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HEALTH

Coronavirus: How much is the Delta variant spreading in Italy?

As a new study estimated that Italy ranks fifth in the world for the spread of Delta coronavirus variant, an Italian virologist has predicted that the strain is set to become 'dominant' in the country.

Coronavirus: How much is the Delta variant spreading in Italy?
Photo: Gianluca CHININEA / AFP

Contrary to the Italian health authorities’ recent evaluation that the Delta variant is rare in the country, new data analysis appears to show that the strain of coronavirus first identified in India in late 2020 now actually accounts for more than a quarter of Italy’s cases.

Some 26 percent of the country’s cases can be attributed to Delta, according to an international report by the Financial Times together with data from Belgian research institute Sciensano, based on figures from the virus-variant tracking database Gisaid

That’s a stark difference from the 1 percent estimated in the latest report from the Italian national Higher Health Institute (ISS) – which also included cases known to be caused by the similar Kappa strain, likewise first detected in India.

READ ALSO: Delta variant in Italy: What’s the risk of another Covid-19 surge?

“The Delta variant of Sars-CoV-2 is set to become dominant in Italy. If what the British said is true, that it has a higher transmission index, it is clear that it has a competitive advantage and will therefore expand,” Andrea Crisanti, director of molecular medicine at the University of Padua, told news agency Adnkronos on Monay.

The report places Italy fifth in the world for the share of cases driven by the spread of Delta, coming behind the UK, where the concentration of cases is 98 percent, followed by Portugal, Russia and the US.

While the new strain still only accounts for a fraction of the total coronavirus cases in mainland Europe, “it is gaining ground”, stated the analysis.

Although having reported much more conservative figures, the ISS noted that “there has been a recent increase in the frequency and spread of such reports within the country.” 

ISS head Silvio Brusaferro stated: “Outbreaks of variants, such as Delta, with greater transmissibility and/or the potential to evade immune response have been reported in Italy as well. More vaccine coverage and completion of vaccination cycles is essential to prevent resurgence.”

So far, concern about Delta has prompted the Italian government to reinstate a mandatory quarantine and testing for travellers from the UK, amid growing concern over the strain.

Italy had already banned travel from India, Bangladesh and Sri Lanka due to concerns about the spread of variants.

TRAVEL: How many flights are still available between the UK and Italy?

Elsewhere in Europe, the spread of the Delta variant has prompted the British government to delay easing restrictions as planned, and France has warned that the same number of cases are being reported now as the UK did a few weeks ago.

In Spain, health experts have predicted that the Delta variant will become dominant within a month. Meanwhile in Germany, doctors are urging people to avoid travel to places particularly affected by the strain.

Delta variant ‘more transmissible’

“Based on available scientific evidence, the Delta variant is more transmissible than other circulating variants and we estimate that by the end of August it will represent 90% of all SARS-CoV-2 viruses circulating in the European Union,” stated Dr. Andrea Ammon, ECDC Director

“Unfortunately, preliminary data shows that it can also infect individuals that have received only one dose of the currently available vaccines. It is very likely that the Delta variant will circulate extensively during the summer, particularly among younger individuals that are not targeted for vaccination,

“This could cause a risk for the more vulnerable individuals to be infected and experience severe illness and death if they are not fully vaccinated.”

“The good news is that having received two doses of any of the currently available vaccines provides high protection against this variant and its consequences. However, about 30% of individuals older than 80 years and about 40% of individuals older than 60 years have not yet received a full vaccination course in the European Union.”

In the UK, where the first cases were recorded in February, the Delta variant has superseded the Alpha variant, first detected in Kent, England.

This itself is believed to be 43-90 percent more transmissible than early strains, according to a study by Science magazine.

Portugal and Russia are also seeing increased spread of the Delta variant, while the circulation of the Alpha strain gradually declines.

This trend hasn’t yet been recorded in Italy, the US, Belgium and Germany, where the Alpha variant still seems to be the decisively prevalent one.

The Alpha variant is still highly prevalent over the Delta variant. Source: Financial Times

Some scientists fear the Delta variant may have already spread further than the figures show, according to the FT study, but have “gone undetected given that less of the genomic sequencing needed to identify variants has been completed in mainland Europe”.

The study reported that the UK has sequenced more than 500,000 Sars-Cov-2 genomes, while Germany has sequenced 130,000, followed by France and Spain at 47,000 and 34,000 respectively. No data were given for Italy.

The reason for either vastly differing sequencing figures, or none at all, is that “it’s costly, it’s time consuming and it was neglected,” Antoine Flahault, director of the Institute of Global Health at the University of Geneva, told the newspaper.

Obtaining as many of the variant’s genetic sequences as possible is crucial to tracking the spread of the Delta variant, according to the scientists interviewed.

Genomic sequencing analyses a virus sample taken from a diagnosed patient and compares it with other cases, which allows tracing of outbreaks.

Looking at Gisaid data in comparison with the FT’s projections, the share of Delta cases in Italy currently stands at 7.7 percent. However, this isn’t the full picture as not all laboratories that carry out genomic sequencing share the results in real time in the international database.

Delta’s response to vaccines and impact on symptoms

The rising number of cases has caused concern that this will be a roadblock to the progress made in the EU vaccination rollout, due to how rapidly it spreads and its potential resistance to current vaccines.

