Whatever happens in the fall, whether or not there is a serious fourth wave or whether there are the fortunate conditions to escape it and live only the tail of the pandemic, what begins is a new era for medicine and healthcare. And what will happen will hopefully be a whole new normality, the daughter of Covid-19 and the mourning it has sown, together with the clearest evidence that reforms must be made. But also of the concreteness of drugs and vaccines dished up in a few months by a muscular and solid scientific and industrial research, by the acquired knowledge of the mechanisms of action of a family of viruses, of new techniques to fight all germs.
Covid-19, those who get vaccinated are not contagious. The aim is for the immunity license
by Irma D’Aria
Whatever happens in the autumn, we are preparing a return to normality based on new knowledge both on the medical-scientific and on the socio-health front. A “Back to the future”, in short, as we wanted to title our Festival. But to prepare for it you have to start changing the terrain right away, otherwise, whether it’s the third or fourth wave or a new virus, we’ll be in trouble again.
At least this is what all those who have experienced the emergency are clamoring for, whether it was in the wards of a hospital, in an intensive care unit, in a doctor’s office, in a home for the elderly or to volunteer at the hospital. alongside patients. It is no coincidence, then, that one of the latest initiatives in this sense is called Time to Act, time to act, presented by the European Cancer Organization and supported in Italy by Foce, the Federation of Oncologists, Cardiologists and Hematologists, and by the Italian Association of Medical Oncology (Aiom).
Longform
Covid vaccine guide: how, where and when
by Elisa Manacorda
One fact is unequivocal: the Covid-19 pandemic has in many ways hampered the fight against cancer and the management of many other diseases. Across Europe, 100 million cancer tests are not performed. In Italy, says the Gimbe Foundation Report (Italian Group for Evidence-Based Medicine) presented during the “My health cannot wait” campaign promoted by Johnson & Johnson Medical Italia, mammography screenings have seen a decrease of 37.6% , equivalent to over 750,000 fewer mammograms in 2020 than in 2019.
Pathologies left behind
In the context of colorectal cancer screenings, the reduction was 45.5%, equal to more than 1,100,000 fewer examinations in 2020 compared to 2019, with significant variations from region to region. Result: many cancer surgeons already complain of the arrival of patients with advanced tumors in a number much higher than the pre-pandemic norm. Not only that: a survey by the Association of Italian Hospital Surgeons (Acoi), recalls the president Pierluigi Marini, denounces an 80% reduction in elective surgery, and a 35% contraction also in those in urgency. AND Carlo Lavalle, national councilor of the Italian Association of Arrhythmology and Cardiac Stimulation, adds: “During the Covid-19 emergency there was a very important reduction (almost 70% less) in the implantation of pacemakers and defibrillators in primary and secondary prevention, and the elimination of ablation interventions in tachyarrhythmias. The result of this reduction is represented by the peak in the number of sudden deaths per population contextual to the peak of the pandemic, and by a second subsequent peak, due to the lack of electrophysiology procedures “.
Covid, a year without hugs
by Cinzia Lucchelli
Similar delays and consequent problems are found in bariatric surgery for obesity (overall a decrease of 32.1% equal to 2,832 fewer operations), and in orthopedics: the Italian Society of Orthopedics and Traumatology estimates a reduction of over 130,000 operations in election during 2020 over 2019).
At the base of these delays there was the lockdown and therefore the difficulty of going to the structures dedicated to the prevention and treatment of pathologies. But, as shown by a recent survey by Elma Research, also the fear of citizens of going to hospital, passed in the opinion of many from being treatment centers to possible places of contagion. So, in this fall of 2021, the photograph is that of a serious diagnostic and therapeutic delay, with many citizens lining up to get the skipped benefits due to Covid. But the lines were already there before, and today the hospitals are in unprecedented trouble.
Vaccines for over 80s: phase two of the Italian plan has started
by Fiammetta Cupellaro
From here you have to start. “They are indispensable – he underlines Francesco Cognetti, president of Foce – new funds that compensate for the gap in structures, doctors, nurses and funding that Italy has with other European countries. There is also a need for a serious strengthening of the hospitals that have been weakened by years of irresponsible and indiscriminate cutting policies ». In short, the sector is beating cash, especially in view of the PNRR funds: those destined for the Health Mission are 20.22 billion to be spent in the period 2021-2026.
The complaint: “We nurses, threatened with death by our colleagues no vax”
by Donatella Zorzetto
Funding was only part of the problem
“Yes, health care has been cut for ten years, which translates into critical issues – he explains Renata Gili, Head of Research on Health Services of the Gimbe Foundation – they certainly were not born with the pandemic, nor do they recover within a few months. The approximately 37 billion euros that have gradually been missing from the appeal represent the price paid first and foremost by health personnel, who today are underpowered and with an advanced average age “.
Covid vaccines: which is the best for over 80s
by Irma D’Aria
And yet, continues Gili, we must not forget that a report by the Court of Auditors also notes a great difficulty in the use of funds, for example those allocated in 2020 for the recovery of activities not provided during the pandemic. “The unused sums – adds the Gimbe researcher – are even about 67% of the total. And there are some regions in the south that have not spent up to 96% of the available sums”.
Covid, outbreak of infection in French retirement home. The only unvaccinated one dies
by Noemi Penna
More than 112 million euros could have been spent on staff incentives for hospitalizations, over 355 million euros for outpatient specialist services, and 10 million euros for the increase in the number of hours of the agreed outpatient specialist. In short, the resources had been allocated. The fact that they have not been used is the light of an organizational problem that comes from afar, and that the pandemic has only highlighted.
More “fluid” blood reduces the risks for Covid-19 in the hospital
Time to act then, but where
“We are at a crossroads. We can decide to do a facelift to our National Health Service, or to intervene on the root causes of its difficulties,” says Gili. The Health Mission of the PNRR acknowledges the main causes of the Covid tragedy and focuses on strengthening local medicine, with new principals and new staff, and on telemedicine, with strong investments in the digitalization of the NHS. An opportune choice that, however, adds the researcher from Gimbe, must take into account the criticalities of our health system: made in watertight compartments, where the objectives of the territorial structures do not always coincide and above all where there is no real integration between the hospital, the treatments primary and chronic diseases. Plus, professionals don’t show the flexibility to move where those specific skills are needed.
Covid, to protect the elderly, London thinks about the mandatory vaccine for doctors and nurses
by our correspondent Antonello Guerrera
A separate chapter is that of formation. “In Italy we have a sort of training funnel: many medical graduates do not have the opportunity to progress in the specialization path, because for years the places have been insufficient with respect to hospital and territorial needs. So we have not trained a sufficient number of specialists or of general practitioners who could replace retired ones, ”Gili adds. How much this represents a problem in emergencies has made us understand the lack of staff in the resuscitation wards: but it takes five years to train an anesthesia specialist.
The elderly of Bergamo: Fontana and Moratti cut the funds to the nursing homes
by Priscilla Di Thiene
To close, the last but no less serious problem. The lack, too often, of a loyal collaboration between the Government and the 21 different regional systems. A problem of a political nature, rather than an economic or health one, which opens a new paragraph, so well highlighted during the pandemic: the relationship between the regions, which are responsible for health care, and the central government. Matter for constitutionalists. But urgent matter.
The complaint: “We nurses, threatened with death by our colleagues no vax”
by Donatella Zorzetto
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