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HEALTH

Coronavirus: Where is the Delta variant spreading in Italy?

As the Italian government confirmed on Friday that the country is seeing more outbreaks caused by the Delta variant of coronavirus, we look at where the clusters being detected around the country.

Coronavirus: Where is the Delta variant spreading in Italy?
Photo: MIGUEL MEDINA/AFP

Until now, the risk posed by Delta in Italy has largely been dismissed by Italian authorities, who were describing its presence as “rare” in the country as recently as last week

However, this week authorities are re-evaulating their strategy for mitigating the risks posed by the more infectious new strain after Italy’s independent health watchdog, the GIMBE Foundation, criticised the government for its response.

The health ministry on Friday instructed regional health authorities to carry out more tracing and sequencing of variants after the Higher Health Institute (ISS) revised its figures, now estimating that the number of infections caused by the Delta and Kappa variants in Italy have increased by 16.8 percent in June, up from 4.2 percent in May.

READ ALSO:Italian health experts warn about Delta variant as vaccine progress slows

“From our epidemiological surveillance, a rapidly evolving picture emerges that confirms that also in our country, as in the rest of Europe, the Delta variant of the virus is becoming prevalent,” said Anna Teresa Palamara, director of ISS’s infectious diseases department.

According to the latest ISS data, the SARS-CoV-2 variant prevalent in Italy was found to be the Alpha variant (B.1.1.7), responsible for 74.9 of cases. This is now also the most prevalent globally.

Cases associated with Kappa and Delta variants (B.1.617.1/2) “are few overall in January to June”, the report added. But it stated that the frequency and spread of these reports has rapidly increased across the country.

The new ISS figure however is still lower than GIMBE’s estimate on Thursday that Delta now accounts for as much as 32 percent of cases.

Coronavirus: How much is the Delta variant spreading in Italy?

So how prevalent is the strain really and where is it being detected?

Several regions have already reported cases of the Delta variant, though the amount of test result sequencing and analysis carried out by local health authorities in Italy varies and is often low.

Each region volunteers to do genetic sequencing of positive swabs, which means that Italy has less data available about the spread of variants than countries where sequencing is more widespread and systematic, such as the UK or Denmark.

Following the latest health monitoring report on Friday, more local health authorities have said they will now start taking steps to identify the new strain in order to better understand the development of the outbreak.

For now, here are the regions providing Delta-strain data this week, and the data available on cases confirmed so far.

Emilia Romagna – Lombardy

25 positive cases have been found between Piacenza in Emilia Romagna and Cremona in Lombardy, detected in a logistics hub involving employees and their family and friends.

“We have contacted about 800 people to undergo a swab as part of the contact tracing of the coronavirus for the Delta variant outbreak in the Piacenza area, but almost 300 of them have yet to show up for the test,” Marco Delledonne, head of Piacenza’s public health department, told TV chat show ‘Mattino 5′, reported news agency Ansa.

Covid-19: When do you still need to wear a mask in Italy?

“Now we are also activating the local police to track them down because they are not being found,” he added.

The director general of Piacenza’s health authority, Luca Baldino said tests “would be compulsory but people are escaping,” according to the news report. He added that the infected were “all unvaccinated”, both the workers and their friends and relatives.

Lombardy’s councillor for welfare, Letizia Moratti, stated the Delta variant counts for a total of 3.25 percent of all cases, reported news website Adnkronos.

From the data collected so far in June on the new virus strains in Lombardy, the Alpha variant, first identified in England, is dominant with 64 percent of the total number of variants, followed by the Indian (Delta 3.25 percent, Kappa 0.8 percent), the Brazilian (1 percent) and the South African (2 percent).

Campania

83 cases of Delta variant have been recorded in the areas of ‘Napoli 3 Sud’, a grouping of 56 municipalities, which include Sorrento and Pompeii, reported Ansa.

None of the cases has required hospitalisation so far. Of the 83 cases, 44 have been identified in an outbreak in Torre del Greco in Naples, the municipality with the highest number of inhabitants in the whole local health authority.

