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The story of S., 43, from Milan, illustrates that something in Milan does not work as it should be in the handling of swabs, in the tracking of positives and in the public information service in charge of the Territorial Health Authority. With strong consequences in the control of the epidemic in a critical and complex territory such as the area of the city of Milan. Let’s proceed in order. S. works in the world of advertising, has a wife and two school-age children, lives in the city. And this is his story.
In the driveway: “Excuse me, do you have covid?”
It all started, as often happens, from communicating that a person with whom S. had been in contact was positive. A collaborator with whom I also took a car trip at the end of September. A few days later the “contact” symptoms of the cold appeared. I didn’t give it a lot of weight because my son also had a cold and he often happens to me. But after my colleague told me that I was safe, I immediately jumped on to reserve a tampon. The company S. works for has entered into an agreement with the Centro Auxologico in Milan, so he decides to proceed privately: on October 7 he takes the scooter (his wife was using the car) and goes personally to the Auxologico. But there they warn him that, since he is symptomatic, they cannot let him enter the facility and must go to one of the diagnostic centers where “drive through” swabs are made, or in a car. So I went to the San Carlo hospital and got in line with my scooter. Fortunately, while I was waiting, an employee came to give me the information: a reservation was required to make the swab or have activated the request through Ats. So, while waiting I call my GP, or rather, I send him an urgent message, he calls me and immediately activates the procedure through Ats. I can wash my tampon. When I arrive in front of the assistant, he asks me “do you have symptoms?” I answer yes. Then he asks me “do you have covid?” I answer that I am here to find out, but the question amazes me. But only the first rarity in a series. Why the same employee, to the question “Until I have the answer I have to remain isolated?” answer “no, it doesn’t matter, he can do whatever he wants“. Wrong answer.
Isolation? Unnecessary
In the swabs service they also tell S., and that’s right, that the answer would arrive in 72 hours: it would reach his doctor and it would be inserted into the electronic medical record. A service that every citizen can activate if they have a spid, which is their digital identity, or the “cie” (electronic identity card) or the health card with the reader. But S., like many, has none of these. Because my wallet was stolen and I’ve been waiting for a new Lombardy region health card for about a year. Because my doctor has access to my file and told me that he would review it. So I calm down.
The first 24 hours pass and by talking with friends and acquaintances, S. comes to know that in case of positivity he is notified within 24 hours after the swab. Right information. In fact, it is usually provided by the same drive-through employee who proceeds with the pick-up or by the health worker on the phone when making a reservation, but has not been given S., in fact, they have been told that they can get out safely. A mistake which, as we will see, can have unpleasant consequences.
Six days to get the positive report
At 24 hours I start to send messages to my doctor so that he finds out about the report, he does not find anything, I think: ok, I am negative, also because in the meantime everything had happened. It was about the weekend I go for a walk, I go out to dinner. Monday October 12th, 5 days have passed since my swab and my doctor still cannot find my report. Finally, on the morning of the 13th, six days after the swab, the doctor wrote me something cryptic: swab of 9 positives, the one of 10 negatives. But I haven’t had two tampons in two days … Not even my doctor can explain it. I thought maybe they had tested my swab twice to be sure … Even in San Carlo they don’t know what to answer but they invite me to come in person to get the report. I go and pick up a single report, the 9: positive. So my doctor calls me to tell me that He was wrong.
Doctor’s supervision
Here’s the second mistake: the GP misread the medical record. Because S. had previously made another swab, but on September 10, not October, when, after returning from vacation, his company took it upon himself to keep an eye on all the employees returning from their vacation resorts. The doctor did not see that one tampon was from September (the negative) but the next, the important one, was from October 9. Summary of mistakes made: 1) incorrect information on preventive isolation, 2) “carelessness” in reading the electronic medical record, 3) failure to communicate the positive swab within 24 hours, 4) the time elapsed between the swab and communication of the report 6 days of positivity (who does it depend on? The doctor? The hospital?). A deadly sequence. But sadly it is not over.
Ats does not respond
On my way home with the positivity report, I warn the friends I had gone out to dinner with and reserve, at my expense, the quick swab at home for my wife and children: they are all negative, but they are left isolated waiting a second . hyssop, as I’m still positive. But perhaps the most disturbing detail is that S. no one called about the famous “contact tracing” This is the research and contact management activity that the territorial ATS attends, also through the Immune App and which is crucial in epidemic control strategies. Even trying to call public service S. I never got to talk to anyone. I called the Ats number many times to take care of this, I was waiting up to 40 minutes each time but nothing: at the end of the queue the queue inexorably fell. Then, as I tried to call on a Saturday morning, I heard from the Lombardy region that Ats number does not work on weekends. It seemed strange to me, so I tried calling again the following Monday, or yesterday, October 20, many times and not even this time. To be clear, the number S. has been trying in vain to call 02/85781 for days. We tested it too and a registry replied that the service is active from Monday to Saturday. But then when it comes to talking to the operator, the line drops.
Immune? No one called me to validate the code.
With the positivity report in hand, S. also reported on the Immune application that I had downloaded and activated a short time ago. Once the report is made, a code arrives that, however, as I understand from the instructions in the App, must be validated by a healthcare professional so that I can actually activate the alert on all the phones of my possible contacts. But no one called me at the moment. Should I call myself? But who to call since Ats is not responding ?.
Quarantine: 14 or 10 days?
Also on the quarantine front there was a misunderstanding: is there a 14 or 10 day wait? According to the new Dpcm it would be 10 but since the Dpcm is not retroactive, for tampons manufactured prior to their entry into force, the 14-day rule still applies. It is a pity that the information telephone service (a service where only recorded information is listened to) talks about 10 days without making this specification. In the end, after several attempts, I managed to talk to someone, calling the Lombardy Region, and they told me that Ats should call me before 23.
In short, S. waiting, isolated in a room, at home, like so many others in his condition, and you cannot “shorten” the quarantine with a private swabEven if the diagnostic centers that make private swabs are in fact the same ones, here in Milan, that have agreements with the Ats, but the law does not provide for it. Fortunately, he did not need hospital treatment and his symptoms were little more than a cold and a little burning in his eyes, but the reality of asymptomatic or, as they say, paucisymptomatic, constitutes the bulk of those positive for the coronavirus. Therefore, its monitoring would be essential to control the epidemic.
Summing up my entire Odyssey, says S. I see three serious things: a positive result that came to me six days after the swab, no one calling me to join a contact tracing activity, a family doctor who may not be well informed about the procedures to follow and did not know what to advise me. But do you know what I find truly absurd? What’s up a phone number that everyone, positives and suspects, should access. Wouldn’t it be simpler and more functional for people who have a positive Covid report to have a different path? More accessible? Quicker to respond? American soldier. It would be better.
October 20, 2020 (change October 20, 2020 | 18:32)
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