by Ruggiero Corcella
The antigen or molecular test is no longer mandatory, but remains recommended especially for frail people (elderly, immunocompromised) and the over 60s or if you have at home or come into contact with people who fall into these categories
Covid has become a less aggressive and less lethal disease for several months now, with SARS-CoV-2 attacking the upper respiratory tract more. These new characteristics, together with the immunization induced by vaccination campaigns (no longer mandatory) and by the disease, are limiting serious cases, hospitalizations, access to intensive care and deaths. However, the virus has also become much more contagious and is still widespread, posing risks above all for the fragile population, i.e. the very elderly, patients suffering from chronic diseases, immunocompromised subjects.
Tampon, I know not
In this panorama, what is the situation regarding the swabs to ascertain the possible positivity to the virus? Does it still make sense to do them? After the end of even the 5-day isolation for those who test positive, psychologically one could be led to think that the swab is useless. On the other hand, swabbing is always a preventive and common sense measure, especially for those who fall into the fragile category for the over 60s but also for those who have relatives with these characteristics at home – says Fabrizio Pregliasco, professor of general hygiene and preventive medicine at the University of Milan and medical director of the Irccs Galeazzi Hospital – Sant’Ambrogio of Milan — . Obviously without falling into hypochondria, given the more favorable situation in general.
I think it’s worth it – adds the virologist -. However, Covid is not a trivial infection and cannot be considered as a “trivial” flu. We must remember that even seasonal flu is by no means trivial, given that epidemiological data speak of an average of 8,000 deaths caused by it every year in Italy. As far as Covid is concerned, today we have specific therapies available such as the latest generation antivirals, so having the diagnosis can facilitate both the doctors’ decision and the recovery of patients.
By law, the swab is no longer mandatory but recommended
The obligation to swab for exiting Covid isolation was abolished as early as December 2022, even if a circular from the Ministry of Health had recommended its immediate prudential execution. After the approval, last August 7, by the Council of Ministers of the end of isolation for those who are positive for Covid-19, in a subsequent ministerial circular people who have tested positive for a molecular or antigen diagnostic test for SARS-CoV-2 are recommended to observe the same precautions valid to prevent the transmission of most respiratory infections. Which? Wear a respiratory protective device (surgical mask or Ffp2), if you come into contact with other people.
What to do if you are positive
Also in the same Circular it is explained: If you are symptomatic
stay home until symptoms subside. Apply good hand hygiene. Avoid crowded environments. Avoid contact with frail, immunosuppressed people, pregnant women, and avoid attending hospitals or nursing homes. This recommendation assumes particular importance for all healthcare and social-health care operators, who must therefore avoid contact with patients at risk.
How to behave in case of contact with positive people
For people who have come into contact with Covid cases, no restrictive measures are applied, but it is still recommended that they pay attention to the possible appearance of symptoms suggestive of Covid (fever, cough, sore throat, tiredness) in the days immediately following contact. During these days it is advisable for the person to avoid contact with fragile people, immunosuppressed people, pregnant women. If symptoms suggestive of Covid appear, it is recommended to carry out an antigen test, even self-administered, or molecular.
What the data on the trend of Covid say
The data from the latest monitoring (August 17-23) collected by Regions / Autonomous Provinces, the Ministry of Health and the Istituto Superiore di Sanit (ISS) are clear: 11,606 new cases, compared to 5,919 the previous week. In total, the current positives are 119,753 (Ministry of Health dashboard, data as of 8/23); 44 people died, however, compared to 56 a week earlier. The positivity rate went from 6.5% to 9.2%. Tampons are also increasing, which have exceeded 126 thousand for over 91. Data from the ISS COVID-19 Integrated Surveillance (14-20/8), show an incidence of diagnosed and reported cases equal to 14.5 cases per 100,000 inhabitants, an increase compared to the previous week (07/08/2023-13/08/202, 11 cases per 100,000 inhabitants).
The recommendations of family doctors: swabs in suspected cases
In this scenario and with the emergence of new Omicron subvariants such as EG.5, renamed Eris, defined as the variant of interest (Voi) by the World Health Organization since it can become dominant in some countries or even globally, and Ba. 2.86 renamed Pirola, which the WHO has instead classified as a variant under monitoring due to the high number of genetic mutations (more than 30) in the Spike protein, the general practitioners of Simg have drawn up some recommendations: avoid contact in case of symptoms and swabs in suspected cases and swabs in suspected cases.
To preserve the health of fragile subjects and to prevent them from being exposed to the risk of contagion from SARS-CoV-2, Simg recommends all those with symptoms attributable to Covid (fever, sore throat, cough) to stay at home , not to attend public places and even less health facilities, not to be in contact with fragile people – underlines Professor Claudio Cricelli, president of Simg -. Furthermore, it is essential that those who suspect that they have come into contact with the virus or present symptoms attributable to it carry out an antigen or molecular test (swab): in the event that a positivity is actually found, even if there is no legal obligation, it will become it is even more important to comply with the aforementioned recommendations, with particular reference to possible contacts with fragile subjects.
The recommendation for the autumn: resume vaccinations
To complete the indications of family doctors, there is the recommendation to carry out vaccination against SARS-CoV-2. Like last year, a vaccine against SARS-CoV-2 updated to the most recent subvariants will be proposed – adds Cricelli -. It will be appropriate for frail subjects to undergo this new booster dose. We hope for a trend reversal compared to last season, when coverage rates were very low both in the over 65s and in the risk categories.
August 27, 2023 (change August 27, 2023 | 16:16)
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