ROMA – Give the General Practitioner a decisive role in the management of infectious diseases, starting from Covid-19 to get to HIV and Hepatitis. This is one of the needs that emerged with the pandemic: the effects, in fact, were not only on chronic diseases, certainly penalized for the reduction of checks and diagnoses. Even some infectious diseases, now chronic or treatable, have been neglected, while it is precisely the family doctor who can play a decisive role. From here a new training and information project starts.
ACUTE PATHOLOGIES
So we read in a note. “We are starting to design a path for the new generations of doctors – he underlines Claudio Cricelli, President of Simg– This process mainly concerns the so-called acute pathologies, sometimes underestimated by general medicine. As emerged with Covid, these today represent emergencies, they are part of daily life and patients come to the specialist when the opportunities for resolution have already been wasted. We must therefore draw a new training model, based on greater awareness, concrete tools, intervention skills for early diagnosis and immediate application of therapy of the case”.
The project ‘We stand with public health: a call to action for infectious disease. Salute pubblica: presente e futuro’organized by Regia Congressi with the patronage of the Italian Society of General Medicine and Primary Care – Simg and of the Italian Society of Infectious and Tropical Diseases – Simitwith the non-conditioning contribution of Gilead Sciences, was presented at the Press Room of the Chamber of Deputies on the initiative of the Hon. Mara Lapia, Member XII Social Affairs Commission Chamber of Deputies. The introduction was by Claudio CricelliPresident Simg, and of Massimo AndreoniScientific Director Simit.
Alessandro Rossi, Project Coordinator and Infectious Diseases Area Manager Simg presented the project. Ignazio Grattagliano, COVID-19 Simg activity coordinator intervened with ‘New organizational models for the management of Covid-19 patients’; Barbara Suligoi, Head of the AIDS Operations Center of the Istituto Superiore di Sanità, with ‘HIV as a chronic disease: integrated long-term health management’; Loreta Kondili, National Center for Global Health Istituto Superiore di Sanità Hcv, with ‘The enlargement of screening programs’; Marco Borderi, Medical Director of the Infectious Diseases Unit of the Sant’Orsola Malpighi Hospital, Bologna, with ‘The integration of services for an effective management of the HDV’. The scientific journalist Daniel Della Seta will moderate.
THE SIMG PROJECT FOR A NEW MANAGEMENT OF VIRUSES
The Simg project will be articulated over the next winter 2022-2023 through a cycle of four webinars focused on as many Infectious Diseases: Covid-19, HIV, Hepatitis C, Delta Hepatitis. A choice dictated by the function that the family doctor can perform.
As for Covidin addition to maintaining an important role in vaccinations, the Mmg will have to work on the interception of any complications, promptly suggesting and prescribing therapies with direct antivirals or monoclonal antibodies to more fragile patients, solutions that have maintained validity despite the evolution of variants.
Per l’Hiv it is possible to make the virus chronic, a concept summarized in the scientific evidence U = U, Undetectable = Untransmittable, Undetectable = Non-transmissible: HIV is not transmitted with the correct intake of effective antiretroviral therapy, which makes the viremia no longer detectable in the blood.
The Hepatitis C viruson the other hand, thanks to the new therapies, it can be permanently eradicated, in a few weeks and without side effects.
For Delta Hepatitis, the most severe of the different hepatitis, the new molecule bulevirtide represents a revolutionary advance because it allows to treat patients who previously could not receive any therapy. The problem for HIV, Hcv, HDV is given by late diagnoses, which often come when the patient is already in AIDS (in the case of HIV) or on the way to a serious cirrhosis or hepatocellular carcinoma in hepatitis. The undeclared is therefore considerable and screening is currently not sufficient.
THE ROLE OF THE GENERAL MEDICINE DOCTOR
“The role of Mmg on these four infectious diseases must become proactive– Alessandro Rossi underlines- He must be a careful observer of the risk profiles of his patients he knows very well and establish screening interventions and, where necessary, propose vaccinations in fragile subjects. Naturally, territorial care must be revolutionized with new information, IT, personnel and network tools to alleviate the burden of hospitals and allow Mmg to better manage patients at risk.
The four webinars will feature the contribution of several stakeholder: on the one hand there will be the scientific world, represented by Simg and Simit, as well as the health authorities; on the other hand, there will be a strong interaction with the institutionsin particular regional, whose commitment is essential to implement efficient programs of screening e you linkage-to-care. In the wake of these initiatives, Simg will make available to doctors some instruments that will be integrated into the Mmg file, which will be able to consult recent guidelines, updated laws, scientific analyzes, the Health Search scientific observatory. For General Medicine it will be a training and integration process“.
A NEW ORGANIZATION
“The pandemic has shocked the whole world and has put public health in difficulty not only for hospitalizations, but above all in the assistance in chronic diseases – continues Prof. Massimo Andreoni – Among the chronic diseases there are also infectious diseases that have this connotation. We have had great difficulty in assisting and screening for this type of disease. This suggests a transition from a mainly hospital-centric public health to a network between hospital and territory, in such a way that what the latter can take charge of certain activities and the hospital focus on the acutely ill. This different organization may favor therapeutic continuity and the diagnosis of any new pathologies “.
“Greater interaction between general practitioners and infectious disease specialists is essential– highlights the Hon. Mara Lapia- The health of the future lies in a more rooted local medicinewith in-depth training and able to intervene quickly with screening and diagnosis, which, if it arrives in time, for some diseases can be decisive not only to survive, but also to guarantee a good level of quality of life. Therapies, treatments, follow-ups and controls can become solutions especially in fragile patients such as cancer patients, on whom the linkage-to-care for an infectious disease can be even more relevant “.
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