According to the latest data available, in Italy there are currently 516 thousand coronavirus positive people, a number that does not include the thousands of people who in all likelihood have not yet been included in the counts, having been infected in the days immediately preceding the Christmas weekend or precisely in the weekend just ended, without have still had the opportunity to take a test. It is a figure that according to all projections will rise quite rapidly in the coming days, due to the omicron variant and the frequency of gatherings between family and friends at the holidays.
Considering that at the moment deaths and ICU admissions are much lower than in previous waves, due to the evident protection offered by vaccines against severe forms of COVID-19, it means that in all probability there will be a number of of people in quarantine as had never been seen since the start of the pandemic. In fact, the overall positive people had been significantly more at the end of November 2020, when however the greater restrictions and precautions limited the number of contacts at risk.
The quarantine, which has so far been fundamental and essential for the containment of infections, will probably become a problem both for the tampon system already in crisis, both for the world of work. It is possible that the absences of isolated people as a precaution create imbalances and inefficiencies. For this reason, the question has become topical as to whether the rules on quarantines for close contacts should, or at least can be, made less stringent.
It is a delicate issue in which the right to health, especially in the workplace, and the need to live with the coronavirus must be kept together. Furthermore, changing protocols in a more permissive way is particularly risky at a time when the epidemic curve is growing again.
There are no data or estimates on people currently in isolation or quarantine because they are positive or because they have contacts with positive people. Neither of those that are formally, on the orders of the ASL, nor of those that are informally: with the contact tracing which has already jumped everywhere, and with the parties out of the way, these days there are thousands and thousands of people who have isolated themselves without following any official protocol, but because informally warned by positive acquaintances with whom they have been in contact.
Estimating that there are at least 3 or 4 for each positive person, we already reach a total between 1.5 and 2 million, only considering the positives already officially registered. It is conceivable, or at least plausible, that the total number of people in quarantine will be in the order of a few million in a few days.
– Read also: What to do if you have had contact with a positive
This situation could also worsen in the very short term, with the effects of gatherings on holidays.
Within a few days, from early January or at the latest after the Epiphany weekend, many workplaces may have an attendance problem. It is the reason why in these days some experts are asking that the rules on the quarantines of close contacts of positives be changed: it would be an operation deemed necessary to coexist more functionally with the coronavirus, but at the same time very delicate to decide at a moment in time. which the omicron variant is spreading very quickly, also infecting vaccinated people and without the consequences being very clear, with the most pessimistic scenarios not very encouraging.
Currently, the protocols of the Ministry of Health provide for a 7-day quarantine period for people who have completed the first part of the vaccination course for at least two weeks (therefore two doses, or one for Johnson & Johnson) and who have been in close contact with a positive. This form of quarantine is exited after seven days with a negative molecular or rapid test. Same procedure for the unvaccinated, but for 10 days instead of 7. If you don’t want to get tested, or if you can’t do it, you leave after 14 days without symptoms. There is no quarantine for vaccinated people who have had “low risk” contacts, ie essentially – da definition of the minister – close but lasted less than 15 minutes.
These are the official rules, then the reality is something different: the ASLs are not already managing to trace the contacts of the positives, and therefore a large piece of the isolation and quarantine mechanism is taking place informally, through the reports of the people. involved and the subsequent precautions taken on individual initiative and sensitivity.
It means that in fact in these days and in the coming weeks a significant percentage of the quarantines will not be enforced by the health authorities, but will in fact be self-regulated. Even in these cases, when there are no formal impositions, the indications and rules of the Ministry of Health regarding the duration of the quarantine and the tests must be observed.
– Read also: Omicron appears to cause milder symptoms
These days the media are reporting some calls for health protocols to be changed in order to shorten the quarantine period for close contacts vaccinated, or at least for those who have already received the third dose. For those who have received the recall, in fact, high protection is also confirmed against the omicron variant at least as regards serious illness, although the effects on simple infections are not yet consolidated.
These requests are supported with the first studies, yet to be confirmed, according to which the omicron appears to cause milder symptoms: the National Health Safety Agency of the United Kingdom (UKHSA) he estimated that for people with an omicron variant infection, the risk of hospitalization is 50 to 70 percent lower than for delta variant infections. It is practically certain that the next rapid investigation by the Istituto Superiore di Sanità will find that omicron has become prevalent among the new infections.
