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COVID-19 STATS

EXPLAINED: Why is Italy’s coronavirus infection rate rising again?

After Italian health ministry data showed Covid cases are on the increase for the first time in weeks, why is this happening and is it likely to continue? Here's what Italy's health experts say.

EXPLAINED: Why is Italy’s coronavirus infection rate rising again?
Commuters wearing protective masks on Milan's metro. Photo by Miguel MEDINA / AFP

The number of Covid cases detected in Italy has been falling for the last five weeks. But it began to rise again in early March, according to the latest data published by the Higher Health Institute (ISS) and the health ministry on Friday.

“During this week there was an inversion in the trend of the Covid-19 curve in Italy,” confirmed ISS President Silvio Brusaferro as he presented the data at a press conference. 

“In recent weeks it has been decreasing. Last week the decrease slowed down, and this week we are witnessing a curve that begins to rise again”.

The increase came despite the fact Italy has strict health measures in place including the requirement to show proof of vaccination or recovery under ‘super green pass’ rules, and a mask mandate for all indoor and some outdoor public places.

In the last two weeks, the incidence of Covid infections in around half of all Italian provinces has stalled or risen, health ministry data showed.

The number of known current positive cases is once more nearing a million, and the weekly incidence rate has risen to 510 cases per 100,000 people, up from 433 the previous week.

On Monday, official data showed new cases were up by 30 percent week-on-week, while the test positivity rate is 14.1 percent.. 

Giovanni Rezza, the health ministry’s director of prevention, confirmed that hospitalisation rates are still decreasing for now.

“Regarding the occupancy rate in the hospital wards and intensive care, we are at 12.9 percent and 5.5 respectively,” he said at Friday’s press conference.

People wearing face masks at the Capitoline Hill in Rome. The Italian government eased the requirement to wear masks outdoors after a decline in the number of Covid-19 cases in February, but the rule still applies in some settings. Photo by Vincenzo PINTO / AFP

Though Italy’s health experts are urging people to remain cautious, they stress that it is too early to know whether the situation is likely to worsen further.

“There is no reason for us to be alarmed ahead of time”, immunologist Sergio Abrignani, a member of the government’s scientific advisory board, told newspaper Corriere della Sera on Monday. 

The increase in cases is due to “a series of factors”, he said, “and it is not guaranteed that it will persist.”

Nino Cartabellotta, president of Italy’s evidence-based medicine foundation Gimbe, said it would take “7-10 days” to see whether this is truly a reversed trend or “just a rebound”.

“We now have a fairly high circulation of the virus. We still have a million positives and 40,000 cases per day,” he cautioned in an interview with Radio Cusano Campus. “There is no doubt about this. But the element of concern is that the descent has stopped and there are also hints of an ascent”.

Experts attributed the rise to several factors, including colder weather, and decreased caution as people look ahead to the planned end of certain health measures in Italy.

Decreasing vaccination rates are also thought to be a major factor, as well as new “sub-variants” of coronavirus, Brusaferro noted at the press conference.

“Omicron sub-variants, such as 2, the most transmissible, are growing,” he said.

Cartabellotta also said the rise may be due to “the sub-variant Omicron 2 , of which we know nothing” as well as the recent spate of very cold weather meaning “we are more indoors where the virus spreads more”. 

He said the rise was also connected to public behaviour, with Italy now looking ahead to a promised relaxation of the health measures – even though the government is yet to confirm details of the plan.

Italy eased some measures in early February, including the requirement to wear a mask in all outdoor public places.

“In Italy the increase in Covid cases is linked to a series of factors, including a certain relaxation on the part of the population, coinciding with the end of the state of emergency – which has been sold, even though it is a deadline of a purely regulatory nature, as a sort of watershed”.

Italian Prime Minister Mario Draghi confirmed in late February that the country’s state of emergency – the condition that allows the government to pass emergency laws by decree – will end on March 31st, after more than two years.

This doesn’t automatically mean the end of health measures in Italy. However, Draghi also confirmed that ‘super green pass’ rules would be lifted “gradually” from April.

The government is expected to give further details of plans for easing the rules on Thursday, March 17th.