“We are working to try to identify ‘patient 1’. The same goes for the case of the cluster detected in a gymnasium in Agerola, where about 10 cases have been recorded. We are also working to trace all the close contacts of the positive subjects,” said the health director of Campania’s health authority, Gaetano D’Onofrio.

“We must make a clear distinction between cases and relapses in hospitals. It is true that recently there have been more infections in relation to the so-called Delta variant, but it is also true that this has not affected the health structures,” he added.

Photo: Pau BARRENA/AFP

Friuli-Venezia Giulia

The Alpha variant is the dominant strain in this region followed by the Delta variant and then the Brazilian variant, according to the vice-governor of the region’s health authorities, Riccardo Riccardi, reported Ansa.

In a sample of 96 cases detected in the region, the presence of the Alpha variant was found in 50 cases, spread across Gorizia, Trieste, Pordenone and Udine.

As for the Delta variant, there were 28 cases in the sample across Trieste, Pordenone and Gorizia.

Abruzzo

At least five Delta variant cases have been identified in the Teramo and Chieti areas of this region, reported Abruzzo Live.

The new cases emerged from the analysis of 3,378 molecular swabs with just over 1 percent of the samples testing positive.

Three cases were reported by the Teramo Local Health Authority, one reported in the Chieti area and one in Vasto.

Sardinia

15 people were found to be infected with the Delta strain in the north of the island, following the discovery of 22 confirmed cases of Covid-19 among crew members involved in the filming of the Disney movie, ‘The Little Mermaid’, reported newspaper Il Messaggero.

The presence of the variant was detected by genome sequencing carried out by a hospital laboratory in Sassari, which is now also working on sequencing the Brazilian variant.

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HEALTH

‘Behind the times’: Why women in Italy struggle to get menopause treatment

For many women living in Italy, accessing HRT means paying for private treatment and, in some cases, travelling abroad in order to find a doctor willing to prescribe the medication they need.

'Behind the times': Why women in Italy struggle to get menopause treatment

Sitting in her garden in rural Tuscany, Tara Gould, a 55-year-old British national, reminisces about her old job back in the United Kingdom. 

“It was such a support group for people like me, so to be able to work for it and help other women was such a bonus,” Tara says.

The support group Tara worked for was the Latte Lounge, an online community for UK women over the age of 40 going through menopause. The site had resources such as articles, help finding a nearby specialist and in-person events. Tara managed the emails sent in by women who were either asking questions or struggling.

READ ALSO: Public vs private: What are your healthcare options in Italy?

“I had a few women reach out to me who were feeling suicidal and had nowhere to go or no one to ask about what they were going through. Talking to them about their options and helping them out, helped me out too.

But in Italy, she says, “I cannot find any support network like that here.”

In the two years she’s been living here full-time, Tara has had to go back to the UK for her hormone replacement therapy (HRT) which is crucial in managing symptoms such as hot flashes, sleep problems, and low moods. 

“In Italy, it is like what it was like in the UK 30 years ago, and coming from there two years ago was a massive shock to the system,” she adds.

“Women just have to grin and bear it.”

She believes the situation in Italy boils down to a lack of knowledge and possible embarrassment about discussing menopause. While the UK is far from perfect on the issue, she says, there is help available for women needing it, while Italy is “behind the times”.

READ ALSO: Why are medicines so expensive in Italy?

Tara is not alone in feeling this way. A post on the topic in one expat Facebook group this month sparked a lively discussion, attracting hundreds of comments from women in Italy sharing their personal stories, advice, and observations on the differences in menopause treatment between Italy and other countries.

But, she says, continuing to travel back to the UK for this routine treatment is “becoming too expensive for me especially as I’m paying into the SSN here too.

“I shouldn’t have to go back to the UK for this.”

Tara returns to the UK once her medication finishes and forks out around €600 each time she goes: €100 for flights and €500 for the HRT medication via private healthcare. 

“It should be a standard medical procedure, but it isn’t here. I can’t keep on going back to the UK and paying out every time I need something, because it is a need not a want.”

