Why did you (and your colleagues) write this paper? What was its main purpose?

GRIGORIS GEROTZIAFAS 

The SARS-CoV-19 pandemic triggered a long-lasting and devastating public health crisis. Massive rapid vaccination program aims to decrease the number of patients with severe COVID-19 who need hospitalization and to build immunity in the community. The legal frames of intellectual property limit the major projects for production of COVID-19 vaccines to less than 10 pharmaceutical companies and corporations worldwide and render the vaccines more expensive and still rare. Middle- and low-income countries, have restricted access at the vaccines. Social inequality is also a limiting factor for massive vaccination in western countries. The data from epidemiological studies conducted worldwide, allow to recognize the medical and socio-economic profile of citizens at risk of infection with SARS-CoV-2 and those who are at high risk of COVID-19 worsening as well as to identify spatial - territorial distribution of clusters of the hardest-hit areas.

Taking into consideration that the end of the pandemic is not predicted for the near future, a revision of the actual strategy is urgently needed. To respond to this need a multi-disciplinary panel of 55 experts participated in the project for the elaboration of an integral and equitable strategy against COVID-19 pandemic.

What are the main conclusions? 

GRIGORIS GEROTZIAFAS 

Given the acuteness and drama of the pandemic, every schematization even coming from multidisciplinary experts may appear simplistic or utopic as well as pretentious. After reviewing the one-year experience in the pandemic we propose a balanced, and integrated strategy for the management of the COVID-19 outbreak organized on the following three axes (PDA).: Prevention of the SARS-CoV-2 infection mitigation of virus spread and development of collective immunity on global level, Detection of the dynamics of the virus circulation, detection of patients with COVID-19 and prompt identification of those at high risk of disease worsening are necessary steps for the offer of effective medical care, Anticipation of medical care in patients with COVID-19 by active involvement of primary health care for early - home based personalized therapeutic strategy (as is recommended today) and prompt identification of patients who need prioritized hospitalization.

What are the paper's implications? - to the public? -to medical professionals?

GRIGORIS GEROTZIAFAS 

The PDA strategy could help in elaboration of concrete integrated and equitable program, adapted at the characteristics and needs of countries and regions, for the management of the next phases of the pandemic in order to preserve the health of peoples and the social cohesion. Pharmaceutical companies and consortiums having a pivotal role in the development of vaccines, diagnostic tests and treatments for COVID-19, need to cooperate and diffuse technological knowhow for massive production of the tools required for the control of the pandemic. According to the WHO and the World Trade Organization (WTO) there is an urgent need for “global solidarity and unhindered global sharing of technology and knowhow”. Educational programs must be elaborated for citizens and for physicians, particularly general practitioners and family doctors.

Should these change practice?

GRIGORIS GEROTZIAFAS 

The PDA strategy has been endorsed by prestigious scientific societies from many countries (VAS-European Independent Foundation in Angiology/Vascular Medicine, the International Union of Angiology, the Lebanese Society of Hematology and Blood Transfusion, the Lebanese Joint Coalition Against Thrombosis, the Serbian Lymphoma Group, the Global Thrombosis Forum, the Balkan Thrombosis Forum, the European Venous Forum, the Asociacion para el Estudio de la Medicina Vascular en Espagnaa, the Russian Academy of Sciences, the Cyprus Medical Association, the Chinese Academy of Medical Sciences and the Moroccan Society of Vascular Diseases). This reinforces the message of the position paper towards citizens, policy makers and the governments. The PDA strategy is in phase with the priorities set by the WHO for the management of the pandemic. The recognition of the negative impact of the social inequalities on the risk of SARS-CoV-2 infection and the negative outcome of patients with COVID-19 imposes the need for special care for citizens with low income, people leaving in environmentally degraded regions as well as in regions with low accessibility to medical care. The support of health systems and the development of the primary health care is an urgent need. The increase of the budget for public health and the use of the most modern technologies in the fight against the pandemic are first line duties.