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Ciociaria with special surveillance. The sharp increase in the contagion curve in recent days has triggered the red alert. The Dpcm of Prime Minister Conte is expected and then the Lazio region will decide on the possible issue of more restrictive measures. Among which, the most drastic is the adoption of red zones at the local level. And the center of attention is also in some municipalities of the province of Frosinone.
The stages
Let’s start with the new positive cases. In the last twenty-two days, 3,732 have been registered, for an average of 169.63 every twenty-four hours. And on Sunday the daily record was reached, with 399. Yesterday there were 87, but of 460 swabs made. 18.9%. High percentage: one infected for every 5.2 molecular or rapid tests performed.
And in the last thirty-three days, 4,014 new cases have been registered, for an average of 121.63. All the figures lead to a single conclusion: for two weeks Ciociaria has been the province of Lazio with the highest number of new infections. In particular, the Rt value, the virus transmissibility index, is under observation. It fluctuates around 1.5. Yesterday in Lazio it was 1.51 and Commissioner Alessio D’Amato said in recent days that in the provinces this figure is higher than in Rome. And according to the value of Rt, the Regions will have the possibility to choose the color of the “traffic light”: green, orange, red. Red is the maximum blocking level, parameterized in the document of the Istituto Superiore di Sanità that has been shared with the Regions. Document updated to October 12.
It will be necessary to see what date will be indicated in the Dpcm, because before October 12 the contagion situation in Ciociaria was not as it is now. But the restrictive measures will be adopted based on the Rt index and 21 other criteria that define the risk thresholds. And it should be noted that the red zones are adopted also and especially with reference to individual municipalities. That is why in these hours under the lens of the Lazio Region are the situations of various municipalities of Ciociaria. Scenario 4 is the most serious, because it is characterized by a situation of uncontrolled transmissibility of the virus. Let’s talk about the number of infections produced by an infected person during their infection period. A value that determines critical issues in the health system. All issues were also addressed in the course of political meetings (naturally “at a distance”) that took place in recent days in the Region. On Saturday a confrontation within the majority, with the commissioner Alessio D’Amato. Then a videoconference link from President Nicola Zingaretti and Alessio D’Amato himself with all the directors, even the minority ones. However, one thing is very clear: it will be the Dpcm that makes explicit the RT thresholds that will trigger the closures of the territories. And therefore, in essence, the Rt value, which is the transmissibility index of the virus. But also other 21 values: these are the parameters on which the adoption of local red zones throughout the national territory will be decided, local red zones will be decreed automatically. In the territories subjected to this type of measures it would almost stop. Another element of evaluation will be the relationship between the swabs performed and the positive cases found. Meanwhile, the hieroglyphic tests that the Frosinone ASL has been performing for months continue. We reached 20,550: the positives, that is, those who developed antibodies, were 389. A percentage of 1.9%.
Fabrizio Spaziani on the front line
The pressure on Fabrizio Spaziani of Frosinone, the reference center of this area for the pandemic, is very strong these days. There are 109 Covid patients hospitalized, a figure higher than in March and April, when there were 106 hospitalized for weeks. With this structure then: 26 to Infectious Diseases, 40 to Covid Medicine, 20 to Covid Emergency Medicine, 20 to Intensive Care. The modular process has been reactivated a few weeks ago. There are 26 beds in Infectious Diseases, 26 in Emergency Medicine, 24 in Covid Medicine, 13 in Pulmonology (of which 6 in subintensive therapy). While 15 patients are currently hospitalized in intensive care. And 3 other stations can be activated. The resuscitation department can reach up to 20. But already in the last hours additional beds have been obtained in the rooms already dedicated.
Patrizia Magrini, interim general director of the ASL, held a series of meetings yesterday to urgently assess the possibility of moving more departments. The objective is to strengthen Covid Medicine in Frosinone, but for this it is also essential to strengthen the staff.
In other words, more doctors and nurses are needed in the room. The idea seems to be to bring Frosinone to the doctors currently in force in Alatri. In Fabrizio Spaziani, 36 more beds would be obtained to dedicate them to patients with Coronavirus. That is, a total endowment of almost 160 stations for patients with Covid. However, the problem arises from the admissions of non-Covid patients who need to be hospitalized in Medicine. Besides the fact that in this way there would also be effects on the “profile” of San Benedetto di Alatri.
First aid in the trenches
At ProntoSoccorso diFrosinone, an average of 50 to 60 Covid case visits are traveled per day and approximately 20 patients stay for more than 24 hours. Considering the provincial level, we are between 80 and 100 daily accesses. But yesterday there were about 40 Coronavirus patients admitted to the Frosinone Emergency Department, waiting to be placed in the wards.
An unsustainable situation. Among other things, the head of the department, Fabrizio Cristofari (who is also president of the provincial order of doctors) had clearly said in recent days: “This is not the case.” Even in the Cassino hospital there are an average of 20 accesses per day of Covid patients per day. And 4-5 remain hospitalized for up to four days before being selected in the dedicated wards of Spaziani or other Roman hospitals. But yesterday in Cassino’s emergency room there were about 10 hospitalized. Upon returning to the Frosinone Emergency Department, the pre-fab modules will replace the pre-sort tents. Always with a view to isolating and harboring suspected cases of Covid. Among other things, in recent times ambulances have lined up, considering the exceptionality of the influx.
Affiliated RSAs
There is another front where ASL is committed to tackling the shock wave of Covid patient hospitalizations.
It is the availability of some affiliated RSAs to hospitalize patients with Coronavirus. At Villa Gioia di Sora there are already 22 beds. As for Ini White City, the beds available for Covid patients are 114. Until yesterday, 108 were occupied, so 6 are still free. There are also 10 beds at Rsa San Camillo di Sora. Yesterday, the Local Health Authority also tested the availability of another 2 facilities in Cassino. Precisely the San Raffaele and Villa Serena.
With the aim of having other beds, precisely 24 and 38. We are talking in total, between Fabrizio Spaziani and RSA, of something like 368 beds for patients with Coronavirus. Without considering those who go through emergencies. Figures that give the size of the autumn wave.
The Covid hotel
The hotel in Fiuggi is operating where people who must observe a period of home surveillance (for positives) or in fiduciary isolation (for negatives) will go. There are 50 places available. A measure taken for those who do not have the possibility to remain in quarantine at home. Because there is also the need to have spaces to protect other members of the family.
The lost track
Let’s talk about the procedure known as “contact tracing.”
This is the investigation and contact management of a confirmed case of Covid-19. An essential public health action to combat the ongoing pandemic. Identifying and managing the contacts of confirmed coronavirus cases allows you to quickly identify and isolate any secondary cases and thus interrupt the chain of transmission. An operation that now has to deal with the exponential increase in the contagion curve. The estimate is that for each positive case there is an average of 10 contacts (during the confinement there were 3). On average it takes two to three hours of phone calls to reconstruct the network of contacts of a single infected person and to carry out the epidemiological investigation. With all that it entails: calling the right people, understanding how they are doing, checking for symptoms, and then filling in the chart. An activity that is parameterized in the numbers of the island of origin. In the province of Frosinone there are currently around 2,500 positives in home surveillance. That means 25,000 contacts to monitor.
An impossible figure for any tracking system.
National charts
Ciociaria Today offers two national charts. One about the trend of infections (but not only) from March to today. The other on the fatality rate by age group.
There are absolute numbers that then statistically lead to 0%. This is the case of two groups: 0-9 years and 20-29 years.
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