Four years after the start of the Covid pandemic, the virus is no longer scary. The protections have fallen, as has the idea that protecting oneself from contagion is not that necessary. But, four years after the start of the pandemic, how can anyone who gets infected, because it still happens, realize that they are no longer contagious? And how can anyone who has already been infected, perhaps several times, know what possible repercussions, and on which organs, they may suffer? Therefore, Covid, and Long Covid, are still being talked about. Let’s see in what terms.
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What’s happening now in Italy: the trend of infections
First of all, what phase of the contagion are we experiencing now in Italy? New positive Covid cases are decreasing, as are victims and hospitalizations, both in the medical area and in intensive care. The weekly bulletin says so regarding the progress of the epidemiological situation for the week of 22-28 February 2024.
There is a very slight increase only for the transmissibility index (Rt), as reported by the ISS-Ministry monitoring, based on cases with hospitalization as of February 20: the Rt is below the epidemic threshold and is equal to 0.73 , while it was at 0.65 on February 13th.
In detail, there are 1,103 new positive cases with a change of -31.4% compared to the previous week (1,607), 39 deaths, down 25.0% compared to seven days before (52), 132,482 swabs, -9 ,8%. The employment rate in the medical area as of February 28th was 1.9% (1,154 hospitalized), compared to 2.1% (1,311 hospitalized) on February 21st, while that in intensive care was 0.5% (45 hospitalized ), compared to 0.6% (51 hospitalized) on February 21st.
“The degrowth figure has now become standardized as widely expected – he says Francesco Vaia, general director of health prevention at the Ministry of Health -. The ministry is working on prevention as an actor of possible change, starting from the relaunch of screening to raising awareness on the adoption of correct and healthy lifestyles, also through an increasingly strong alliance between healthcare, school and family”.
We still get infected
But we still get infected. So it is legitimate to ask ourselves: if we now have Covid, when will we be able to emerge from isolation? If you resume activities outside the home, can you be sure you are no longer contagious? “The important thing to consider is that every person and every case of Covid is unique – say the experts -. There is no hard and fast rule on how ill a person will get or how long they will remain contagious. The (ISS-Ministry) guidelines offer framework, but patients should take into account their circumstances, priorities and resources to assess risk.
Here are the symptoms of Covid
What are the symptoms of Covid in 2024? Even today, the typical signs of the SARS-CoV-2 virus are fever or chills, cough and sore throat, headache, runny nose, hoarse voice, fatigue and tiredness, muscle pain, congestion or cold, loss of smell and of taste (more rarely than in the past).
And again: Covid brings breathing difficulties (especially in the most severe cases) but, as always, it is also possible to have been affected without showing symptoms, and therefore be asymptomatic patients. Therefore, to be sure of a diagnosis, it is recommended to take a nasopharyngeal swab, one of the many tests available to identify the new Coronavirus.
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How long do you have to isolate yourself for?
Anyone attacked by the virus and showing the symptoms in question is no longer required to isolate themselves for five, or a specific number of days. As with other common respiratory viral illnesses such as influenza and RSV (Respiratory Syncytial Virus), you should stay home and away from others if you have symptoms, including fever, chills, fatigue, cough, runny nose and headache .
You can resume normal activities when, for at least 24 hours, the symptoms have improved overall and you have no fever without taking medications. Not all respiratory virus infections cause fever, so paying attention to other symptoms is important to determine when you are well enough to leave home.
When are symptoms improving?
A respiratory virus infection can present many types of symptoms, some of which can last beyond the time the person is contagious, such as a persistent cough. So having a single symptom or a combination of symptoms is not as important as overall feeling better and being able to resume activities.
What other prevention measures to adopt at work
Once normal activities have resumed, as a precaution it would be appropriate to adopt further preventive measures in the following five days to curb the spread of the disease. This includes improving ventilation by opening windows to bring in fresh air from outside or purifying indoor air, washing hands frequently and cleaning frequently touched surfaces, wearing a well-fitting mask, and maintaining distance from others.
And for the elderly, children and frail people?
Older people can and should get vaccinated with an additional dose of the latest coronavirus preparation. At the same time, maternal vaccinations for RSV (Respiratory Syncytial Virus) can protect very young children, while the monoclonal antibody nirsevimab can also be administered directly to many young patients.
Then there are the fragile. Patients with a weak immune system are advised to get vaccinated against the coronavirus and in this regard can ask about specifically recommended treatments, which for some people with disabilities, may also include antiviral treatments.
What to do during pregnancy
Pregnancy can cause changes in the immune system, heart and lungs, making pregnant women more likely to become seriously ill from respiratory viruses. Therefore, vaccination during pregnancy is recommended to help protect the new mother and her baby after birth.
End of isolation, why do test symptoms matter more?
There are essentially two problems: anti-Covid tests can approximately indicate that a person is still contagious, and home tests for other respiratory viruses are not entirely available. Therefore, the majority of patients do not know which virus is causing the current infection, and to clarify their ideas they have only one tool: anti-Covid tests, which are insufficient to resolve the issue. Additionally, the severity of some Covid and flu symptoms, particularly fever, correlates to some extent with how long the virus spreads, which is an indicator of contagiousness. In conclusion: according to ministerial lines, as symptoms improve, especially fever, infectivity tends to decrease in most people.
Do we still have to wear masks? And when?
In addition to swabs, one of the best-known measures used against Covid are masks, personal protective equipment that slows down the circulation of the virus. For some time, however, this PPE has no longer been mandatory, except in some cases. In 2024, the extension of a 2023 ordinance from the Ministry of Health was issued, which provides for the obligation to wear a mask for workers, users and visitors of health facilities within the departments that host frail, elderly or immunosuppressed patients. But also for workers, users and visitors of social and healthcare facilities, hospices, rehabilitation facilities, residential facilities for the elderly, including those who are not self-sufficient. In other departments, however, everything remains at the discretion of the health management.
The obligation is not foreseen for children under the age of 6, for patients with pathologies or disabilities incompatible with the use of the mask, as well as for those who must communicate with a person with a disability so as not to be able to use the device . However, experts recommend the use of masks even for those who work in close contact with people; close to vulnerable people and inside public transport.
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If I get infected several times, do I risk other illnesses?
The case of possible reinfections from SARS-CoV-2 has become very frequent in the four years of the pandemic. A study completed by researchers at Washington University School of Medicinewhich examined the medical records of more than 5 million people from the electronic database maintained by the Department of Veterans Affairs of the United States, i.e. the department that deals with veterans discharged from the US armed forces, has ascertained that, compared to individuals who have not had reinfections, those who have developed them have shown an increased risk of hospitalization, as well as a greater risk of death from all causes and also an increased risk of developing disorders affecting various organs and tissues, such as pulmonary, cardiovascular, hematological, gastrointestinal, musculoskeletal, neurological, diabetes and mental health problems.
However, research highlights a potential increase in the risk of developing adverse health conditions in the event of reinfections, especially if repeated. If you have already experienced a SARS-CoV-2 infection, therefore, it would be best to avoid running into a new one; if, however, two infections have already developed, it would be advisable to avoid a third and so on. What is certain is that having already been infected once and become ill does not guarantee protection from subsequent reinfections.