Coronavirus, the Italian study: “The body does not eliminate it for 30 days.” The call: “Stop the double buffer”

The news of the last few weeks has told us many stories of patients who have stayed positive for a long time: for days, weeks and even months. A 4-year-old girl has been weakly positive (therefore no longer infected) for four months and there are people who have had to wait until 28 for it to finally be negative. Now an Italian study reveals that the coronavirus is carried on average a time of 30 days from the removal of the first positive swab from the body, half of the patients remain positive 30 days after diagnosis and 36 days after the appearance of the first symptoms.

The work was published in the British Medical Journal Open and carried out by the Local Health Unit – Irccs of Reggio Emilia in a sample of symptomatic individuals who tested positive for the virus between February and April. Still not clear the length of time the subject remains contagious from the moment of diagnosis. The WHO recommends 13 days of isolation from the onset of Covid symptoms and 10 from the date of the positive swab in an asymptomatic person. “In Italy – explains one of the study authors to Ansa, Francesco Venturelli, from the Epidemiology Service of the Emiliana health company – we adopted a more rigorous protocol that foresees the need to obtain consecutively two negative pads to get out of isolation. According to the results of the study, continues the epidemiologist, it appears that approximately half of the patients are still positive 30 days after the first swab. “Carrying out a new swab 2 or 3 weeks after diagnosis is associated with a high risk of` “ false negatives ” (in one case in 5), that is, having a negative result for a swab not confirmed by the next test.

In the double positive buffer there are those who think it is time to stop. In fact, from the scientists who wrote “Pills of optimism” comes an appeal to the main Italian institutional offices, the Minister of Health and the Scientific Technical Committee to abandon the procedure according to which a patient suffering from Covid 19 is officially considered sick and contagious, for up to two consecutive times, the nasopharyngeal swab test does not give negative results. In the letter the team, led by the virologist Guido Silvestri what if Paolo spada, asks that Italy comply with the new directives of the World Health Organization (WHO) and reduce the period of illness for Covid from 19 to 10 days (plus 3 days without symptoms, if any), abandoning the use of the control panel . And this for 3 “key” reasons, which concern people’s lives, the economy and public health. “As you know, remember the authors of the appeal, in our country, a patient affected by Covid 19 is officially considered sick and contagious, until the analysis of the nasopharyngeal swab is twice in a row. This criterion, initially adopted by the World Health Organization, then it was progressively changed in many countries and, finally, by the WHO itself, based on growing and now consolidated scientific evidence: the period of contagion that begins about 48 hours before the onset of symptoms, peaks in the first days, and then rapidly decreases and disappears substantially. In 10 days. The positivity of the swab, on the other hand, can remain so for many weeks, up to more than 4 months after the disease, identifying, in fact, only traces of the genetic material of the virus, inactive and incapable of transmitting the infection ”, write the scientists . Precisely because, as the Reggio Emilia researchers found, the expulsion of the virus from the body lasts almost a month in some cases.

Therefore, we ask you to replace the double negative buffer criterion with that indicated in the new WHO guidelines, reducing the period of illness due to Covid-19 to 10 days (plus 3 days without symptoms, if any) and abandoning the using the control panel. We ask for this for three reasons, each of which seems sufficient to us to justify our request. The first reason refers to the lives of the people involved: keep in forced isolation a patient who in all probability is no longer contagious has no significant utility, either for the patient or for the community ”. The second reason “refers to the economy and the recovery of our country: our community needs the contribution of these people, now left for a long time in a state of unjustified immobility. The third reason, which seems to us even more important than the others, refers to public health: the fear of being isolated without a temporarily defined term is a dangerous disincentive to report one’s symptoms for those who get sick and to use the tracking application, which instead urgently needs many new members ”.

“In contrast to our request, it is often argued that the new WHO directives would be designed for countries with limited resources and therefore cannot guarantee a second mattress in all cases where it is needed, due to insufficient tools and medical personnel. In our opinion, the objection described does not hold. First, the scientists note, Most European countries have long adopted the new WHO guidelines. Second, the public health reasons mentioned above would justify taking even a very modest risk, if it were actually associated with the new guidelines. “Finally, there is a great demand on the part of the regions with greater resources to increase the buffers: the election that we are asking them could offer an important help in this direction.”

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