Some doctors at the forefront of the fight against Covid say they have begun to see “things we no longer saw”, Mario Balzanelli, the national president of the 118 emergency health service, said. “While previous versions of Omicron spared the lower airways, we are now starting to see pneumonia caused by Omicron BA.5, which can reach the alveoli. And some require assisted ventilation.” The peak of infections of the summer wave should arrive in mid-July. Today the “unofficial” positives in Italy could be about two million. 84,700 cases registered yesterday, with 325,000 swabs when in December-January we reached up to one million a day.
Covid: what happens in hospitals
Balzanelli explains that in hospitals “we begin to observe oxygen desaturations in the blood, especially in cancer and haematological patients, despite the fourth dose of the vaccine“. In general, he adds, “wards are filling up with infectious diseases and there are also gastrointestinal symptoms.” Four aspects of Omicron 5 worry the medical expert. “The first is the ability to reach the pulmonary alveoli, causing desaturation, pneumonia and respiratory failure.” Second, “the sub-variant is refractory to high temperatures”. Third “it is incredibly contagious”. Fourth “is capable of evading the immune defenses”, since “we see people vaccinated with 4 doses or cured of Covid with high fever and cough and vaccinated with 3 doses with important phenomenological pictures”.
Many cases, explains Balzanelli, “are discovered by chance in the emergency room, where the tampon is mandatory. They are people who are there for other reasons, totally asymptomatic”. This is above all a sign of “a very high viral circulation”.
Family doctors: “Boom of positives, not pneumonia”
“As family doctors we are observing an exponential increase in Covid infections” in Italy “with numbers never observed in over 2 years of pandemic”. The latest national bulletin, with 84 thousand new infections, represents an “impressive case series”, which “for some colleagues with many clients means seeing even 50 cases a day”. Silvestro Scotti, general secretary of Fimmg, Italian Federation of General Practitioners, traces to beraking latest news Salute a picture characterized by a boom of new Sars-CoV-2 positives, but “with prevalent symptoms affecting the upper respiratory tract”, then without an increase in pneumonia. However, especially “in this summer period – specifies Scotti – a respiratory disease such as Covid-19 could create complications also not exclusively due to the virus. It is one thing to have a cold in winter, when you tend to stay covered in the heat, a ‘ other is having it in the summer, subject to continuous “external-internal” temperature changes, thanks to “air conditioning” and “risk factors that can create accessory complications”.
“I have a lower number of clients than the average of an Italian family doctor, because for obvious reasons I limited my limit to a thousand patients – said the number one of the Fimmg – But only today I had 6 new positives”, against the ” 2-3 cases a day “previously recorded,” and at this moment I follow about 30 positive patients who are in the period of isolation. But they are all home isolations, without the need for hospitalization or symptoms affecting the lower respiratory tract, even in virtue of the relatively young average age of our newly infected, which also explains the low use of antivirals “.
Scotti operates in Campania, a ‘young’ region compared to the rest of the Peninsula, and “in any case we also have elderly patients with comorbidities”, he points out. “What I see – he highlights – is that in this moment, as they are aware of being fragile, they have a more defensive attitude; they are certainly those who have a higher vaccination coverage and continue the prevention actions, with the use of the mask and the tendency to avoid gatherings. The elderly and people with pathology, being a little more careful, are therefore at less risk of contagion “.
Quarantine can change
The requests do not stop also to review the obligation of isolation by return of post, at least for those who have no symptoms and work in essential services or in any case providing mini quarantines as happens in the USA where asymptomatic positives can leave the house after 5 days. and without doing any tests. The epidemiologist Pierluigi Lopalco invites us to hurry up and change the rules on the isolation of those who have Covid and launches the idea of removing home isolation at least for asymptomatics who work in essential services, such as safety and health, but always wearing the Ffp2.
If millions of people go into isolation all together, essential services are at risk, starting with Healthcare where 20,000 positive workers remained at home in quarantine alone in June. If, as expected, in two to three weeks the wave reaches its peak, home isolation could put transport, hospitals and other public services in difficulty, already struggling with the days of summer holidays that often reduce the staff.
A general rethinking of the home isolation of the infected will in any case have to take place sooner or later, because the greater contagiousness of the new variants and their less pathogenicity will be characteristic of the evolution of Covid towards endemization. In the course of next week, in the event of a further boom in infections, it cannot be excluded that the government and the Ministry of Health will be “forced” to accelerate in modifying the current rules on the isolation of positives.
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