What open questions and new practices has COVID-19 left to the healthcare sector?

Five years later, what impact has the COVID-19 pandemic had on the healthcare system? What questions and areas of research remain unresolved? Prof. Enos Bernasconi, Full Professor at the Faculty of Biomedical Sciences of Università della Svizzera italiana (USI), Prof. Davide Robbiani, Full Professor at USI Faculty of Biomedical Sciences and Director of the Institute for Research in Biomedicine (IRB), and Prof. Emiliano Albanese, Full Professor at USI Faculty of Biomedical Sciences tackled the topic in two reports on Quotidiano (RSI).

During the pandemic, various measures were implemented to ensure personal protection, including wearing masks, sneezing into the crook of our elbow, and frequently disinfecting hands. After the health emergency ended, these habits seemed to be at least partially forgotten, as explained by Professor Enos Bernasconi. "We have noticed that the protective measures we diligently followed during COVID-19 are now somewhat neglected. As people feel safer, they are adhering to these precautions less rigorously. In hospitals, there is regular monitoring of the use of protective measures, such as hand sanitisers and masks, so I am confident that these practices won't completely be abandoned. I am more concerned about the general population, who, frustrated by the rules, might forget them."

The COVID-19 virus is still an interesting subject of study for researchers, as Professor Davide Robbiani explains: "One of the ongoing questions is why, even today, some patients experience only mild symptoms of the disease while others, unfortunately, end up hospitalised. Another significant concern relates to Long Covid, a condition in which individuals continue to experience symptoms for weeks or even months after the initial illness."

Long Covid is a key research area at the IRB, which has focused on COVID-19 research since 2020. "We are conducting a study in collaboration with the Moncucco Clinic. Additionally, we are engaged in other translational studies. One of the challenges with COVID-19 is its constant evolution, leading to the emergence of new variants that can render previously effective treatments ineffective. We are developing immunotherapies that are resilient to these viral changes," explained the Director of the IRB.

Researchers worldwide are working on developing an effective vaccine that can target as many variants of the coronavirus responsible for severe pneumonia, such as COVID-19, as possible. This research is particularly challenging due to the virus's continuous mutations. However, it has led to the development of new technologies, as explained by Professor Bernasconi: "mRNA technology has the potential to help us develop a universal influenza vaccine, potentially even before we achieve one for COVID-19. Additionally, this technology is being increasingly utilised in oncology. The application of mRNA technology in the COVID-19 vaccine has not only contributed to disease prevention but has also spurred medical innovations that can be applied in other fields."

The issue of vaccines has undoubtedly been controversial, as many people have been reluctant to be vaccinated, often fearing side effects. As Professor Emiliano Albanese explained, vaccines must meet strict quality standards: "One of the aspects of the very high standards of vaccine safety is related to the fact that they are aimed at a large number of people in a usually tight time frame and that the people involved are healthy. Therefore, the number of side effects that can be afforded is lower than for drugs, for which people are willing to pay a higher price in exchange for the benefit provided". The USI professor went on to explain how, in part, the distrust of vaccines is linked to the increased use of social media as a means of information: "Infodemic, as it has been called, is the key to understanding the widespread distrust towards authorities and the decisions made in the collective interest during the pandemic."

In addition to the development of innovations in the therapeutic field, the COVID-19 pandemic has provided experts with food for thought on how to manage such crisis events. "We had forgotten that pandemics come and go, so we were all very surprised by the arrival of COVID-19. In reality, the cyclical nature of pandemics is well understood. The revision of the pandemic response plan must incorporate the lessons learned from COVID-19, but it should not be overly focused on recent events. The future pandemic plan needs to be flexible and adaptable for any upcoming pandemics," explained Professor Albanese.

The pandemic, as Professor Albanese pointed out, has also shown the need to find strategies for effective information sharing: "There was a need to share data that was not only fast but also highly reliable. It was essential to guarantee all privacy standards while ensuring access for everyone who needed it to process the information."

Furthermore, the pandemic has made the public more aware of the importance of paying sufficient attention to mental health: "Investing in mental health contributes to a more prosperous society. Everyone needs mental health support at all times, but it is essential to participate in this process actively. Unfortunately, there has been a trend to relieve individuals of their responsibilities. In reality, caring for our mental health should be a personal and daily commitment," said Professor Albanese.