The fifth wave of Covid does not let go – on Wednesday still 107 thousand infections and 72 deaths – and even if it causes much less pneumonia than the previous waves it risks sending hospitals back to havoc already this summer since in a few days the quota will be exceeded 10 thousand postive hospitalized at Covid: Wednesday there were 8,220, of which only 325 in intensive care.
A taste of the possible chaos with consequent stop to other treatments for Italians already struggling with the waiting lists that could wait for us next autumn if we do not soon run for cover with directives or guidelines to manage numbers that could be a lot higher than now: the problem with Omicron 5 is not so much the serious patients, which are growing but contained – Wednesday +2 intensive therapies – as also underlined by the Prevention Director of the Ministry of Health, Gianni Rezza: “Fortunately, Covid pneumonia today they are rare, thanks to the fact that Omicron is a less aggressive variant than Delta ». The crux is the fact that of the more than 8 thousand Italians already in hospital today and positive for Covid, about half have discovered it after a swab done perhaps in the emergency room or before a hospitalization for another pathology: in practice they are infected without symptoms or with mild symptoms who had gone to the hospital for another reason. But that now, after the discovery of positivity, they must be isolated from the other patients in the cardiology, surgery, etc. ward.
A logistics problem that is not exactly easy to manage that had already emerged in the fourth wave, the first of Omicron marked by many infections and many hospitalizations of patients not only “for” Covid (ie with respiratory diseases linked to the virus) but also “with” Covid (i.e. that they are found to be positive after a swab in the hospital). With the Regions that had asked to remove patients “with” Covid from the admissions count.
To photograph the impact of the various “types” of patients day by day is Fiaso, the federation that brings together the managers of Asl and hospitals thanks to the monitoring of its “sentinel” hospitals: the latest report published on Wednesday 6 recorded a overall increase in hospitalizations (+ 19%) in the last week with a greater increase in those “for” Covid (+ 24.5%) compared to those “with” Covid (+ 13.7%). For the first time, the former exceeded the latter, but in any case, if 52% are hospitalized for respiratory symptoms, as many as 48% are in hospital for other reasons.
So how to manage this huge number of positive asymptomatic patients in the wards? “In light of the experience of these two years and this last period when we were the first to document the presence of these two types of patients we are working on a document with models and best practices that we will deliver to the ministry”, warns Giovanni Migliore president by Fiaso. He explains: «We will have to change our care model, not only by opening Covid departments for patients with respiratory diseases. After the arrival of the vaccines there are two possible models for patients with Covid: one with fewer hospitalizations provides for the isolation of the positive in areas, cohorts or bubbles, within the individual departments dedicated to various pathologies, the other – clarifies Best – which works best with larger numbers of hospitalizations like the current ones involves opening multidisciplinary wards to isolate positive patients. In practice, creating a large “dirty” area where to admit positive patients but hospitalized for other reasons ».