According to a study by The Lancet, the Delta variant is responsible for roughly double the risk of hospitalisation compared with the Alpha variant. The findings were based on hospitalisations reported in Scotland over two months.

READ ALSO: EU and AstraZeneca both claim victory after Covid vaccine judgement

After one dose of either the AstraZeneca or Pfizer vaccine, there is a much lower level of protection against the Delta variant, according to research – just 33 percent for in the case of Pfizer.

However, the latest data from Public Health England suggests that vaccines are more effective against the most serious consequences of the new strain.

The Pfizer vaccine was found to be 96 percent effective against hospitalisation from the Delta variant after two doses, while AstraZeneca’s offered 92 protection. From the first dose, Pfizer was found to be 94 percent effective and AstraZeneca offered 71 percent protection after one shot.

Studies have also found that symptoms from the Delta variant are different, with the most common symptoms reported including headache, followed by a sore throat, runny nose and fever, according to the Covid Symptom Study.

Certain symptoms, such as coughing and loss of smell or taste have almost disappeared, it found.

Member comments

  1. Why doesn’t anybody ever talk about how dangerous the Delta variant is? We hear it spreads more easily but not if it is putting people in hospital more frequently. So Delta is “more widespread” than we even know but deaths and hospitalizations are still going down. Why use fear of Delta to keep travel restrictions in place?

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HEALTH

How bad is Italy’s north-south ‘healthcare gap’ really?

Despite recent improvements, stark regional differences in healthcare provision persist in Italy and the problem seems to be here to stay, writes Silvia Marchetti.

How bad is Italy’s north-south ‘healthcare gap’ really?

Italians have a sad saying: ‘health is a right in the north, and a hope in the south’. 

Despite recent improvements, regional differences in healthcare standards continue to plague the country, telling a ‘tale of two Italies’ with the country divided in half, and featuring a trend of southerners travelling north for treatment.

The south-north healthcare gap of the past has of course significantly shortened. Things are very different now from the days when Turin doctor Carlo Levi wrote ‘Cristo si è fermato ad Eboli’ (Christ stopped at Eboli) in 1945, when he talked about the shock of seeing poor children in Matera, the capital of Basilicata, with flies in their eyes and infections. 

Today, Basilicata leads southern regions on healthcare performance. And there are significant differences in standards between southern regions, with Calabria and Molise lagging behind Sicily, Puglia and Campania for treatment and services.

READ ALSO: Five essential facts about Italy’s public healthcare system  

But differences remain, and the pandemic has worsened the outlook according to a recent report by the government’s CNEL agency.

Public healthcare expenditure is at a national average of 1,838 euros per person per year. But the figure is much higher in northern regions than in the south: for example, it’s 2,255 euros in Bolzano versus 1,725 euros in Calabria. 

This translates into lower investments in healthcare in the south, ranging from research in medicines and therapies to top doctors and avant-garde treatments. 

The Policlinico A. Gemelli Hospital in Rome. Italy’s capital is home to several highly-rated hospitals and clinics, but some residents still travel north in search of better or faster treatment. (Photo by Filippo MONTEFORTE / AFP)

Waiting lists in the public healthcare system for checks and surgeries are longer in the south than in the north, where all the best doctors tend to be. I’ve met many southern doctors who, after studying abroad, ditched their native regions for Rome or Milan where most of the top-rated clinics and hospitals are located.

Lombardy, Piedmont and Emilia Romagna have always shone when compared to Sicily and Calabria. And even Rome, despite being the capital, lags behind Milan.

However there have been a few improvements in southern standards lately, and the situation varies depending on the type of treatment.

According to the 2021 public hospitals performance report (PNE), even though the north is showing better results in terms of treatments for cancer and orthopaedics, the poorer southern regions are raising standards in some areas.

For instance, among the top 10 facilities with higher proportions of primary angioplasty guaranteed within 90 minutes, a good index of appropriateness and timeliness, seven are based in the south.

READ ALSO: Who can register for national healthcare in Italy?

Still, the gap has led to a type of ‘health tourism’ within Italy. There are no statistics, but I’ve met many southern people who have had to fly to the north for particular treatments, access to top doctors and cutting-edge surgeries, for example for knee and hip replacements. 

They rented apartments or stayed at hotels for weeks after their surgery to undergo rehab and physiotherapy, at considerable extra expense. 

I’ve met others who had to fly from Salerno and Puglia to Millan and Bologna for hip, shoulder and knee joint reconstruction or replacement, with all the hassle of the journey in poor health and the extra transport and accommodation costs it entails. 

It was striking to find that many Romans are among those who regularly travel to Milan for heart and orthopaedic checks and surgeries. Rome does have a few top-rated clinics, but apparently not as many as Milan.

Meanwhile many doctors from Milan, Padua and Bologna come ‘fishing’ for desperate patients in Rome and Naples who have failed to find a surgeon willing to operate on them due to their complex conditions. 

READ ALSO: The parts of Italy with the best (and worst) quality of life in 2022

This healthcare gap in my view will never completely disappear, despite the incoming European funds through the pandemic recovery plan aimed at shortening it.

It will be further reduced in time, but not in the near future, particularly if all the good doctors continue to flee north for higher salaries, prestige and a more promising career.

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