Covid Italia, masks and smart working if the epidemic worsens: circular draft

Masks, smart working, event limits: these are the measures hypothesized if the covid epidemic were to worsen in Italy with an increase in infections and in particular in hospitalizations, as evidenced by a new circular from the Ministry of Health, currently still in draft and all examination of the Regions – Adnkronos Salute learns – in which some indications are given in view of the cold season.

“No circular in publication. Monitoring of the epidemiological picture continues and we continue to recommend the fourth dose for the frail and over 60”, specify sources from the Ministry of Health.

The draft

In the case of “an evident epidemiological worsening” of Covid-19 “with serious clinical impact and / or on health care and / or on the functioning of essential services”, the use of masks “in closed public spacesi may be a first option to limit transmission in the community. Similarly, in the event of a significant worsening of the epidemic, the temporary adoption of other measures, such as the work from home o limiting the size of events involving gatherings “.

The summer wave of Covid-19, caused by Omicron BA.4 and BA.5, highlighted “, reads the introduction in the draft of the circular,” that the pandemic is not yet over. “” Several factors contribute to making uncertain the epidemiological evolution and the repercussions on the health system in terms of the demand for assistance “: from the appearance of new viral variants able to increase the transmissibility or clinical severity of cases, the degree of adherence to the vaccination campaign (fourth dose) and the observance of sanitation and behavioral measures, up to the co-circulation of other respiratory viruses (influenza, parainfluenza, respiratory syncytial virus, etc.).

“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 an increased health impact could be observed, attributable to various acute respiratory diseases”, he said. reads in the draft of the document. “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 facilities by limiting the incidence of serious illness, especially protecting the most vulnerable people and influencing modifiable factors for which health systems and society must continue to adapt their response to the epidemic of Sars-Cov-2 “.

“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”, reads the provision signed by the director. Health Prevention of the Giovanni Rezza Health Ministry and Stefano Lorusso Health Planning.

The document also underlines how, in the coming winter season, “an increase in pressure on laboratories and for diagnostics is likely, but also more generally, on virological surveillance networks due to a greater seasonal circulation of respiratory viruses”, and therefore recommends the need to foresee “mechanisms for strengthening the systems in place. It will, in fact, be essential – we read – to ensure a sufficient volume of sequencing 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 “.

And again, on the vaccinations: “in 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”. Therefore it will be a priority – according to the ministry – to “consider in the preparation and implementation of the new vaccination strategies” a series of factors including the continuation of the current vaccination campaign, filling the gaps in the vaccination coverage of the primary cycle and the recommended boosters; the possibility of combining vaccination campaigns against Covid-19 and influenza and vaccination programs with adapted vaccines, identifying priority population groups and ensuring that there is sufficient availability of doses.

Finally – according to the Ministry of Health – “the identification of cases through tests, the isolation of cases and the targeted search for contacts continue to be useful tools for managing the SarS-CoV-2 epidemic”. “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. example, an emerging variant of interest or concern) “.