Covid. Are the masks back? “If the situation worsens, reintroduce the obligation indoors”. The draft circular of the Ministry of Health. But in the evening, Minister Speranza stops everything

by Luciano Fassari

A new document is ready with directions to prepare for the cold season. “Although the evolution of the pandemic is currently unpredictable, our country must prepare – for the third consecutive year – to face an autumn and a winter in which we could observe an increased health impact attributable to various acute respiratory diseases”. But in the evening the minister stopped everything: “No circular to be published”. THE DRAFT OF THE CIRCULAR

04 OCT

“In Italy, the mandatory use of masks in health and long-term care facilities is still in force, in accordance with the provisions of the order of the Minister of Health of 29 September 2022. Their use in closed public spaces may be a first option to limit transmission in the community in the event that an evident epidemiological worsening is documented with a serious clinical impact and / or on health care and / or on the functioning of essential services. Similarly, in the event of a significant worsening of the epidemic, the temporary adoption of other measures may be considered, such as working from home or limiting the size of events involving gatherings “. This is what we read in a draft circular that the Ministry of Health is preparing in which they provide some indications in view of the cold season.

But in the evening, Minister Speranza brakes the technicians (who had already agreed on the text with the Regions): “No circular coming up. The monitoring of the epidemiological picture continues and we continue to recommend the fourth dose for the frail and over 60”.

In any case, this is what the draft circular envisaged.

“Although the evolution of the pandemic is currently unpredictable – we read -, our country must prepare – for the third consecutive year – to face an autumn and a winter in which we could observe an increased health impact attributable to various respiratory diseases acute. The future of the Sars-Cov-2 pandemic depends not only on new variants that can emerge and replace those previously circulating, but also on the behavior and immune status of the population. It is particularly important to avoid congestion in health care facilities by limiting the incidence of serious COVID-19 disease by protecting especially the most vulnerable people and by affecting modifiable factors for which health systems and society must continue to adapt their response to the epidemic. of Sars-Cov-2 “.

The Ministry recalls that “various factors contribute to making the epidemiological evolution and the repercussions on the health system in terms of the demand for assistance uncertain, including:

– Characteristics of the SARS-CoV-2 virus in autumn: the epidemiological and impact trends on health systems could change following the appearance of new viral variants capable of increasing the transmissibility or clinical severity of cases.

– Degree of adherence to the vaccination campaign (4th dose) and compliance in observance of sanitary and behavioral measures for the prevention of transmission of SARS-CoV-2 by the general population.

– Reopening of schools.

– Stay indoors during the winter months.

– Degree of co-circulation of other respiratory viruses (influenza virus, parainfluenza virus, respiratory syncytial virus, etc.) and adherence to the 2022-2023 influenza vaccination campaign.

– Degree of immunity / susceptibility of the population towards infection and serious disease.

– Mobility of the population.

– Long-term effects of SARS-CoV-2 (Long COVID) infection.

In this context, “in the autumn-winter period 2022-2023, the Ministry and the other national institutions will continue to ensure clear, complete and evidence-based communication in order to encourage conscious adherence to institutional recommendations”.

Furthermore, it will be “essential to ensure a sufficient sequencing volume to monitor the viruses in circulation and the emergence of new viral variants and an adequate diagnostic capacity of the laboratories. Therefore, it is strongly recommended at least in elective contexts such as hospitals and emergency rooms, to collect samples to be subjected to molecular tests, to ensure in each Region / PA a minimum number of samples to be genotyped ”.

VaccinationtheIn the autumn-winter 2022-2023 season, the goal of the vaccination campaign will be to continue to make the elderly and frail safe as a priority, protecting them from serious illness and hospitalization.

Priorities and factors to consider in preparing and implementing new vaccination strategies1 include:

– the continuation of the current vaccination campaign, filling the gaps in the vaccination coverage of the primary cycle and of the recommended boosters and maintaining a sufficient vaccination capacity;

– the possibility of combining vaccination campaigns against COVID-19 and influenza;

– the development of vaccination programs with adapted vaccines, identifying priority population groups and ensuring that there is sufficient availability of doses;

– monitoring the efficacy and safety of adapted vaccines once large-scale deployment has begun;

– the implementation of effective communication strategies to promote the intake of booster doses, the completion of the primary series and the campaign on new and adapted vaccines and protein vaccines.

In the autumn-winter 2022-2023 season, the identification of cases through tests, the isolation of cases and the targeted search of contacts for the Ministry “continue to be useful tools for managing the SARS-CoV-2 epidemic, particularly in contexts where the risk is higher, a high impact of COVID-19 on health services. According to recent WHO indications, it would therefore be appropriate to focus on targeted measures that protect vulnerable populations. Contact tracing and quarantine should primarily be conducted and applied in individuals at risk of serious illness, high-risk settings (healthcare, nursing homes and long-term care facilities), and in situations of greater concern (e.g. , an emerging variant of interest or concern). Furthermore, for the autumn-winter 2022-2023 season it will remain important to comply with any precautions recommended in closed environments where outbreaks of high transmission are more likely to occur ”.

Furthermore, the circular invites to “ensure adequate ventilation in closed environments it is a key measure to reduce the risk of transmitting SARS-CoV-2 and other respiratory viruses ”.

Measures of organization of health services
For the autumn-winter 2022-2023 season, the Ministry “considers it essential that the regional health services verify, and if necessary strengthen their state of preparation in order to face a possible increase in the demand for assistance for cases of SARS infection- CoV-2.


04 October 2022
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