“Why the waves come
We don’t know. But now we know how they start and how to stop the most negative effects. Italy can block this fourth ‘awakening’ of the virus, but it will have to hurry up with boosters, which are commonly called the third dose ”. Speaking, in perfect Italian, is Arnon Shahar , one of the calmest, clearest and most convincing scientists I have ever listened to since the beginning of the pandemic. He leads the anti-Covid task force of Maccabi Health Services in Israel, the second largest health institution in the country, graduated in medicine from the University of Bologna and is one of the people who has helped our country the most, with whom he has a special bond, to deal with the health emergency.
For a year and a half, Shahar has held virtual meetings every two weeks with our Ministry of Health. You helped Alessio D’Amato , Lazio’s health councilor, to set up one of the best vaccination campaigns in Europe. “We had a few weeks of advantage, and Alessio asked me what were the most effective practical choices to put in place”.
Israelis have been first in many of the crucial choices during this pandemic, ever since Netanyahu imposed severe restrictions in March 2020, preventing the first wave from being as violent as elsewhere. Boaz Bismuth, director of the Israel Hayom newspaper, says that already in early February 2020 the premier was secretly preparing measures to counter the new coronavirus: “You’ll see, in a few weeks we will talk about nothing else”.
Among the first to close an agreement with Pfizer / Biontech for the supply of vaccines – while Europe haggled with ten different producers, and then changed course several times – in Israel, prophylaxis began early and allowed, together with a second and very hard lockdown, to reopen the country in spring 2021, abandoning the restrictions and returning to almost total normalcy.
Yet, between June and July, cases among those vaccinated with two doses started to rise. It was the now known waning, the progressive reduction of coverage against the virus. Then the health authorities, without having clear precedents but trusting the scientific task forces, ordered the recall: first to the over-60s and health professionals (they quickly reached 90% of third doses), then to all the others.
“In three weeks we have seen the sensational effects of this choice – says Shahar. The booster guarantees even stronger protection than the two doses, and we believe it can be even more lasting, although there are still not enough clinical studies ”. As a doctor, the thing that makes him most proud is that “in two months we have saved three thousand people, even healthy and without particular complications, from death”.
Italy is in a similar situation. Now that many received the second dose between 4 and 9 months ago, there is an increase in cases, even if thanks to vaccines the number of deaths and hospitalized is not comparable to the same period last year. The recall campaign has begun, but more slowly than in Israel. “We quickly reached three million recalls and then, with more difficulty, four million,” explains Shahar. “Don’t think that we lack the skeptics or the undecided. The third dose is more difficult to explain to those who think they have already done their duty “.
Here is the most complicated point: the parameter to determine the waning of vaccines, in fact, is certainly not the serological test that some do to understand how many antibodies still have in circulation. “This is a fact that does not tell us how much one is protected, because antibodies can always be ‘awakened’ in the event of infection and guarantee an effective defense, even if the serological test seems to be few. The answer is not in our blood, but in epidemiology. When infections increase in a given population, that is the sign of less coverage, and of the need for recall. But if you don’t act right away, you risk letting the virus run and doing more damage than it should. We need to prevent a surge in cases “.
Instead of getting lost among useless serological and impossible accounts (“it lasts 6 months”, “no, 9”, “let’s do 12 and we don’t talk about it anymore”) we Italians have the clear example of Israel: maximum effectiveness, thousands of lives saved , negligible adverse effects.
“We can talk about myocarditis, about contraindications, we can talk about what you want. It was our researchers who reported some sporadic adverse cases, let alone if we deny the scientific reality. Last week we hosted a national virtual forum, which was attended by thousands of people, including no-vax, who were able to ask questions to 50 specialists for over six hours. The only thing that matters are the facts. And they tell us that the call is the best way out of the pandemic ”.
Perfect hook for the last question: when
“If I have to make a prediction, and obviously depends on various global factors beyond our control, I mean the second half of 2022. We have the vaccines, the boosters, and the possibility of adjusting the formula every year according to the variants. In the meantime, monoclonal antibodies have arrived which work very well, and recently the antivirals from Merck-Msd and Pfizer. With this arsenal, we will soon be able to consider Covid an endemic virus, and put the emergency behind us. Everything will be as before
. No. We will take some medical measures with us, and it will be good ”.
