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The results of the analysis of sewage water in various cities of Lombardy conducted in the last year, and recently published in the scientific journal JAMAconfirm how important vaccines were in keeping severe cases of COVID-19 under control for a good part of 2021. The new study, carried out by the Mario Negri Institute and the University of Milan, effectively shows the variation in the course the time of coronavirus concentration in wastewater, which has long been considered an important indicator for understanding the actual spread of the virus beyond official but inevitably partial estimates.
Analyzing wastewater for public health reasons was a common practice even before the pandemic. For example, it was used to verify the effectiveness of vaccinations against poliomyelitis, to study the abuse of antibiotics and to quantify the use of drugs among the population, identifying the geographical areas of greatest consumption.
For the detection of the coronavirus in the sewers in these two years of the pandemic, different criteria were used, depending on the needs and the countries in which the research was carried out. In some cases the purpose was purely of study, for example to understand how much coronavirus material is excreted with the feces from the positives, while in other circumstances the purpose was to try to prevent new outbreaks of COVID-19 or to compare official data. , resulting from swab tests, with virus concentrations detected in wastewater.
During 2021, studies of this type had involved many countries, from Hong Kong to the United States, passing through Australia, India, the United Arab Emirates and the Netherlands. The system had gradually received more attention from the health authorities not only because it allows to detect the genetic material emitted by patients with their feces, but also that of asymptomatic patients usually more difficult to identify, especially since there is the protection offered by vaccines. against the coronavirus.
How effectively he had explained long ago Gertjan Medema, microbiologist quoted from the site of Nature: “Not everyone is tested, but everyone goes to the bathroom: it is nice to have an objective tool that does not depend on the willingness of individuals to undergo a tampon”.
The possibility of having reliable data from the urgent needs of the population had also been exploited in Italy with a project coordinated by the Higher Institute of Health (ISS) and then applied by other research centers, both with the aim of keeping the trend of the pandemic is to detect the possible spread of new variants.
The new study published in JAMAand referred to Milan and other cities in Lombardy, is among the most complete because it covers almost the entire period of the pandemic, making it possible to compare the cases detected by swabs and the coronavirus concentration in wastewater, another important indicator.
The graph with the data of the city of Milan shows how the viral load in the wastewater, in November 2021, was similar to that recorded in November of the previous year, despite at the end of autumn 2021 the number of positives and hospitalized for COVID-19 was much lower than in the same period in 2020.
As expected, coronavirus vaccines did not significantly reduce coronavirus circulation. On the other hand, they offered important protection from severe forms of COVID-19, consequently reducing the risk of hospitalization and death, especially for elderly people or those with health problems. The virus has circulated as much as the previous wave, despite the fact that there was a vaccine rate of around 75 percent.
The research in Milan was carried out by taking weekly samples from the Nosedo treatment plant, from whose pipes approximately half of the city’s wastewater passes. The samples were then analyzed to detect the presence and concentration of the coronavirus.
As shown by other similar researches, detections of this type allow us to anticipate by about a couple of weeks what is then detected with swab tests. The elimination of the coronavirus via the feces begins shortly after the onset of the viral infection, even in the absence of symptoms. Particularly rainy periods can affect the readings, but adjustments are made in the calculations to take these and other variables into account.
How has it explained Giovanni Nattino, epidemiologist at the Mario Negri Institute: «The situation photographed by the data confirms that, despite the virus also circulating among the vaccinated, vaccines were fundamental in preventing symptomatic and serious forms of the disease. This should warn immunocompromised individuals and those who have not yet received the vaccine, since the risk of contracting the virus is much higher than what can be assumed based on the number of positive and hospitalized cases “.