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With the increasing spread of the coronavirus, in recent weeks more and more people have come into contact with people who have tested positive, therefore potentially contagious. To further clarify the procedures to follow in these cases, on October 12, the Ministry of Health updated the protocols to follow for those who have come into prolonged contact with a positive person, that is, for their so-called “close contacts” (those who they are often colloquially simply called “contacts”).
To understand the categories established by the Ministry of Health, the concept of close contact is fundamental: it means a prolonged interaction – for example that of two people living together – or a short but meaningful one, such as a conversation of at least a quarter of an hour without a mask or a handshake. For all interactions under the “close contact” bar there are no particular indications, apart from the use of common sense and the most common precautions.
There is one thing to keep in mind about the concept of “close contact”. All those who fall within the definition of the ministry can be considered “close contacts”, but not all are subject to the obligation of quarantine. Mandatory quarantine actually begins when the name of the close contact is entered into the records of the referring ASL: therefore, it is up to the health authority to confirm the status of the close contact.
What to do if it is a close contact of a positive
The protocol to follow after having had close contact with a confirmed positive was updated by means of a circular from the Ministry of Health issued on October 12. Close contact of a positive can be notified of its status by the Prevention Department of your Local Health Authority (ASL), responsible for the contact tracing activity of proven positives, or – this is what happens most frequently at peak times – you are warned by the same proven positive, and only accordingly warn your GP and ASL. The procedure foreseen by the protocols, then, is what we have summarized here in the graph.
The first thing you should do is quarantine yourself, that is, stay home isolating yourself as much as possible from the outside world. At that point, the ASL or GP (depending on the region) do an evaluation of the case and decide whether to perform a swab test immediately.
The practice of these weeks, also suggested by the October 12 circular, is to test only close contacts who develop symptoms, even mild ones. For close contacts who remain asymptomatic, there are three possibilities to get out of quarantine: with a test (molecular or antigenic) carried out on the 10th day after contact with the positive, in case of negative result; with a test carried out in the first ten days, which in case of negative result allows you to leave the quarantine on the tenth day after contact (since the incubation time is estimated to be ten days, the ministry forces you to remain in quarantine for this period even in case of negative result of the test carried out before); without any proof, after 14 days of quarantine.
In all three cases, obviously, to get out of quarantine it is necessary not to present any symptoms. For those with mild symptoms but not safe contact, a Health Ministry circular issued in late May establishes notification to ASL and the need to undergo a swab test.
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However, if the result of the close contact test is positive, the case moves to another binary. Quarantine becomes isolation, that is, physical separation from all other people (in another environment or in different rooms in your home). In the case of an asymptomatic positive, the isolation lasts ten days from the result of the first swab. From the 10th day onwards, a new swab can be made: in case of a negative result, it can be left isolation.
Even those with severe symptoms or mild symptoms can undergo a retest beginning on the 10th day of the first test and exit quarantine if the result is negative and if they have not shown any symptoms in the three days before the second test. Positives who develop severe symptoms, on the other hand, are treated with greater care by ASL and possibly local hospitals.
– Read also: How many have been the deaths from Covid-19
Close contact close contact
The ministry’s Oct. 12 circular does not provide for quarantine or testing for close contacts of close contacts. To understand who they are, let’s take an example. A married couple usually live in the same house and work in two different places. They both go to the office every day. If a colleague of the husband tests positive, the man should quarantine himself as a close contact and avoid leaving the house; However, his wife is under no obligation to do so as she is a close contact close contact. Unless her husband is tested and positive, the woman can continue to go out freely and go to work (with the risk, of course, of contracting the coronavirus from her husband and infecting friends and colleagues).
And immune?
To date, Immuni, the government-supported contact tracing application, integrates differently with contact tracing procedures from region to region and, in some cases, company to company. The Milan ATS, for example, prescribes a quarantine that can only be exited with a negative test result, while others do not seem to have a specific procedure to handle suspected cases reported by Immuni. The ministry simply invites those who receive notification of a potential close contact to “contact the general practitioner or pediatrician of their choice and explain that they have received a COVID-19 close contact notification from Immuni.”
So some general practitioners believe that the Immuni notification alone certifies close contact with a proven positive and initiates the report to ASL; others on the other hand, following for example the school of thought of the Veneto Region, do not consider it sufficient proof and decide autonomously how to behave.
– Read also: What happens when a notification arrives from Immuni?
A particular case: the school
Positive cases and suspected positive cases identified in schools follow different paths than after school: here we have explained what the protocol foresees in the event that a child is positive, and what happens to their classmates and teachers.
– Read also: What to do about the coronavirus at school, explained
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