Covid, such as changing region colors, admission classification and contact tracing
The Gimbe Foundation evaluates the proposals of the regions to simplify the anti Covid rules according to scientific evidence and practical feasibility. Here are ideas and suggestions
The regions are pressing to simplify the rules of coexistence with Covid and have put forward some proposals to be discussed with the government. The Gimbe Foundation , its president Nino Cartabellotta says, has conducted an analysis to evaluate its consistency with scientific evidence and practical feasibility.
WHAT THE REGIONS OFFER
Among the proposals put forward by the regions and shared by the Foundation are: overcoming the color system of the risk areas and suspension of contact tracing.
On the other hand, the revision of the measures relating to health surveillance are not considered acceptable; the revision of the classification of Covid admissions; the updating of isolation measures for essential service workers; review and overhaul of the current surveillance system in schools.
Here because.
OVERCOMING THE COLOR SYSTEM OF RISK ZONES
For the Gimbe Foundation, overcoming the color system of risk zones is a “fully acceptable” proposal for three reasons. First, “there are currently no differences between the white and yellow zones and for the orange zone the (few) restrictive rules apply only to unvaccinated people”.
Second, "the Regions can increase the number of Covid-19 beds to avoid areas with 'more intense colors' but with significant consequences in terms of lack of assistance for patients with other diseases".
Third, "it is appropriate for the Regions to establish red zones, including local ones, in relation to the circulation of the virus, hospital overload and delays in care in non-Covid patients".
SUSPENSION OF CONTACT TRACING
The suspension of contact tracing is also a proposal that Gimbe shares because "with the current number of positives, contact tracing is neither sustainable nor feasible, nor does it contribute effectively to slowing down the growth of cases".
REVIEW OF HEALTH SURVEILLANCE MEASURES
The revision of the measures relating to health surveillance proposed by the regions provides that the asymptomatic positives are separated from the symptomatic ones and this for the Foundation "is not acceptable" because this hypothesis "is not based on scientific evidence".
Today, the discriminating element, on the other hand, "should be represented exclusively by the vaccination status" since, the analysis underlines, "among non-vaccinated people about 50% of infections occur from asymptomatic, pre-symptomatic or pauci-symptomatic subjects , while the vaccine (full course within 120 days or booster dose) reduces both the risk of infection (by 53.2-66.7%) and the probability of infecting other people because the vaccinated person is contagious for a period of time lower than the unvaccinated ".
COVID ADMISSION CLASSIFICATION REVIEW
Why is it not correct and even risky not to count positive patients with other pathologies among Covid hospitalized patients, as instead would like the regions? Gimbe offers various reasons to support this thesis.
First of all, the analysis clarifies, Covid “is a multisystem disease that affects numerous organs and systems and defining the status of 'asymptomaticity' is very complex, especially in elderly patients with multiple pathologies; moreover, the positivity to SARS-CoV-2 can worsen the prognosis of patients hospitalized for other reasons, also in relation to the evolution of the pathology / condition that motivated the hospitalization and to the diagnostic-therapeutic procedures implemented ".
Secondly, “the management of all SARS-CoV-2 positive patients, regardless of the presence of symptoms related to Covid-19, requires dedicated procedures and spaces, in addition to sanitizing the environments. Consequently, it is very difficult to quickly reorganize the management of the 'asymptomatic' without additional resources, in particular local and personnel ".
Third, "the responsibility of assigning the hospitalized patient to one of the two categories, with all the difficulties and discretions of the case, is entrusted to the medical staff and health companies" – therefore, with medico-legal and administrative consequences.
Finally, “eliminating the color system, in fact, would only involve separate reporting, potentially useful for epidemiological purposes and for the future reorganization of hospital services. But the reclassification of hospitalized patients, in any case, cannot derogate from the international standards defined by the World Health Organization (WHO) and the European Center for Disease Prevention and Control (Ecdc) ”.
UPDATING MEASURES OF ISOLATION OF WORKERS OF ESSENTIAL SERVICES
Even the proposal to reduce isolation days for essential service workers, Gimbe says, is not based on scientific evidence to support "the termination of isolation for positives – regardless of their vaccination status – 3 days after the onset of symptoms. , without ascertaining its negativity with an antigenic or molecular buffer ".
REVIEW AND OVERCOMING SURVEILLANCE SYSTEM IN SCHOOLS
The regions would also like to modify and overcome the current surveillance system in schools, suspending face-to-face teaching only for symptomatic subjects; suspending contact tracing and maintaining self-surveillance.
For the Foundation this “is not acceptable, as the discriminating element for the purposes of quarantine in the event of a negative swab should be represented by the vaccination status and not by the presence / absence of Covid-19 symptoms. Furthermore, in the event of a positive swab, the student must be isolated, regardless of the vaccination status ".
This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/cosa-pensa-gimbe-proposte-regioni-semplificare-regole-anti-covid/ on Thu, 27 Jan 2022 14:35:33 +0000.