Home Health Covid: Grattagliano (Simg Puglia), ‘we have to choose who to vaccinate first’

Covid: Grattagliano (Simg Puglia), ‘we have to choose who to vaccinate first’

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Rome, April 14 (beraking latest news Salute) – “Hundreds of phone calls from patients arrive in our clinics asking us how to organize vaccination, which vaccine is most suitable for their characteristics and this involves a considerable waste of energy on our part. We knew that vaccination would be it was ready by the end of 2020, at the latest in the first months of 2021, which is why we could have organized ourselves at a national and regional level as early as last summer. The fundamental issue to date is that of identifying the vaccination of fragile subjects “. This was stated by Ignazio Grattagliano, professor of general medicine at the University of Bari, as well as president of Simg Puglia, speaking on the occasion of the third Talk of Allies for Health (www.alleatiperlasalute.it), the new portal dedicated to medical information -scientific made by Novartis.

‘Vaccinations and frailty, which approach for chronic patients?’ is the title of the debate, which was also attended by Massimo Galli, primary infectious disease specialist at the Sacco hospital in Milan and professor at the State University of the Lombard capital, and the journalist Silvia Bencivelli.

“Frailty – continues Grattagliano – is an extremely complex condition that requires attention from the whole social and health system that was initially focused on by general medicine as an increased risk of susceptibility to acute diseases or hypothetical acute damage. It would be a mistake to think that it is fragility of an individual is only physical. It must, however, be extended and included also on a psychic and social level, it goes beyond the condition of illness and comorbidity. It is necessary to stratify the subjects considered fragile, most of them are over 80 years old , over 70. But how do these people live? Alone, in RSA, in the family, can they count on a family and a caregiver in all these situations, or not? This is the scenario where the fragile, especially the elderly, is placed “.

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But can fragile subjects approach vaccination with serenity? What attentions must be respected? How to set up the dialogue with the doctor? These are some of the themes at the center of the talk.

When faced with a patient with severe cardiovascular or pulmonary disease, “the difficulty arises as to who to vaccinate first”, admits the president of Simg Puglia. “As general practitioners, in almost all regions of Italy – he explains – we have very few vaccination doses per week. Having said that, the ethical problem also arises as to who to vaccinate first. vulnerable who could receive the vaccine first. It is clear, we are talking about relatively short times, but as it is also reasonable to imagine that people really want to get vaccinated and to be safe. From this point of view, in the various regions who administers us is not particularly close to us “.

As to why general practitioners were not listened to and considered, Grattagliano has no doubts: “The problem is on the part of the institutions,” he says. “We – he continues – found ourselves catapulted into an emergency situation, first in Northern Italy and after the summer in the rest of the peninsula, so we all had the experience with Covid”.

“At the beginning – says Grattagliano – we were taken aback, no one knew how to treat and cure the disease. In the hospital, where the most serious patients ended up, the doctors had drugs not present in the area, so the hospital colleagues did theirs. tests, their experiences with different molecules until a relatively effective therapy was standardized. To us doctors treating Covid it presented us with the evidence of the application of mathematics to clinical medicine. It led us to consider extremely rationale the importance of distancing, of the incubation period of the subject after contact with a positive. On the other hand, it made us consider that precisely the people most susceptible to the damage of the explosion of systemic inflammation, not only at the respiratory level , are the subjects who develop the most severe form of Covid. These are subjects that must be paid attention, not only for Covid, but various aspects. They have more important cardiovascular events (heart attack, stroke, heart failure) earlier than others “.

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During the online meeting it emerged that 50 between Associations and Patient Federations of the Associations on the Net network, in a letter sent to the Government on March 15, propose, among other things, the involvement of general practitioners to identify patients at risk , and a vaccination access plan for patients with pathology / multiple morbidities and their family members / caregivers currently not foreseen as a priority in the vaccination plan.

“If the vaccine reaches us – concludes Grattagliano – and if the type of vaccine is distributed in an effective and useful way for mass vaccination in our studios or in vaccination hubs, we are certainly available. After the AstraZeneca affair we were hit by our assisted who at all times ask us and ask us if they can do that type of vaccine or not, if there are contraindications and if they run risks. Our task is to reassure people who undergo the AstraZeneca vaccine, as well as to all other vaccines, on the efficacy and safety of these shield products. Our role is fundamental “.

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