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COVID-19 ALERT

Covid-19: European summer holidays threatened by rise of subvariants

A resurgence of Covid-19 cases in Europe, this time driven by new, fast-spreading Omicron subvariants, is once again threatening to disrupt people's summer plans.

Covid-19: European summer holidays threatened by rise of subvariants

Several Western European nations have recently recorded their highest daily case numbers in months, due in part to Omicron sub-variants BA.4 and BA.5.

The increase in cases has spurred calls for increased vigilance across a continent that has relaxed most if not all coronavirus restrictions.

The first resurgence came in May in Portugal, where BA.5 propelled a wave that hit almost 30,000 cases a day at the beginning of June. That wave has since started to subside, however.

READ ALSO: KEY POINTS: German Health Ministry lays out autumn Covid plan

Italy recorded more than 62,700 cases on Tuesday, nearly doubling the number from the previous week, the health ministry said. 

Germany meanwhile reported more than 122,000 cases on Tuesday. 

France recorded over 95,000 cases on Tuesday, its highest daily number since late April, representing a 45-percent increase in just a week.

Austria this Wednesday recorded more than 10,000 for the first time since April.

READ ALSO: Italy’s transport mask rule extended to September as Covid rate rises

Cases have also surged in Britain, where there has been a seven-fold increase in Omicron reinfection, according to the Office for National Statistics (ONS).

The ONS blamed the rise on the BA.4 and BA.5 variants, but also said Covid fell to the sixth most common cause of death in May, accounting for 3.3 percent of all deaths in England and Wales.

BA.5 ‘taking over’

Mircea Sofonea, an epidemiologist at the University of Montpellier, said Covid’s European summer wave could be explained by two factors.

READ ALSO: 11,000 new cases: Will Austria reintroduce restrictions as infection numbers rise?

One is declining immunity, because “the protection conferred by an infection or a vaccine dose decreases in time,” he told AFP.

The other came down to the new subvariants BA.4 and particularly BA.5, which are spreading more quickly because they appear to be both more contagious and better able to escape immunity.

Olivier Schwartz, head of the virus and immunity unit at the Pasteur Institute in Paris, said BA.5 was “taking over” because it is 10 percent more contagious than BA.2.

“We are faced with a continuous evolution of the virus, which encounters people who already have antibodies — because they have been previously infected or vaccinated — and then must find a selective advantage to be able to sneak in,” he said.

READ ALSO: Tourists: What to do if you test positive for Covid in France

But are the new subvariants more severe?

“Based on limited data, there is no evidence of BA.4 and BA.5 being associated with increased infection severity compared to the circulating variants BA.1 and BA.2,” the European Centre for Disease Prevention and Control (ECDC) said last week.

But rising cases can result in increasing hospitalisations and deaths, the ECDC warned.

Could masks be making a comeback over summer? (Photo by OSCAR DEL POZO / AFP)

Alain Fischer, who coordinates France’s pandemic vaccine strategy, warned that the country’s hospitalisations had begun to rise, which would likely lead to more intensive care admissions and eventually more deaths.

However, in Germany, virologist Klaus Stohr told the ZDF channel that “nothing dramatic will happen in the intensive care units in hospitals”.

Return of the mask? 

The ECDC called on European countries to “remain vigilant” by maintaining testing and surveillance systems.

“It is expected that additional booster doses will be needed for those groups most at risk of severe disease, in anticipation of future waves,” it added.

Faced with rising cases, last week Italy’s government chose to extend a requirement to wear medical grade FFP2 masks on public transport until September 30.

“I want to continue to recommend protecting yourself by getting a second booster shot,” said Italy’s Health Minister Roberto Speranza, who recently tested positive for Covid.

READ ALSO: Spain to offer fourth Covid-19 vaccine dose to ‘entire population’

Fischer said France had “clearly insufficient vaccination rates” and that a second booster shot was needed.

Germany’s government is waiting on expert advice on June 30 to decide whether to reimpose mandatory mask-wearing rules indoors.

The chairman of the World Medical Association, German doctor Frank Ulrich Montgomery, has recommended a “toolbox” against the Covid wave that includes mask-wearing, vaccination and limiting the number of contacts.

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