They have a fundamental role: they allow hospitals to keep some free beds, support general practitioners and pediatricians, who are particularly stressed during this period, and help patients feel less alone and more cared for.
We are talking about the special assistance continuity units, the Usca. That is, the doctors who manage Covid patients at home: those who take the car every day, arrive at the positive person’s house, wear overalls, gloves, mask, visor, and enter the infected person’s apartment for a check-up or to administer drugs. They are sentinels of the territory, who work in very close contact with general practitioners and pediatricians, allowing the hospitals to breathe (euphemism, given the situation).
Among the 13 doctors in the very first line there is also Francesca Desiderato: 28 years old, born and raised in Rovereto, in a year and a half he will complete his career at medical school and “then I dream of becoming a family doctor in Rovereto, that’s what I’ve always wanted”. In the meantime, since last March she has taken the field to help and train herself, as well as «being able to always be on the spot, informed about therapies and research, living Covid in close contact with patients. Today I made 8 home visits with the nurse and now I’m writing the diaries of the people treated ». There are 13 doctors in the special care continuity units. A number that should be increased, as also requested by the Medical Association.
Doctor, you are on the front line: how is the situation?
People who are cared for at home and have symptoms are growing: to give a given I who follow Vallagarina and Altipiani Cimbri I currently have 41 people, or rather families, but only two weeks ago they were 3. The trend is clearly growing.
But are we still far from the situation in March? And “clinically” do people feel the same way?
In spring we managed to have about 300 nuclei, today in Trentino we have about 200. So there are margins, but what is worrying is the fact that in the area it doubles from week to week and it would take more staff. As for the variety of clinical pictures, we see many different ones both before and now. The difference is in the work to be done.
Explain to us better.
In March our contribution was mainly by telephone, for patient monitoring. We were less aware of the virus and people tended to be treated in hospital. Now we try in every way to avoid hospitalization: let’s say that people with similar parameters ended up in the ward in March while today we try to follow them at home and we know which drugs to administer: those that work best can also be given at home.
You who have experienced the first wave and are experiencing this beginning of the second, did you expect it?
Certainly not so disruptive, I would never have believed that the second wave would be a bomb, so fast and so strong.
When and how do you enter the scene?
The clinical management of the Covid patient is the responsibility of the general practitioner, who can decide whether or not to activate the Usca. Some doctors prefer to take care of everything and make do, others entrust us with some aspects, still others accompany us to visits. There are three main services: medical examinations, telephone monitoring and the supply of the oximeter, a fundamental tool for verifying an aggravation of the situation.
The visits are not easy: you don’t ring the bell and drink coffee with the patient …
No. We leave with the bag and I use clothes only for when I visit, which I don’t take home except to wash them. Under the domicile there is an airy place and there is barda, with the help of the nurse or colleague, or sometimes it is I who help them if it is they who enter. There is an automatism, a delicate sequence that must be done carefully. And then the undressing, no less important, because everything you wore must be considered contaminated.
Is your private life also affected by this work in contact with the virus?
Let’s say that I have given myself a progressive shortened hair and I take showers after showers. And then no visits to grandparents, goodbye to family lunches and dinners and the few encounters are remote and with a mask. But the professional experience is really very formative, I’m happy. Even if it is hard and the most difficult moment is when the “weapons” run out and the patient must be transferred to the hospital.
How do you treat positive people at home, who are currently 1,896 in Trentino, but fortunately for the most part asymptomatic?
Care is a big word. Let’s say that there are support drugs, from tachipirina to heparin, passing through cycles of cortisone, which I never recommended, however, and classic cough remedies.
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