“We denounce waste and malfunctioning of the local public health system. The direct consequence of this weighs on our shoulders, forcing us every day to intubate and hospitalize dozens of patients in intensive care, exactly as it happened in March – April. The speculation of private health care, with the indirect but concurrent complicity of bad public health management, is unacceptable “. Thus begins the indictment letter to an entire system delivered to Fanpage.it by a group of professionals who preferred to sign the report with an abbreviation that is only apparently ironic: “Some silent craftsmen of the anesthesia and resuscitation services of the metropolitan city of Milan”.
The reference is to another letter, that of the president of the Lombardy Region, Attilio Fontana, who on 5 November sent the letter to Lombard “doctors, health and social health workers” asking them to “work together and quickly” to defeat “an invisible enemy” who “has returned to condition our lives, to exert pressure on our hospitals “. The governor had written: “We need your precious contribution as ‘silent artisans of the culture of proximity and tenderness’, to quote the words of Pope Francis”. Many doctors didn’t like that quote because it seemed like a form of of earning goodwill not to mention system failures.
“The tracking of infections is inefficient”
“With this letter we want to highlight and denounce how the erroneous strategic decisions taken so far by our governors, deaf to the calls of the scientific communities, are a contributing factor to the current emergency situation in the metropolitan city of Milan. Today in Milan, the infection tracking system is inefficient and is reflected in a huge waste of public resources “, we read in the letter that it is anonymous because the authors (many) want to avoid personalization and above all to avoid references and threats to those who have exposed themselves by putting their name and surname. Not fear, but a precaution against an often vindictive world.
“The contacts by Ats for the surveillance of positives are delayed by weeks, arriving at the paradox that infected citizens are contacted at the end of the period of home isolation. This flaw in the tracing leaves it to individual responsibility to isolate themselves and communicate the their positivity to risky contacts, without any effective intervention by the institutions All this has very serious consequences on the regional health system, on the spread of the pandemic and on the health of citizens. It is not possible to declare that the tracking system has numbers that are no longer sustainable, if the tracking is not carried out correctly. Thousands of swabs were made last summer in airports to control return flows (a practice of doubtful utility, as it assumes that the prevailing access to a metropolitan area such as that of Milan is limited only to airports or stations ) yet now, it is not possible to monitor the outbreaks within the city “.
“WHO guidelines are not followed”
The central point of the doctors letter is dedicated to “contact tracing” and the guidelines of the World Health Organization (WHO), according to which “when applied systematically, contact tracing breaks the chains of transmission of an infectious disease and is therefore an essential tool for public health to control infectious disease outbreaks “. Well, the signatory doctors write that “the statements of the leaders of the Higher Institute of Health (ISS), promptly re-launched by the management of Ats Milano in public statements released a few weeks ago, are in contrast with the recommendations of the WHO and the national scientific societies and international “why”lowering epidemiological surveillance at this stage of the epidemic is dangerous and not justified for a public health body such as the ATS “.
“The Immuni app is useless without Ats quick response”
The problem, according to the signatories, is that the number of people dedicated to contact tracing by Ats is “obviously insufficient” and this contributes to fuel the “delay of weeks between the positive response to the swab and the telephone contact. 100 per cent usefulness of the tracking. To this waste of resources is added that of the funds invested by the government for the IT tracking through the Immuni app. The positivity to the system can only be reported through the ATS health worker: as long as the Ats does not contact the positive to the swab, the positivity cannot be reported to the application and therefore the system is not able to record the movements of the positive, totally nullifying the usefulness of tracking via the app “.
Speculation and economic interests, the citizen pays
Then there is the economic question, not a trivial matter. The doctors do the calculations: “The inefficiency of the identification and tracing system by Ats leads to an exponential increase in the use of private screening services (swabs and serological blood tests) which fill the lack of accessibility to public services. Milanese families to whom close contact with a positive is communicated have no alternative but to turn to private paid structures (with costs up to 130 euros for a tampon). The speculation of private healthcare, with the indirect but concurrent complicity of bad public health management, it is unacceptable.
Funds for emergency management should be equally divided between: the strengthening of care systems (expansion of places in intensive care units and optimization of measures in support of public hospitals and healthcare personnel) and prevention systems. It is inadmissible that almost a year has passed since the beginning of the epidemic and the state of emergency imposed by the first pandemic peak, there is no accessible and rapid public system for booking screening tests for the population “.
Finally, the latest jab at the Lombard top, starting with the governor: “The Lombard public health management escapes that the cure for a pandemic phenomenon of this magnitude is primarily given by prevention, as recommended by the WHO Guidelines, while the treatment of the sick is much more complex and expensive. Our impression is that the efforts and investments reserved for the care of the sick are not equally balanced on the prevention front “.
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