The pandemic has taught us how a family doctor should be prepared for interventions in the area in the area of infection. We need a new plan to take charge of the Covid patient and proactively intervene in the fight against HIV and hepatitis. Professor Claudio Criselli, President of SIMG: “We need to design a new training paradigm based on increased awareness, concrete tools, and capacity to intervene for early diagnosis and immediate application of appropriate treatment”
Rome, 7 July 2022
General medicine is trained in infectious diseases
To credit the GP with a critical role in the management of infectious diseases, from COVID-19 to HIV and hepatitis. This is one of the needs that emerged with the epidemic: its effects, in fact, were not only on chronic diseases, but were certainly punishing for limiting examinations and diagnoses. Even some infectious diseases, chronic or treatable, have been neglected, while it is the family doctor who can play a decisive role in this.
From here begins a new training and information project. “We have begun to design a course for new generations of physicians – confirms Prof. Claudio Criselli, President of SIMG – this process relates primarily to so-called acute diseases, which are sometimes underestimated by general medicine. As shown with Covid, these cases today represent cases of Emergencies, they are part of everyday life and patients come to the specialist when opportunities for a solution have already been missed. So we must design a new training model, based on greater awareness, tangible tools, and the ability to intervene for early diagnosis and immediate application of appropriate treatment.”
We Stand with Public Health: A Call to Action for Infectious Diseases project. Public Health: Present and Future”, organized by the Regia Congressi under the auspices of the Italian Society for General Medicine and Primary Care – SIMG and the Italian Society for Infectious and Tropical Diseases – SIMIT, was presented in the press room of the Chamber of Deputies at the initiative of the Hon. Mara Labia, 12th member of the Committee on Social Affairs, Council Representatives.
The introduction was made by the professor. Claudio Criselli, President of SIMG, and Prof. Massimo Andreoni, Scientific Director of SIMIT. Alessandro Rossi, Project Coordinator and SIMG Infectious Diseases Area Director, presented the project. Ignazio Gratagliano COVID-19 Coordinator of SIMG Activities enters with “new organizational models for the management of Covid-19 patients”; Barbara Soligoy, Head of the Center for AIDS Operations at the Graduate Institute of Sanita, with “HIV as a Chronic Disease: Long-Term Integrated Health Management”; Professor Loretta Condelli, National Center for Global Health, Higher Institute of Health HCV, with Expansion of Screening Programs; the professor. Marco Bordere, Medical Director of the Infectious Diseases Unit at St Ursula Malpighi Infirmary, Bologna, with “Integration of Services for Effective Management of HDV”. Science journalist Daniel Della Sita Cedre.
SIMG project to manage new viruses
The SIMG project will be expressed during the upcoming winter 2022-2023 through a cycle of four webinars focusing on several infectious diseases: Covid-19, HIV, hepatitis C and delta hepatitis. The choice dictates the job the family physician can perform. With regard to Covid, in addition to maintaining an important role in vaccinations, the GP will have to work to intercept any complications, and suggest prescribing treatments with direct antivirals or monoclonal antibodies quickly to the most vulnerable patients, solutions that have maintained their viability despite the evolution of variables.
For 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 administration of effective antiretroviral therapy, making viremia Not detectable in the blood.
On the other hand, the hepatitis C virus can be permanently eradicated, thanks to new treatments, within a few weeks and without side effects. For delta hepatitis, the most severe of the different types of hepatitis, the new polyfertide molecule represents a revolutionary advance because it allows the treatment of patients who were previously unable to receive any treatment.
The problem of HIV, CV, and HDV is attributed by late diagnosis, which often occurs when the patient already has AIDS (in the case of HIV) or is on the way to serious cirrhosis or hepatocellular carcinoma in hepatitis. So what has not been announced is significant and screening is currently insufficient.
“The GP’s role in these four infectious diseases must become proactive – as Alessandro Rossi emphasizes – he must be a careful monitor of the risk profiles of his patients who he knows well, establish screening interventions and, when necessary, suggest vaccinations for vulnerable people. Of course, care must revolutionize Regional with new information, information technology, personnel, and network tools to reduce hospital burden and allow GPs to better manage at-risk patients.The four webinars will feature the contribution of various stakeholders: on the one hand, there will be the scientific world, represented by SIMG and SIMIT, as well as health authorities; On the other hand, there will be strong interaction with institutions, particularly regional institutions, whose commitment is essential to implementing effective screening programs and linking them to care.Following these initiatives, SIMG will provide tools for clinicians to be incorporated into the GP profile, who will be able to refer to the guidelines Modern laws, updated laws, scientific analyzes and a scientific observatory of health research. For general medicine, it will be a process of formation and integration.”
“The epidemic has shocked the whole world and made it difficult for public health not only in hospitals, but above all in helping with chronic diseases – emphasized Prof. Massimo Andreoni – among the chronic diseases there are also infectious diseases that have this meaning. We have had great difficulty in helping detection of this type of disease.This refers to the shift from a public health system dominated by the hospital to a network between the hospital and the district, so that the latter can take over some activities and focus the hospital on acute patients.This different organization may prefer treatment continuity and diagnosis of any new diseases”.
“Greater interaction between general practitioners and infectious disease specialists is essential – highlights the Hon. Mara Labia – future health lies in more rooted local medicine, with in-depth training and the ability to rapidly intervene in screening and diagnosis, which, if arrived in time, may be Crucial for some diseases not only for survival, but also for ensuring a good level of quality of life. Therapies, treatments, follow-up and controls can become solutions especially in fragile patients such as cancer patients, for whom the link to care for an infectious disease can be more relevant.”