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Coronavirus cases skyrocket (this week almost doubled compared to the previous: 29,621 to 15,459), restrictive measures are back in the field, albeit in a completely different way than before. emergency shutdown which for months has blocked the entire country. In short, the second wave is reality. Announced, expected, it is here and although the hospital system continues to hold, given the still manageable numbers of intensive care, the alert is at the highest levels. And the knots reach a critical point.
Along with local public transport and schools – apart from football, it could be said – there is in fact another sensitive issue, on which the Gimbe Foundation in Bologna focuses its attention: local health services that, despite the resources allocated by the Relaunch Decree (and which still exists), have not been improved in test and trace capabilities. Translated: tampons are still our Achilles heel.
“Despite the apparent increase due to the new measures, the quantity of buffers is still largely insufficient.” And we are about to lose, if it hasn’t happened yet, the ability to track infections, which is essential to contain the virus and to enforce those nefarious little locks needed to avoid the danger of shutting everything down. Also because we simply cannot afford a second economically and socially. emergency shutdown.
The plan and critical issues
While on the one hand there is the new Dpcm, on the other the Gimbe foundation on the sanitary measures included in the last circular of the Ministry of Health “Prevention and response to COVID-19: evolution of the strategy and planning in the transition phase for the autumn-winter period ”, he explains:“ This is a very complex plan that outlines four scenarios for the evolution of the epidemic in relation to different levels of risk and the consequent measures, which in the worst scenario foresee a new emergency shutdown national”.
The insufficient capacity to track new cases, adds the president of the Nino Cartabellotta Foundation, is “one of the determinants of the progressive increase in cases that began at the end of July, which after a month triggered an increase in hospitalizations, and after about 2 months. ” the one of the deaths “.
The effects of the restrictive measures of the new Dpcm signed overnight by Prime Minister Giuseppe Conte and Minister of Education Roberto Speranza will not be seen, if any, before the beginning of November. In any case, they appear to be small: “The extent of the restrictions contrasts with the lack of strengthening of the territorial services in charge of locating, despite the resources already allocated by the Relaunch Decree,” says Cartabellotta. “Once again, bureaucratic delays and conflicts between the Government and the Regions place the responsibility of controlling the epidemic on the citizens through restrictions on personal freedoms.”
And give
12,564,713 swabs were performed on October 11. But from this total, “only as of April 19 is it possible to separate from the total the number of cases analyzed, that is, the subjects subjected to the test to confirm / exclude infection by SARS-CoV-2, excluding repeated swabs in the same person to confirm virological recovery (at least 2 so far) or for other reasons, “explains Gimbe. Up to phase two, therefore until the first partial reopening on June 3, an average of 35 thousand form tests were performed per day. Then, a figure was reduced to an average of 25 thousand, while “only as of mid-August, after the increase in cases, it increased to 67,000 / day in the week of 5 to 11 October”.
An increase that, however, is not homogeneous from one region to another. “In the period from August 12 to October 11, compared to a national average of 5,360 cases analyzed per 100,000 inhabitants, the range varies from 3,232 in Sicily to 8,002 in Lazio”, explains the Foundation. Bolzano, Tuscany, Lombardy, Emilia Romagna also did well. Man, along with the region of Sicily, also Puglia, Piedmont, Marche. Of 20 regions, 10 are below the national average.
Since the end of August, Gimbe had already urged the Regions to strengthen their testing and tracking activities, adds Cartabellotta, “because in the slowly rising phase of the epidemic curve, the battle with the virus is won in the territory.” Tampons, on the other hand, “strengthened modestly”, and with the rebound in cases “they turned out to be a too narrow” bottleneck “that favored the growth of new infections that in the last 10 linear days became exponential”.
Not only that: the swabs have not strengthened “in proportion to the increase in the circulation of the virus,” they repeat since the foundation, “which translates into a net increase in the ratio of positives / cases analyzed nationwide than since the mid- July to mid-August it went from 0.8% to 1.9%, reaching 6.2% in the week of October 5 to 11 with considerable regional variations: from 1.7% in Calabria to 14% in the Aosta Valley ».
Since April, the number of accredited laboratories has doubled in the regions: from 152 to 270, “also with the accreditation of private laboratories.” But it is not known, says Gimbe, “neither the number of swabs that individual laboratories can process on a daily basis, nor quantitative information on the personnel involved in the territory to take the samples.” Meanwhile, the queues at the rides in documented by newspapers and television, “or dedicated telephone numbers to which nobody answers”, for Gimbe “besides the inconveniences they can generate diagnostic delays in positive patients with worsening clinical results”.
Government action
Politics is trying to take cover. But that is not enough: the strategy seems to clash once again with regional differentiations, the impossibility of finding standards and balances, the chronic criticalities of a system that has not brought, in nine months of health emergency, a turning point. The novelties in quarantine (“single swab to confirm virological recovery”) will allow “” to recover “a certain number of swabs, which cannot be accurately quantified but can be estimated at around 20,000 / day, since the controls represent around 40% of the total “.
And then there is the question of fast buffers: “In addition to supplies from some Regions that had already moved independently, Commissioner Arcuri’s public bid request, which expired on October 8, foresees the purchase of 5 million tampons fast “, says the foundation. But at the moment,” the moment of the offer is not yet known, nor the moment and the criteria for redistribution to the Regions. “So, using them is not so simple: the clinics of the Family physicians and pediatricians often have inadequate structures “to ensure dedicated routes for suspected Covid cases.”
And the schools? The (legendary?) Figure of the “doctor / nurse plexus” is not present in the system. And in general, who should and could get quick tampons – in school and elsewhere, therefore family doctors, pediatricians, school nurses – does not seem to have carried out the necessary training, except in sporadic cases. And “the probability of false negative results to rapid tampon increases in inexperienced hands.”
In short, much remains to be done. Because the figures of what had appeared in the news as the “Crisanti Plan” – 300 thousand swabs per day, “as a result of what the Gimbe Foundation had already proposed” in May (200-250 cases analyzed per 100 thousand inhabitants ) – is still a chimera.
On the cover ANSA / Massimo Percossi | Queues for the buffer at a drive-in at that point in Rome, October 10, 2020.
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