Use of masks indoors, home work and reduction of mass aggregations, ventilation of closed environments and intensification of the fourth doses of the anti-Covid vaccine and a further dose for some categories at risk. These are some of the actions indicated by the Ministry of Health, in the event of a worsening of the epidemiological situation, in the circular ‘Interventions in place for the management of the circulation of SarsCoV2 in the winter season 2022-23’. The document indicates the interventions in the event of a worsening of the evolution of Covid in Italy.
Masks
Their use “is effective in reducing the transmission of respiratory viruses and in the event that an evident epidemiological deterioration is documented with a serious clinical impact and/or on the functioning of welfare services, their use in closed spaces could be indicated, aimed in particular to protect people at high risk of serious illness”. At the moment in Italy the use of respiratory protective devices is mandatory for workers, users and visitors to healthcare facilities and nursing homes. The circular also calls for ensuring “adequate ventilation in enclosed spaces”.
Agile work and gatherings
“In the event of a possible significant worsening of the epidemiological picture, the temporary adoption of other measures can be evaluated, such as working from home or limiting the size of events involving gatherings”.
Swabs and sequencing
Strengthen surveillance systems and increase genomic sequencing to detect new variants of the SarsCoV2 virus. It is strongly recommended, at least in hospitals and emergency rooms, to collect samples to be subjected to molecular testing, to guarantee a minimum number of samples to be genotyped in each Region”.
Vaccines
The ministry recommends the anti-Covid vaccination in the 2022-2023 winter season, with the aim of “continuing to secure the elderly and frail as a priority, protecting them from serious illness and hospitalization”. The administration of the fourth doses with bivalent vaccines is recommended for categories at risk, and an additional booster dose with mRNA vaccine in the bivalent formulation “is currently recommended for the following categories of people who have already received a second booster dose with monovalent mRNA vaccine, once at least 120 days have passed since the same or since the last infection: people aged 80 and over, RSA guests, people aged 60 and over with frailty.
hospitals
For the winter of 2022-23, it is “essential that the regional health services verify and, if necessary, strengthen the state of preparation in order to deal with a possible increase in the demand for assistance for SarsCoV2 cases”: verification of beds in hospitalization and intensive care; the procurement of devices, drugs, vaccines; the availability of trained healthcare personnel who “can support local departments and services in the event of an increase in cases such as to exceed the current capacity of the healthcare systems”.
Home care
The clinical management of patients with Covid allows early management of the infection by limiting the overload of healthcare facilities. This management “has evolved over time, reflecting the evolution of knowledge relating to the pathogenesis, the symptoms presented by patients, new evidence on therapies, and the availability of new antiviral drugs and monoclonal antibodies”.
