Mario Balzanelli, the national head of the 118 Health Emergency Service, said some doctors at the forefront of the fight against Covid say they are starting to see “things we no longer see”. “While previous versions of Omicron survived the lower airways, we are now beginning to see pneumonia caused by Omicron BA.5, which can reach the alveoli. Some of them need assisted ventilation.” The peak of infections in the summer wave should reach in mid-July. Today the “unofficial” pluses in Italy can be about two million people. There were 84,700 cases recorded yesterday, with 325,000 swabs when we hit 1 million cases a day in December through January.
Covid: What is happening in hospitals?
Balzanelli explains that in hospitals, “we begin to notice oxygen saturation in the blood, especially in patients with cancer and blood diseases, despite the fourth dose of the vaccine.” In general, he adds, “the wards are filled with infectious diseases and there are also digestive symptoms.” Four sides of the 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-variable is resistant to high temperatures”. Third, “it’s incredibly contagious.” Fourth, “able to evade immune defenses,” as “we see people vaccinated with four doses or cured of Covid with high fever and cough and vaccinated with three doses with significant phenotypes.”
Palzanelli explains that many cases “are discovered by chance in the emergency room, where tampons are mandatory. They are people who are there for other reasons, completely asymptomatic.” This is above all a sign of “extremely high viral prevalence”.
Family Physicians: “Surge Pros, Not Pneumonia”
“As family doctors, we are noticing a massive increase in Covid infections ‘in Italy’ with numbers never observed in more than two years of the pandemic.” The latest national bulletin, with 84,000 new infections, represents an “impressive case series”, which “for some colleagues with many clients, means seeing up to 50 cases a day.” Silvestro Scotti, Secretary General of Fimmg, the Italian Federation of General Practitioners, tracks an Adnkronos Salute that is characterized by a new positive Sars-CoV-2 mutation, but “with predominant symptoms affecting the upper respiratory tract”, then without an increase in pneumonia. However, particularly “in this summer period – Scotty identifies – respiratory illnesses like Covid-19 can cause complications even not exclusively due to the virus. It’s one thing to catch a cold in the winter, when you tend to stay covered in the heat, The other takes place in the summer, subject to constant “external – indoor” changes in temperature, thanks to “air conditioning” and “risk factors that can create accessory complications”.
“I have fewer clients than the average Italian family doctor, because for obvious reasons I set the maximum number of patients at 1,000 – number one at Fimmg said – but only today I had 6 new positives,” versus “2-3 cases a day” Previously registered, “and at this moment I am following up about 30 positive patients in the isolation period, but they are all isolated at home, without the need for hospitalization or the appearance of symptoms affecting the lower respiratory system, even in light of the relatively young average age of the newly infected, which explains The use of antiviral drugs is also declining.”
Scotty works in Campania, which is a “young” area compared to the rest of the peninsula, “and in any case we also have elderly patients with comorbidities,” he points out. “What I see – highlights – is that at this moment, because they are aware of their vulnerability, they have a more defensive stance; they are certainly those who have higher vaccination coverage and are continuing prevention measures, using the mask and the tendency to avoid gatherings. So the elderly and people who are suffering Of the diseases, if they are a little more careful, they are less likely to get infections.”
Quarantine can change
The requests also do not stop the review of adherence to isolation by return mail, at least for those without symptoms and working in essential services or in any case introducing mini-quarantine as is happening in the United States where asymptomatic positives can leave home after 5 days and without work No examinations. Epidemiologist Pierluigi Lopalco calls on us to hurry up and change the rules for the isolation of people with Covid and launches the idea of removing at least home isolation for people who are asymptomatic and who work in essential services, such as safety and health, but always wear Ffp2.
If millions of people go into isolation all together, essential services will be at risk, starting with healthcare where 20,000 positive workers stayed home in quarantine alone in June. If the wave reaches its peak, as expected, in two to three weeks, home isolation could put transportation, hospitals and other public services into difficulties, which are already struggling with summer vacation days that often reduce staff.
Sooner or later home isolation of the infected will have to be generally rethought, because greater infection of the new variants and lower pathogenicity will be a feature of the evolution of Covid towards endemicity. Within the next week, in the event of another surge in infections, it cannot be excluded that the government and the Ministry of Health will “have to” quickly amend the existing rules on isolating positives.