Will the second wave of the epidemic arrive?
It cannot be predicted with certainty. We are dealing with a new virus, which has surprising behavior, he explains Francesco Le Foche, head of the day hospital of immunoinfectivology at the Umberto I university hospital in Rome.
Could this happen in the autumn, as Silvio Brusaferro, president of the Higher Institute of Health assumes?
I would move the arrival of a possible second wave farther in December in the cold. The virus must have time to lift its head after being stopped by the lockdown. In July circulation is likely to be even smaller than now. I don’t think that in September-October the epidemic would already be able to recover due to the limited time span.
Would the return be as fierce as the first phase?
I don’t think we will go back to having such a tragic experience. I think more of a wave comparable to that produced by a strong influence than a serious disease, let’s not forget, with important complications and fatal outcomes. We have had influenza outbreaks characterized by a lethality similar to that of Covid.
Is the health service ready to face a new emergency?
S that it. The ability to intercept outbreaks on the territory has greatly improved. The key to success is to prevent infected patients from arriving at the hospital and therefore to create alternative treatment paths, a strategy that has been applied. We can no longer afford to deprive cancer, heart and serious disease patients of controls and treatments as happened in these 3 months. They must not be placed on the corner.
Did the virus subside?
Judging by the sequences of the unmodified genome. For we find less aggressive syndromes. New patients are doing well enough that one might think of a new expression of disease to call Covid like, Covid-like. Mild symptoms, fever that does not go away for days, but the swab remains negative as the viral load is low and positivity is not detected.
How do you explain it?
The virus may have found cohabitation with the human cell it infected. A peaceful coexistence that was established with lockdown. His interest now has become that of not killing the guest, because he has to survive and has no interest in killing him.
Does Sars-CoV-2 force you to review medical texts?
Yes, a strange, different virus. We immunologists knew that usually a virus when it enters the body induces the production of IgM antibodies (immunoglobulins) and then of IgG antibodies. It was a fixed rule. Instead, we now see the IgM appear without being followed by the IgG. Or the IgM arrive late, in the third week from the start of the infection, rather than immediately after contact with the foreign agent. Previously it was assumed that the IgM corresponded to the acute phase of the disease and that the IgG indicated a previous infection. We know for certain that severe patients, hospitalized in intensive care, develop IgG that are neutralizing, protective.
So do the rapid serological tests make sense, which detect the presence of the two types of antibodies and which some Regions intend to propose as an access license?
We are sure that this virus leaves a trace but we don’t know how to interpret it. So there are no preconditions for talking about immunity licenses.
How to defend yourself then?
It is up to us to make ourselves immune by respecting the rules of interhuman distancing and hygiene and by wearing masks. I am opposed to gloves, dirt vehicles.
How long will we have to keep our distance?
Life changed forever. No more restaurant fees, slalom between the sunbeds on the beach and the crowd in the bus. Behaviors contrary to public health. The promiscuit to forget forever. Now the sound principles of civic education apply.
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