December 3, 2021

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In those partial facts the true meaning of science – Corriere.it

from Paolo Giordano

We would like unified answers, we are impatient: but ignorance is still open and honest. Any option to combat the epidemic can only be mediation

Last summer I found myself at a luncheon. All people present were vaccinated, by age, and some had Covid. It amazed me that they, almost without exception, underwent a serological test to assess their protection, and that at one point they had some kind of competition over which of them had the most antibodies. Almost none of that conversation made sense, though the opinions of the family doctors involved and this or that experienced acquaintance were questioned.

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Use of serological tests to determine the level of individual protection against COVID disinformation, however they are imposed by public thinking. The common use of the serum has, in fact, been one of the most mysterious areas of the epidemic, possibly also due to the lack of formal denial by scientific institutions. But knowing how protected you really are, from a vaccine or from a previous infection, to know what’s going on inside us at the level of antibodies, is practically impossible. It would be wiser and more cautious to treat our body like a black box.

However, determining the level of protection for an individual seems crucial again now, in this near winter, with pandemic standards rising and some tension spreading again. To think properly about these issues, one cannot ignore the way in which vaccines are made effective, as well as the gradual loss of their effectiveness over time. (waning) are measured. Both measures, in fact, depend on what is observed later, later, not in the individual individual but in the population. Not on blood tests, then, but on epidemic numbers. More precisely: the population is vaccinated, and at different time intervals the effect of vaccination on reducing transmission and hospitalization is noted. If these positive effects are reduced over time, again at the community level, then we have waning And try to quantify it. And this is not at all simple, because it forces us to compare different periods, when variants of different contagion are traded, and determine what is due to what.

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It may seem like a very technical explanation, but if you don’t understand this, or how you measure it, you won’t be able to get a reliable idea of ​​what’s going on. No opinion of any kind can be expressed about the advisability or undesirability of the third doses, nor about how they are regulated.

One of the most comprehensive studies on waning, by Sarah Y Tartov et al., published in scalpel, has the retroactive keyword already in the title. In the case of the Pfizer vaccine, it appears that the efficacy against infection drops from 88% in the first month to 47% after five months. On the other hand, the effectiveness against hospitalization remains high, 93%, even after six months. These results were obtained, in fact, retrospectively, from the overall statistics, from the infection trend. However, once obtained, it has a precise individual value. Much more accurate and reliable than paid serological tests. although waning The scaling may not be literally correct, especially for me, I should act as if it were. Because this is the best data I have available. My reference on how protected I feel a month, five, six months after my second dose, and how to act accordingly.

Even the best data is in the hands of institutions. Last week, especially because of a controversial report by a report, it was reported that the current validity of the Green Corridor, twelve months, is in stark contrast to the evidence on waning, which does not allow us to look beyond the horizon of six. Objection is justified. But to discuss the merits of regulation, it is necessary, from the individual plan, to return to the collective plan, and to consider the necessity of adjusting the viability of the green corridor also with respect to other variables: the time required for pollination as well as the innumerable other logistical complications. It is necessarily a question of mediation, because every option to compare the epidemic formed so far has been mediation. Saying the Green Corridor, as it is, has no biased scientific basis. If anything, we must make sure that this is the best mediation possible. In addition to questioning, for example, whether public health organizations should not expect reinforcers to improve sooner than the delta variable.

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Our rushing mind. He veers constantly, sometimes in one direction, sometimes in the opposite direction, but is always looking for final sentences. We hear the news of the drug approved by Pfizer with a very high efficiency in reducing severe forms, and we conclude: Now there is a cure. They tell us that according to the data, a booster is needed for everyone and we conclude that the vaccine doesn’t really work. WHO is talking about the fourth wave in Europe, about the possibility of another half a million deaths, and we don’t go and look at WHO-checked Europe, nor how deep the heterogeneity is within it in terms of vaccination. We are impatient. We want unique answers. Because partial truth, in the making, is much more troublesome to deal with. But unfortunately, which we have been dealing with for a year and a half. It is not a fact that exists a priori as a whole, but a fact that we can define gradually, acquired month by month. The uncertainty that accompanies it can easily be exploited as an argument by critics of vaccines and those who criticize the green corridor, with the brief conclusion: Do you see? They don’t know either. The scientific basis is missing. But what distinguishes the scientific position from the anti-science position is precisely the relationship that is maintained with non-knowledge. Or rather, with no knowledge yet. He is in the first case open and honest, in the binary and opportunistic.

Based on this growing reality, science cannot make long-term, or even completely reliable, medium-term promises. And yet he is able, as at every moment of the past months, to determine what is more suitable for his work now, at the present time, on the basis of the knowledge he has accumulated. The positive, rather than the extraordinary, effect of vaccines, in this sense, is a well-established fact, which has already been around for several months. The need for the booster has also emerged clearly, but when and for whom – in order for the strategy to be ideal – is under investigation (and a complex investigation). We didn’t know before, it’s true, but now we know, and our previous ignorance means nothing. We will discover other ignorance in the future, because the epidemic is still long. And we will overcome them, one by one.

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Nov 6, 2021 (change on Nov 6, 2021 | 22:53)