The real effects of the period of strong mobility and conviviality of the days between those before Christmas and the beginning of 2022 will be fully seen in the first half of January. But with the data available it is likely that for a while the infections will increase daily by tens of thousands.
There is great concern about the consequences that could have on the health system. Although omicron causes fewer hospitalizations, the significant increase in infections could put hospitals under enormous stress, with the risk of saturation of intensive care. In short, the risk is that many more people contract the coronavirus in a short time than previously and that therefore the rare cases in which the vaccine does not protect against the disease are many in absolute terms.
To put it more brutally: if many people are infected it is inevitable that there will be more sick people, even among the vaccinated.
If this possibility worries the experts and managers of the health authorities, with many requests not to relax the precautions in such an uncertain and delicate moment, more and more people are warning that such a high number of infections risks having significant consequences even outside hospitals: precisely because of the high number of people who could end up in quarantine.
The test system, both public and private, may fail to answer the question, as already happened in these days of Christmas. It means that for many people who have had risky contacts, ascertaining their negativity could be long and complicated, with the possibility of not being able to get out of quarantine even after a week. A limited ability to test is also a clear obstacle to further shortening quarantine times for close contacts, a relaxation of precautions that should probably be compensated for by guaranteeing more swabs.
Quarantines also have consequences on the workplace: cases of entire offices or departments where staff are at home for a positive case are increasingly frequent. What was a fundamental public hygiene practice before the vaccination campaign risks being difficult to sustain in many contexts after almost two years of pandemic, especially with tens of thousands of new cases a day.
Smart working, that is the main solution to this kind of problems, in many private workplaces was strongly discouraged during 2021, and the government itself discouraged and limited it in the public administration. The companies and offices in which it has not been maintained and structured, often because it was deemed to be detrimental to productivity, today find themselves in great difficulty in these two years.
In any case, there are many sectors in which smart working is not applicable or is only partially applicable, and the case of the thousands of international flights canceled in recent days due to infections among ground or on-board personnel. is an obvious example the possible consequences of the increase in cases on essential services.
Reconciling the need to guarantee these services and to avoid production imbalances in general with that of continuing to protect the right to health of workers could soon become one of the main problems of the government. Also because there is an accumulation of reports and complaints of cases in which many employers have already been autonomously deciding that the current quarantine system is not sustainable, requiring employees to violate health rules precisely in order not to compromise productivity. For example, by not denouncing close contacts in the office, or by lobbying for those with symptoms not to undergo tests and still show up for work, putting public health at risk.
– Read also: The boring pandemic
The quarantine rules in Italy, at the moment, are particularly restrictive when compared to those of other countries: but in all cases, the looser rules were formulated before the arrival of omicron, and it is not certain that they cannot be of again exacerbated in the coming weeks with the increase in infections.
Currently the Center for Disease Control (CDC), the US public health authority, they do not prescribe for example the quarantine for people who have completed the first part of the vaccination cycle for at least 14 days and have been in close contact with a positive, in case they have no symptoms themselves. They only recommend wearing the mask indoors and getting tested after 5-7 days. The guidelines also provide for the possibility of taking the quick test yourself, possibly asking the health authorities for help on how to do it.
Also in the UK the guidelines of the National Health Service they do not foresee that you should quarantine yourself if you have been in contact with a positive (and not even if you live with it) if you have completed your first vaccination course for at least 14 days, or if you are under the age of 18 and six months. They “strongly” recommend taking a quick test every day for seven days, limiting contact with the people most at risk and scrupulously following the hygiene rules linked to the pandemic. However, it is foreseen that the health authorities may order the quarantine of close contacts in certain specific cases.
In Germany, quarantine it is not currently planned for close contacts of positive people who have completed the first vaccination course by 14 days. But for those who have been in contact with a variant of interest (from which the delta is excluded), even if vaccinated, a 14-day quarantine with health monitoring is still prescribed. With the spread of omicron also in Germany, and given its ability to infect vaccinated people, the health measures to be applied to those who are vaccinated are being re-discussed in these days.
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