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A circular from the Ministries of Labor and Health establishes that “the greater fragility in the oldest age groups of the population must be understood in conjunction with the presence of comorbidities (or the coexistence of multiple pathologies) that may integrate a condition of greater risk” . In practice, being over 55 years old is not enough to feel at risk and ask to be exempt from certain activities.
by Andrea Gagliardi
A circular from the Ministries of Labor and Health establishes that “the greater fragility in the oldest age groups of the population must be understood in conjunction with the presence of comorbidities (or the coexistence of multiple pathologies) that may integrate a condition of greater risk” . In practice, being over 55 years old is not enough to feel at risk and ask to be exempt from certain activities.
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Covid-19 also brings with it another emergency on the school reopening front: that of “fragile workers.” Hundreds of professors have already asked not to return to the chair because they are more exposed to the infection. In need of appointment of a substitute. These are teachers over 55 years of age, perhaps with asthma and allergy problems, or with chronic diseases or with ongoing chemotherapy cycles. It was Carmela Palumbo, the director of the Veneto school office, who found hundreds of letters to the teacher directors asking to be exempted from service.
Being over 55 years old is not enough to be exempt from the service
However, today’s circular from the Ministries of Labor and Health made it clear that there is no automaticity between the age of the worker and the possible condition of fragility with respect to Covid. The age parameter alone is not a sufficient element. “The greater frailty in the oldest age groups of the population must be understood in conjunction with the presence of comorbidities” (that is, the coexistence of multiple pathologies) that can integrate a condition of greater risk “, specifies the circular. In practice , being over 55 years old is not enough to feel at risk and request exemption from certain activities, but rather the employer should be asked to “activate adequate health surveillance measures due to exposure to the risk of Covid in the presence of pathologies with poor compensation clinical “(such as cardiovascular, respiratory, metabolic diseases).
Without automaticity between age and frailty
The circular highlights that the more consolidated data have highlighted a series of aspects: the risk of contagion from Sars-Cov is not significantly different in the different working age groups; 96.1% of the deceased had one or more comorbidities and precisely 13.9% had one pathology, 20.4% two pathologies, 61.8% had three or more; the most frequent pathologies were represented by chronic degenerative diseases that affect the cardiovascular, respiratory and renal systems and by metabolic diseases; the increasing trend in the incidence of mortality with increasing age is correlated with the higher prevalence of these pathologies in older age groups; In addition to these pathologies, others have been found that affect the immune system and oncology, not necessarily correlated with increasing age. That is why, according to the circular, the concept of frailty “must be identified in those conditions of the worker’s health with respect to preexisting pathologies that could determine, in the event of contagion, a more serious or fatal outcome.” Therefore, it is not detectable – we read in another passage – any automaticity between the personal and health characteristics of the worker and the possible condition of fragility ”.
Periodic medical examinations
It is up to the doctor to determine, through a visit, to determine the state of frailty. As required by workplace safety laws, some employers must have the figure of a competent doctor, who must take care of employees. Not all schools have it. And where there are none, the employer can refer the worker to Inail. Or the circular introduces two other possibilities: in fact, it can also address “local health companies or the departments of legal medicine and occupational medicine at universities”. After evaluating the worker’s duties, the doctor will issue a “suitability judgment.” But the exemption from work will not be automatic in any case. In fact, the doctor has the task of providing “as a priority the indication for the adoption of more precautionary solutions for the health of the worker to face the risk of Covid.” The sentence of “temporary insufficiency”, with relative exemption from work, is limited to cases “that do not allow alternative solutions.” In any case, “the need remains firm” to periodically repeat the visit, also in light of the epidemiological trend and the evolution of scientific knowledge in prevention, diagnosis and treatment.
