“They too are a risk”

ROME The proposal was re-launched, for the umpteenth time, yesterday by the Lazio health councilor, Alessio D’Amato: «We need one simplification of quarantine for those who have three doses of vaccine and it’s asymptomatic. We must make life easier for the vaccinated, fewer tampons, fewer certificates and less bureaucracy ». In summary, the Regions say: when a person who has already received the booster tests positive for the swab (it can happen) but is totally asymptomatic, he remains in isolation for five days, then returns to his normal activities without forcing him to perform a new swab and apply for a healing certification. Raffaele Donini, president of the health commission of the Conference of the Regions and councilor for health in Emilia-Romagna, observes: “If we do not simplify the procedures and eliminate a little bureaucracy, the system will not hold up”.

CAUTION

But is it right to release after five days, even without a negative swab, a person vaccinated with three doses who had tested positive, but has always been asymptomatic? Doesn’t it risk infecting other people even on the sixth day? The Regions have put forward the proposal to “simplify life for those vaccinated with the booster”. D’Amato insists: “Experts from CDC, the US agency, share this line.” The Ministry of Health has opened a phase of reflection on this hypothesis. He did not close, but he nevertheless explained that a decision of this type must be evaluated very carefully, taking into account the pros and cons.

However, the Higher Institute of Health is very cautious: «Experience has shown that most infections, particularly in vaccinated subjects, proceed asymptomatically or with very nuanced symptoms. Not monitoring these cases would limit our ability to identify the emerging variants, their characteristics, and we would not be able to know the clinical status that follows the infection in the different populations (for example by age, vaccination status, comorbidities). Furthermore, it would not make it possible to monitor the trend of the circulation of the virus over time and, consequently, the risks of a detrimental impact on the ability to maintain adequate levels of health care even for diseases other than Covid-19 “.

Well, sure that the ISS is prudent, but how likely is it that a vaccinated with three doses, positive asymptomatic, five days after the positive swab could infect another person? Professor Pier Luigi Lopalco, epidemiologist and full professor of Hygiene at the University of Salento, makes this analysis: «The risk exists, but as usual we have to make a pragmatic evaluation. From a strictly biological point of view, the viral load of a positive vaccine, after five days, can spread viral particles, but the probability that it will infect is very low. The contagion of another vaccinated with three doses is even more unlikely “.

Wouldn’t it be more prudent to prolong the isolation until the person has a negative swab? “In this pandemic phase, of very high circulation, it makes very little sense. How many people are there on the street who unknowingly have a much higher viral load? At this stage it is more important to focus on the sick people. It is now clear that the virus will not be eradicated, thinking about tracking these numbers is illusory, it makes you smile. Concentrating resources on a positive asymptomatic, after five days, vaccinated with the booster, makes little sense. Rather, we promote the use of Ffp2 masks even more forcefully ».

DANGERS

In practice, Lopalco seems to say, it makes no sense to chase someone who has a small knife (the vaccine with asymptomatic third dose tested positive five days earlier) and in the meantime to neglect, because the resources are not infinite, who runs with the bazooka or who is injured and must be taken care of. «And they don’t make sense – says Lopalco – even the exit tests from quarantine are an incredible waste of resources, the swab system with such an intense viral circulation could never hold up. The problem is another: we must increase the number of people protected by the third dose vaccine, because for a vaccinated the consequences of the infection are, normally, much less serious “.

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