give their fourth dose while waiting for new updated vaccines. What can we tell them?
I can tell vulnerable people over 80 to get vaccinated right away and not wait because for them it’s a lifesaving process. Don’t arrive in vulnerable conditions in September when the study again begins to unleash an infection process driven by the most infectious virus ever seen in microbiology’s history.

Today, with more than 100,000 new diagnoses every day, the risk of infection for them is great.
In my opinion, today we are traveling on numbers of over 100,000 new cases per day, and the true figure will be at least double if not triple. This is also because vaccines save lives and protect against serious illness and death, but have a much lower impact against infection.

In the current epidemiological context, can the use of masks be recommended for the vulnerable and for the people who live with them?
But of course, they must continue to maintain a high level of interest in terms of communication and presence in public. And they need to get their fourth dose as soon as possible to protect themselves from the most serious risks.

If these are buildings, at the level of organization of the hospital, schools and transportation, are we ready to face next fall?
He is confident that we will face significant problems as of today. This would be the time to put in place a great plan that is articulated in several points: immediately protect the most vulnerable with the vaccine, equip schools with proper ventilation systems, strengthen public transportation, leave them to the obligation to use masks and expand the public immediately for the fourth dose even for those above The Seventies and Healthcare Professionals. If we don’t do these things, we will surely face a disastrous fall with a massive increase in the mortality rate of the vulnerable and a strong pressure on the health services.

For the upcoming mass vaccination campaign, will the updated vaccines be used and will they be open to all?
Updated vaccines for the Omicron variant from Pfizer and Moderna are already under review at the EMA. Moderna appears to have come a long way in its licensing process, but today it is still too early to talk in detail about the next vaccination strategy. Perhaps we can consider mass vaccination as priority.

But is it true that with such transmissible variables no containment strategies are able to work?
this is not true. Preventive measures work and reduce the burning blood circulation that puts the lives of the most vulnerable at risk.

However, can we say that with these variants the concept of population immunity has now been replaced?
Yes, we now understand that with these variants there will be no population immunity because people get infected again. Among other things, the more often a person becomes infected, the higher the chances of developing prolonged Covid disorders. Even with Omicron, negativity remains rather slow, on average it takes 10-20 days. That is why the virus must be fought. Any strategy that does not focus on fighting this virus is bound to cause us serious problems.

Giovanni Rodriquez

06 July 2022
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