Tara started going back to the UK after her family doctor in Italy told her they didn’t prescribe HRT and advised her to buy it online, go abroad or go to a gynaecologist. 

“I thought it was outrageous that a female doctor was telling me these things, especially someone trained in the medical field advising a patient to buy medication online.

“I don’t feel hopeful,” Tara says.

Without her oestrogen, Tara says her anxiety goes through the roof making everyday life a struggle. She’s too worried she’d be dismissed in the same way her doctor dismissed her if she went to a private gynaecologist here. 

“It’s worrying. I don’t know what I’ll do. There must be someone here, but I don’t know how I feel. They tend to be more city-focused, and if I’m going to Rome I might as well go to the UK,” she adds.

In a recent study named Menopause: Knowledge, attitude and practice among Italian women co-written by Italian biologist Paola Mosconi along with six other researchers, more than half of their study sample (women with menopause) had not received any information about the condition and possible therapies.

Another survey conducted in 2021 found only 7.6 percent of the 1028 Italian women surveyed were on HRT. The majority of them were on herbal remedies.

Whilst a global shortage of HRT was widely reported last year, both the studies found medical expertise in the field of menopause to be only “satisfactory”.

READ ALSO: OPINION: Why Italy’s private healthcare isn’t always worth the cost

This is in spite of the Italian health ministry’s webpage outlining the numerous benefits of hormone therapy for menopausal women, such as improved heart health and a reduced risk of strokes.

Tara says she feels as though the lack of information on this topic trickles down into society, as she has tried talking to her Italian friends about it with little success.

For Liguria-based Noah, from the United States, the experience of obtaining HRT from her doctor was not an easy task.

Like Tara, she finds there is a huge lack of education for practitioners and the general public not just on HRT but around menopause in general, which differs from her experience back home. She also thinks views on it are outdated.

She moved over to Italy four years ago whilst she was going through the change. 

“Our family doctor would not prescribe it and lacked any knowledge around it so she sent us to private clinics instead,” Noah says. “I can laugh about it now, because I finally have it, but it was very frustrating in the beginning.”

Noah and her husband, who is Italian, found out about a doctor in another region who specialised in menopause and whose work on the condition was published in medical journals. She got her HRT from him. Whilst Noah felt very comfortable in his care, she had to stop visiting him because of the distance.

“We went back to our family doctor with literature on the use of HRT and the effects of stopping it abruptly. She then did her own research and now has started prescribing it to me,” Noah says.

Noah largely considers herself lucky. Nevertheless, she has to drive 45 minutes to another town in the region to pick up her prescription.

READ ALSO: ‘Very professional but underequipped’: What readers think of Italy’s hospitals

Tuscany resident Kelly Hodgson, like Noah, has also had to do extensive research into the benefits of HRT before she was prescribed it. She found the process of obtaining her medication extremely time-consuming and disheartening. 

“I had to do all the research myself until finally I found a gynaecologist who is open to HRT,” Kelly explains.

Kelly feels like she should have been able to get HRT from her doctor rather than pay privately. She argues that Italy is advanced in most areas of medical care – but not for menopause.

She thinks a huge reason why doctors are hesitant about giving it out is because they associate it with a high cancer risk.

“There is so much scaremongering,” she continues. “My doctor is female and she point blank said to me no, because I could get cancer, even though I’ve been on the contraceptive pill for years which comes with its own cancer risks.

“I come from a family with osteoporosis so HRT is beneficial to me. If I were in the United Kingdom now, I’d have access to it without having a full gynaecological visit before it’s prescribed.”

Kelly says friends from Turin who are also going through the menopause have had to go privately too, rather than get treatment from their doctor. 

“There has to be more education on menopause here,” Kelly concludes.

For Noah and Kelly at least, their journey to get their medication is within the country. For Tara, unless things change culturally and medically, going abroad is the only option she feels comfortable with.

“The way Italians think about menopause is the old-fashioned way everyone used to think. They view us as grumpy old women rather than looking at the reasons,” Tara says.

“It’s just something you have to deal with. It’s frustrating to say the least.”

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