THE NEW wave of Covid is putting pressure on hospitals, to the point of stopping hospitalizations for interventions, including oncological ones. Again. A scenario that seems to follow that of the first months of 2020. The alarm comes from the Federation of oncologists, cardiologists and hematologists (Foce), which immediately calls for the reform of hospitals, and also from other scientific organizations, such as the Italian Society of Surgery ( SIC). According to the latter, surgical activity throughout Italy has been reduced by an average of 50%, with peaks of 80%. Again we are witnessing the blocking of elective admissions (scheduled), intensive care converted for Covid patients, nurses and anesthetists from operating rooms transferred to assist them.
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“We are very worried about the block, in fact, of the planned surgical activity caused by the new pandemic wave caused by the Omicron variant – reports Foce – This paralysis risks causing serious damage to oncological, cardiological and haematological patients, who are about 11 million in Italy. In fact, we remind you that the postponement of surgical interventions can favor the development of tumors in more advanced stages, with fewer chances of recovery. We need an urgent redefinition of the national health system, modernize and strengthen hospitals, and re-establish local medicine, with a clear separation between hospitals, areas of care and assistance for Covid and non-Covid patients “.
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The effects of the pandemic in 2020
In 2020 there were over 1.3 million fewer hospitalizations than in 2019, even the urgent ones were skipped. In 2021, some of these activities had been recovered, but not all, and now the waiting lists are getting longer. As for patients with cardiovascular diseases, in 2020 the decline in hospitalizations was about 20% (for implants of defibrillators, pacemakers and major cardiac surgery) and even greater for myocardial infarction with increased mortality. The Italian Society of Cardiology is carrying out a survey to update these data, but on a preliminary analysis it seems that the situation has not improved. “In these two years we have proposed operational documents to the institutions with constant confrontation, but nothing has been done to protect fragile patients”, he says Francesco Cognetti, President Foce. In 2019, ordinary hospital beds were 314 per 100 thousand inhabitants, compared to a European average of 500, placing our country in 22nd place in Europe for this parameter. There was also a very evident gap for beds in intensive care, with 9 beds per 100 thousand inhabitants in Italy, compared, for example, to 33 in Germany. Little or nothing – the scientific society points out – has changed in these two years.
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What to do, immediately
“The shortcomings of the hospital sector, as explained in the programmatic document drawn up by the scientific societies gathered in the ‘Permanent Forum on the National Health System in the post Covid’, are among the main causes that are causing extremely harmful effects during the pandemic”, continues Cognetti: ” A revision of the Ministerial Decree 70 on hospital standards is needed as soon as possible. It is necessary to allocate more resources to nosocomial assistance, also drawing from the funds of the National Recovery and Resilience Plan and beyond “.
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We must not let our guard down on cancer screenings either, which see situations that differ from region to region. “We have repeatedly asked for anti-cancer screening to be restarted throughout the country”, concludes Cognetti: “In 2020 compared to 2019, about 2.5 million fewer screenings were performed. The reduction in examinations was 45.5% for colorectal screening (-1.110.414 tests), 43.4% for cervical screening (-669.742), and 37.6% for mammograms (-751.879). In autumn 2020, some Regions managed to deliver more tests than in 2019. However, data for 2021 are missing to photograph the state of secondary prevention programs “, concludes the expert:” We need an update at least every six months to understand the critical issues to be addressed “.
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