“In Italy, where there are health facilities, there are doctors and there are excellent clinicians, I have to explain why mortality from Covid-19 is so high”. The invitation to start a reflection on this point comes from Guido Rasi, former executive director of the Ema drug agency, today consultant to the Coronavirus emergency commissioner and scientific director of the provider of continuing education in medicine. Consulcesi. “Something must not have worked in terms of standardization of care – he observes – because it is not possible for people to die so much”. The expert, ordinary microbiologist at the University of Rome Tor Vergata, puts forward two hypotheses. The phenomenon probably “can be explained in two ways”, he analyzes in an interview with Adnkronos Salute. First, he remembers, “the dramatic mistake committed in the initial phase of the vaccination campaign, in the target of the” immunized population, which often in some areas of Italy was not strategic: in some cases “the vaccines were not concentrated on the population more at risk, an even more serious element considering that there were few vaccines. “Second factor indicated by Rasi:” Surely there is a need to review the standards of care, even at home. Because probably – he warns – the tachipirina approach and Watchful waiting is a bit too minimalist “. AstraZeneca The EU decision, announced by Internal Market Commissioner Thierry Breton, not to renew AstraZeneca’s anti-Covid vaccine order after the expiry of the current contact” does not concern product safety, but the production difficulties encountered, the difficulties in deliveries and the fact that there is a legal action in progress. In this sense it is quite understandable “according to Guido Rasi, former director executive hours of the European Medicines Agency Ema. On the age at which to allocate the Anglo-Swedish ‘shield’, now recommended in Italy as a preferential way for the over 60s, specifies that “potentially the use concerns the entire population aged 18 and over, but having in mind the indications of the ‘Ema “. The EU regulatory body, in fact, recalls the expert, today consultant to the commissioner for the coronavirus emergency and scientific director of the provider of continuing education in medicine Health In-Training, Consulcesi group,” has prepared very clear tables , defining the scenario in which the risk-benefit ratio is maximum “of the Vaxzevria vaccine *: it grows with increasing age and at certain levels of spread of the virus. So the AstraZeneca Covid-19 vaccine “can potentially be used on the entire population aged 18 and over – points out in an interview with Adnkronos Salute the expert, microbiologist at the University of Rome Tor Vergata – but always remembering the 4 parameters of the EMA “, on the basis of which to progressively calibrate the strategy:” Availability of vaccines, trend of the pandemic, hospital capacity and number of already vaccinated “. Vaccines for poor countries” For each dose of anti-Covid vaccine sold to a Rich country, make two available to a poor country “. This could be “one of the possible solutions” to ensure equal access to immunization against the pandemic virus worldwide, according to Guido Rasi. The expert, ordinary microbiologist at the University of Rome Tor Vergata, launches the proposal in an interview with Adnkronos Salute: “It is one example among many”, he begins. But an idea could be to “impose that, on the earnings that the pharmaceutical companies holding the current licenses on Covid-19 vaccines have, there is a determined and verified quota which will benefit those who currently cannot access these products” . Because “the problem is not the patent”, assures the former EMA number one. And suspending the patents tout court “is not something that can in fact be achieved.” “If it were achieved, limited to the pandemic phase and vaccines for the pandemic – he specifies – it would also be a good thing, but on the condition of a key agreement for the transfer But there is another important reasoning to be done “, analyzes Rasi, and concerns the concrete possibility that a new manufacturer, without consolidated know-how, will actually be able to guarantee in good time the essential quality for a hi-tech product. such as the vaccines we are talking about Vaccine campaign for children Formulas such as vaccination open days, during which to offer the anti-Covid ‘shield’ with different schemes than those followed so far, and with particular attention paid to adolescents. Rasi imagines that “from June” Italy could enter a new phase of the anti-Covid immunization campaign. “I am thinking of two parallel strategies”, explains the expert, ordinary microbiologist at the University of Rome Tor Vergata in an interview with Adnkronos Salute: “While the correct indication now is to proceed in an orderly fashion by age group”, looking in the near future “we can also imagine open days once the population at risk has been immunized, therefore when the 60-69 age group has also been made safe or is well on its way to that goal”. So if so far the campaign has been fundamentally carried out by reservation, “from that moment it will be possible to think of strategies such as open days.” By then, in fact, it is expected that there will also be a vaccine approved for teenagers. If today under the age of 16 there are no products authorized against Covid-19, in the coming months a European ok could arrive for Pfizer / BioNTech even in 12-15 year olds. And the former Ema number one invites you to plan now: “An absolutely strategic reasoning will be that of the pediatric population, on which it will be good to start a strategic reflection shortly. The 12-18 year olds will be a key population”, assures Rasi. of the RtAddio Rt? “In a scenario that changes every 15 days, also as a result of vaccinations, it becomes logical at some point to review the risk indicator parameters” in monitoring the trend of Covid in Italy. “It is right to review the parameters in this phase of the pandemic – specifies Rasi – for a very simple reason”, namely because “the number of infected in a unit of time no longer produces the negative effects it produced before” implementation of the vaccination campaign. “Thanks to the effect of the vaccine – reasons the expert, ordinary microbiologist at the University of Rome Tor Vergata – there will certainly be a gap between the number of” Sars-CoV-2 “infections and the severe effects of the disease ” COVID-19. “There will be a drop in hospitalizations and mortality – Rasi points out – while it is not certain that there will be a drop in light infections. So the number of positivity itself is one of the parameters, but it may need to be revised”.