In Italy, the trend of the pandemic confirms a downward trend with stable Covid data (the positivity rate at 14,8%) and declining hospitalizations, while the first administrations of the fourth vaccine dose for over 80, guests of the RSA and for the frail over 60s, however the supplementary booster was already foreseen for immunosuppressed subjects. In view of the autumn, the hypothesis of a new adapted anti-Covid vaccine is being evaluated, an autumn booster as an annual booster which could also include the flu one and concern only the over 50s or 60s. Meanwhile, the ok from AIFA is awaited (Italian Medicines Agency) on the possibility of being prescribed antivirals from your GP.
An improving picture compared to the last few weeks and Italy is preparing to abandon almost all the restrictions that have accompanied us in the last two years. Even if the Xf variant of the virus, a mix of Delta and Omicron, was isolated for the first time in our country. For the number one of the CSS Franco Locatelli "there are no elements of concern" but we still need to "pay attention". Also in light of the resurgence of the virus in China, where the Covid-19 emergency in Shanghai continues to be critical and remains in lockdown.
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Covid, fourth dose for everyone in the fall?
Data is needed, for this May it will also be an important month for understanding what the virus does and what to expect in the coming months, given that a multiplication of infections is assumed at the end of the summer. No particular side effects emerged relating to the administration of the second booster, so the safety profile of the drug remains unchanged. However, at the moment no particular benefits have been found from a new dose of mRna anti-Covid preparation for the under 60s. But everything could change in the autumn.
The goal is to prepare to anticipate a possible escalation of the pandemic. For now, what is certain is that the fourth dose (the second booster) has been recommended since yesterday to the over 80 guests of the RSA and 60-79 year olds with chronic pathologies, for example patients with ongoing cancer, diabetes, pulmonary fibrosis. An Israeli study has shown that the second booster in the elderly protects 4 times more.
Towards the green light from Aifa to antivirals from the general practitioner
The green light from AIFA to prescribe the anti-Covid pill is expected in the coming days, Paxlovid from Pfizer and Merck's Molnupiravirby family doctors so as to shorten the time needed to access such therapies given that the treatment must begin within 5 days of the onset of symptoms and last for 5 days. This was stated by the director general of AIFA, Nicola Magrini, on Tuesday 12 April during the press conference at the Ministry of Health to take stock of the state and the next steps. “Paxlovid will be available in 50 doses per month starting in a couple of months. There will also be adequate training for family doctors. Molnupiravir, on the other hand, is less effective and there will be less investment,” added Magrini.
It should be remembered that not everyone with Covid will be able to be prescribed antivirals. The plan is intended for "adult patients with recent Sars-CoV-2 infection with mild-moderate disease who do not require oxygen therapy and with concomitant clinical conditions that represent specific risk factors for the development of severe Covid-19". For this reason it will be essential to ensure that doctors are adequately trained on the use of these pills and their interaction with other medicines.
This category of patients will thus be able to obtain the antiviral pill without having to go to the hospital. It will be the general practitioner who will have to fill in the treatment plan indicated by Aifa, therefore the patient - once he has received the prescription - will be able to obtain the drugs, probably by going directly to the pharmacy and not only to the centers currently indicated for their distribution.
