“The general situation, from a clinical point of view, is not serious. Patients, for the most part, are vaccinated with two or three doses and do not show symptoms of serious concern or such as to initiate home control or hospitalization procedures. The exceptions are cases of people with multiple diseases (diabetics, heart patients, bronchopaths or the elderly). Few people go to hospitalization, the unvaccinated are at greater risk “. So speaks to Foggia Today Pierluigi De Paolis, president of the Order of Doctors of Foggia, who is the spokesperson for one of the categories put under the most stress in these two years of pandemic. Not to mention the many human losses – also in the province of Foggia – especially during the first wave.
What moment is the figure of the general practitioner experiencing?
“It’s a complicated time. What weighs more are the bureaucratic commitments that pertain to the definition of each case. This does not refer only to reporting to the ASL for the request for a confirmation swab of symptomatic suspicion, but also to the certification procedure or continuation or end of the period of illness, or to the drafting of a certificate that frees you from isolation. Then there is all the information that the patient needs to receive, whether he is in isolation because he is positive or in quarantine because he is in close contact. The latest directives have differentiated the periods of isolation and quarantine also with respect to the vaccine doses received as well as differentiating between vaccinated and unvaccinated. All this conditions us ”.
Speaking of directives, do you think it is appropriate to simplify and streamline the protocols?
“A rather complex legislation has been generated which has generated confusion not only among users, but also among doctors themselves. Think, the last provision we received, probably a summary of all the guidelines, is made up of 75 pages. And this cannot be called a lean model that helps to have clear ideas and to give answers at all times to a patient who has a different condition than another and needs to be addressed for what is the right measure for him. “.
The pre and post pandemic will show in a plastic way the different perception of the role of the general practitioner. But is the change in the doctor-patient relationship already underway?
“This is not an idyllic time. Both we doctors and the users are quite tired. This condition of persistent emergency exacerbates intolerance. Not everyone has the same degree of patience and endurance in situations. And this is also dictated by the duration of this historical moment, which justifies the general intolerance ”.
The vaccine also played an important role.
“Here you have to arm yourself with all the patience you have and with all the possibilities of conviction that are mainly related to our culture with respect to vaccines. History teaches us how vaccines have led to the disappearance of lethal diseases. I am thinking of smallpox, but even more so of Sabin’s vaccine (which he developed, without ever registering the patent, one of the two vaccines against polio, ed), which was fundamental to defeat a disease that claimed many victims in our country as well. What needs to be done is to try to effectively respond to the false beliefs about this vaccine. For a doctor, it is enough to consult scientific publications to become the owner of all the information useful to defeat certain false beliefs, such as those about the mrna vaccine, which does not enter the DNA, but which is eliminated after having completed its task of activating the immune system. “.
As a professional, how do you explain the obstinacy with which a no-vax does not withdraw from certain convictions even in the face of the words of an expert and the concrete data that are shown to him, but perhaps he prefers to rely on other less authoritative sources?
“I am pleased to give this answer to a representative of true information, who is the one who checks the sources and verifies them before spreading news. Today, however, this pandemic falls at a time when we are led to document ourselves on social networks through statements by people, often anonymous, who spread news of which no truthfulness has occurred “.
Can it, therefore, be argued that the pandemic came at the wrong time? Would it have been different without social media?
“I would not say. There has always been the spread of fake news. I am thinking of Orson Welles, author of the radio drama ‘The war of the worlds’ during which he announced the landing of the Martians on Earth. The news, seasoned with details (obviously invented) terrified the country. It was 1938. I believe that social media are very important, but they hide big risks if they are used in the wrong way “.
Speaking of no-vax, how many cases of unvaccinated doctors have been detected?
“The Medical Association proceeded to ratify the suspension of about 80 doctors (surgeons and dentists), a considerable number, about 2% of the members. We are evaluating the new flows arriving both through the federation and through the individual regions that read the platforms on which the vaccinations performed are recorded and compare them with the lists of names of the members of the individual registers. We will proceed with other requests for regularization of your position “.
What was your reaction to these numbers?
“They hurt us a lot. Because I believe that there may be personal reasons in elderly doctors who do not practice the profession and who, due to frailty problems, decide not to get vaccinated. I do not justify other situations: a surgeon or dentist cannot exercise the profession effectively if he has these reservations “.
Among these 80 there are, however, states of repentance.
“About a third of the suspended doctors were then vaccinated. Readmission can only be applied after they have received at least two doses. For now we have readmitted about twenty doctors ”.
In conclusion, hoping for a near end to the pandemic, how should the figure of the general practitioner be thought of in the future?
“The future has taught us precisely this emergency. The pandemic has told us clearly that a doctor cannot cope alone with difficult situations such as this or any other that may arise. It is not possible to continue with an organization in a single form, without the human forces necessary to effectively manage an outpatient clinic for those who are requests for access or information on one’s state of health. We are verifying that the doctors who resist are those who have an organization that provides for the presence of an administrative collaborator and those who also have a dedicated nurse. The future of general medicine is linked only to a study organization that makes it possible to effectively address the needs and health needs of users, which – I play hard – have changed due to this pandemic ”.