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Those who expected and trusted in the disappearance of the Covid-19 virus in the summer months 2023 were disappointed. In these months, after a major decline at the beginning of the year, in much of the world the virus has continued to spread and has resumed infecting without manifesting major symptoms and with low chances of being diagnosed having collapsed in the performance of swabs. We know that after the vaccination campaigns for COVID-19 in 21 and 22 around the world, the virus has learned to live with us and we have learned to live with SARS-CoV-2, but for the current situation of new case growth, most with no or few symptoms, attention to the disease must remain high. Let us remember the effects of LONG COVID, which has affected many of us. A good number of people infected with Covid have continued and continue to have discomfort and severe asthenia for months. Long Covid has been a widespread experience and has involved people of all ages.

And many of those reading this article still experience widespread and unclear malaise.
Fatigue, memory loss, altered blood sugar, cardiological imbalances, breathing difficulties, sense of smell and taste not returned to normal. Long Covid has left a mark and still can hurt.

The big problem I want to highlight and that those in the field have noticed since the beginning of the pandemic has been the diminished immunological response to many infectious diseases. We infectivologists and tropicalists, who are interested in diseases around the world keep tabs on the numbers of many diseases including dengue virus fever, malaria, measles outbreaks, acute and chronic lung diseases, and we continue to see exponential increases in cases compared to the pre-covid era.

The evidence is that the immune defenses of many populations have changed their response. Epidemics of measles, polio itself, the viral and parasitic diseases mentioned earlier, and the occurrence of almost unknown diseases have aroused attention in the action of this virus on global immunological systems. Therefore, attention should be maintained to the spread of the new variants of the virus especially on the population over 70 years old, heart patients, diabetics, bronchopneumopaths, and people with various chronic diseases.

In August 2023 officially, the WHO reported more than 1.5 million new infections worldwide. Specifically from July 31 to August 27, 2023. The upward trend stands at nearly 40 percent more cases worldwide and in Europe at over 40 percent more than the previous month. Officially, more than 110,000 cases have been reported. In Italy in August there was an 81% increase on the infection front compared to the previous month, making it the second largest country in the world in terms of the number of cases (about 30,000 in one month), behind South Korea, which counted nearly 1.3 million cases, up 73%.

South Korea also recorded a sad record of deaths: that is +199% in the last 30 days, more than 600 deaths. And Italy, for those who did not notice, recorded over 200 deaths in one month, an increase of +45%. Among the countries involved in these increases, China sees a growth in the number of monthly deaths of a +193% over the previous month. This is the scenario that emerges from the World Health Organization bulletin. Reported cases, estimated to be one-tenth of the actual virus infection figures, are highlighted, with nuanced and inconspicuous symptoms. Many of us, in recent weeks have suffered from respiratory discomfort, cough, cold, fever, difficulty breathing, and especially great fatigue. The cause of these symptoms may be due to infection and contact with the Covid virus. But practically no one has swabbed, not showing the presence of the virus.

Young people, adults in good health, and most of the population respond well to contact and infection with the virus, in its different variants, becoming infected but showing no symptoms. It is the elderly and chronically ill who must continue to be managed with caution. The more than 200 Covid deaths in August should give us pause.

For the numbers reported, we must continue to keep up our vigilance because it is the older and weaker individuals who can still be attacked and at risk with this virus. Anyone who is not feeling well at this time and is experiencing respiratory and other symptoms, first maintain contact with frail people with caution.
Encounters with the elderly and sick should always be approached in good health.
In a few days, the new Covid vaccine with update to the new variants will be approved by Ema and AIFA.
I believe that above the age of 65/70 years doing the vaccination becomes a preventive practice to be done, adding the flu vaccine as well. Getting the pneumococcal vaccine should also be considered.
Therefore, those with chronic diseases would also do well to consider performing the booster with the new COVID vaccine (diabetics, heart and lung patients, hepato- and nephropathic patients).