‘Unacceptable strategy’: Italian health experts warn about Delta variant as vaccine progress slows

Italy’s independent health watchdog has slammed the government’s “wait-and-see strategy” on managing the spread of the Delta coronavirus variant, which is now thought to account for up to 32% percent of new cases in the country.

‘Unacceptable strategy’: Italian health experts warn about Delta variant as vaccine progress slows
Photo: Tiziana Fabi/AFP

The new report released on Thursday by the GIMBE Foundation, Italy’s group for evidence-based medicine, said the country urgently needs to increase coronavirus screening and contact tracing, as well as analysis and sequencing of data on new strains.

It also sounded the alarm over a recent drop in the number of vaccinations carried out in Italy, and claimed that the number of new cases in the country was probably underestimated as testing rates had recently fallen.

READ ALSO: Italy approves ‘mix and match’ vaccinations for under-60s as regions issue varying rules on AstraZeneca

The report urged the government to follow recommendations from the European Centre for Disease Prevention and Control (ECDC), which said this week that the more infectious Delta variant of coronavirus, first identified in India in late 2020, would soon account for 90% of cases within the EU as summer travel helped facilitate the spread.

“A ‘wait-and-see’ strategy on managing the Delta variant is unacceptable,” wrote GIMBE head Dr. Nino Cartabellotta in the new report.

“The measures recommended by the ECDC must be promptly implemented: enhance sequencing and contact tracing, implement screening strategies for those arriving from abroad, and accelerate the administration of the second dose in over 60s,” he said.

This would mean a change in approach to managing the pandemic in Italy, where authorities have so far hoped that the vaccination programme, along with public health measures such as mask-wearing, would be enough to keep new variants in check.

On Twitter, Cartabellotta said: “You can’t control the Covid pandemic only with vaccines, masks and distancing. Today the Delta variant requires tracing and sequencing”.

He added that the government’s approach of “hoping we can manage” had to change.

GIMBE also stated in the report that there was currently an “absence of reliable data on the presence of the Delta variant in Italy.”

Italy’s Health Ministry and Higher Health Institute (ISS) last week estimated that only one percent of cases in the country were caused by either the Delta or Kappa variants.

But independent data analysis found that the Delta strain may actually now account for more than a quarter of Italy’s coronavirus cases.

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

Some 26 percent of the country’s new 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.

Analysis of the same data set by GIMBE found that the figure had risen to 32% this week.

The report placed Italy fifth in the world for the share of cases driven by the spread of Delta, coming behind the UK, Portugal, Russia and the US.

Amid rising concern about the impact of the variant, which is thought to increase the risk of hospitalisation, Italian health authorities on Monday imposed new travel restrictions on arrivals from the UK – almost a month after other EU countries including France and Germany did the same.

Meanwhile, Italy is easing its own coronavirus restrictions as the infection rate has fallen in recent weeks and months.

The nationwide Rt number, which shows the rate of infection, remained steady this week at 0.69.

While the number of new infections in Italy appears relatively low at the moment, Cartabellotta said this may be an “underestimation”.

“The number of people tested for Sars-Cov-2 has progressively reduced by 52.7%, from 662.549 to 313.122” and with “significant and unjustified regional differences,” he said.

The GIMBE report also found that the number of vaccine doses administered in Italy had dropped over the past week for the first time in months, by -4.5% week-on-week.

At the moment, just over a quarter of the Italian population is fully vaccinated against Covid-19, compared to 46% in the United Kingdom.

Cartabellotta described Italy’s percentage as “worrying” considering “the lower effectiveness of a single dose against this variant “.

He pointed out that some 2.5 million people aged over 60 in Italy have not yet received the first dose of a vaccine.

In Italy, 26.5% have had one dose of a vaccine, while 46% are unvaccinated, compared to 17% and 37% respectively in the UK.

As the number of new coronavirus infections in the UK has risen sharply in recent weeks, health authorities attributed the relatively low number of hospitalisations and deaths in the country to its higher rate of vaccination coverage.

In the report cited by GIMBE, ECDC Director Dr. Andrea Ammon warned that “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.”

“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. Ammon.

“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.”

In its latest weekly coronavirus data monitoring report, released on Friday, the ISS confirmed there were “clusters of the Delta variant” in Italy, and warned that this variant was more contagious and had the potential to partially elude vaccines.

The report also called for more sequencing and renewed efforts to increase vaccination coverage in order to prevent the country’s health situation from worsening.


Semen ‘a vehicle’ for monkeypox infection, say Italian health experts

Researchers in Italy who were first to identify the presence of monkeypox in semen are broadening their testing, saying early results suggest sperm can transmit infection.

Semen 'a vehicle' for monkeypox infection, say Italian health experts

A team at Rome’s Spallanzani Hospital, which specialises in infectious diseases, revealed in a study published on June 2nd that the virus DNA was detected in semen of three out of four men diagnosed with monkeypox.

They have since expanded their work, according to director Francesco Vaia, who said researchers have found the presence of monkeypox in the sperm of 14 infected men out of 16 studied.

READ ALSO: EXPLAINED: How is Italy dealing with rising monkeypox cases?

“This finding tells us that the presence of the virus in sperm is not a rare or random occurrence,” Vaia told AFP in an interview.

He added: “The infection can be transmitted during sexual intercourse by direct contact with skin lesions, but our study shows that semen can also be a vehicle for infection.”

Researchers at Spallanzani identified Italy’s first cases of monkeypox, found in two men who had recently returned from the Canary Islands.

The latest results reported by Vaia have not yet been published or subject to peer review.

Since early May, a surge of monkeypox cases has been detected outside of the West and Central African countries where the disease has long been endemic. Most of the new cases have been in Western Europe.

More than 3,400 confirmed cases and one death have now been reported to the World Health Organisation from more than 50 countries this year.

The vast majority of cases so far have been observed in men who have sex with men, of young age, chiefly in urban areas, in “clustered social and sexual networks”, according to the WHO.

It is investigating cases of semen testing positive for monkeypox, but has maintained the virus is primarily spread through close contact.

Meg Doherty, director of the WHO’s global HIV, hepatitis and sexually-transmitted infection programmes, said last week: “We are not calling this a sexually-transmitted infection.”

Could antivirals curb the spread of monkeypox?

Spallanzani researchers are now trying to ascertain how long the virus is present in sperm after the onset of symptoms.

In one patient, virus DNA was detected three weeks after symptoms first appeared, even after lesions had disappeared – a phenomenon Vaia said had been seen in the past in viral infections such as Zika.

That could indicate that the risk of transmission of monkeypox could be lowered by the use of condoms in the weeks after recovery, he said.

The Spallanzani team is also looking at vaginal secretions to study the presence of the virus.

A significant finding from the first study was that when the virus was cultured in the lab, it was “present in semen as a live, infectious virus efficient in reproducing itself”, Vaia told AFP.

Vaia cautioned that there remained many unanswered questions on monkeypox, including whether antiviral therapies could shorten the time in which people with the virus could infect others.

Another is whether the smallpox vaccine could protect people from the monkeypox virus.

“To study this we will analyse people who were vaccinated 40 years ago before human smallpox was declared to have disappeared,” Vaia said.