Asymptomatic positives, so the rules change from February 1st – RB
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Asymptomatic positives, so the rules change rules from February 1st – RB
Asymptomatic positives, so the rules change from February 1st – RB We have explained the details of the news, step by step, below. Asymptomatic positives, so the rules change from February 1st – RB Keep reading our news. Here are all the details on the subject.
Asymptomatic positives, so the rules change from February 1st – RB
After the pressing of the governors which had lasted for weeks now, here is the carried out “save Regions” by the Ministry of Health . Minister Roberto Speranza has decided to change the method of counting the number of positives in the daily Covid data bulletin.
What changes for Covid positives
What changes? From the daily calculation of the new Covid infections the patients hospitalized for different causes but positive for Covid will be separated ( here when you have to swab according to the new rules and for those who are free).
In the circular that Speranza has just issued, we read that “the patient hospitalized for various reasons is positive for the test for Sars-Cov-2, but asymptomatic for Covid medical Covid, without prejudice to compliance with the principle of separation of paths and safety of patients “.
Basically, hospitalized patients who have undergone a Covid test and positive results, if asymptomatic, will be counted as a Covid case but not included in the total of hospitalized for Covid . Patient safety will obviously remain guaranteed, according to the principle of separation of paths and isolation areas.
What changes from 1 February
Obviously, the novelty of the count implies new rules also for the Regions and for their color change , between the white area , yellow, orange and red. In fact, it is no longer only the data on new infections that determines the passage into another color band, but also and above all that relating to the positives that end up in hospital, in non-critical area or in intensive care.
The new rule enters into force on February 1st 2022 , when the wording “Covid patients hospitalized for different causes” will appear in the bulletin, which will therefore be separated from the other hospitalizations. In the meantime, there will be a note in the general notes to distinguish patients admitted for other reasons.
However, no news regarding the definition of the Covid case : admitted positives “must be traced as cases and communicated to existing surveillance systems “, reads the circular.
Piedmont anticipates the government
A region in the meantime has anticipated the government. This is Piedmont , which has increased the number of beds for hospital admissions, thus avoiding the orange zone .
In fact, in the region led by Alberto Cirio the punctual RT calculated on the symptom start date goes from 1. 44 to 1. 88 and the positive percentage of the swabs rises to 30%. The incidence is 2. 227, 32 cases every 100 thousand inhabitants. The occupancy rate of the intensive care beds is 3.2 points above the threshold (23, 2 %) and that of ordinary beds is 28, 4%, just below the threshold of 30%. Numbers that could have led Piedmont straight into the orange zone, and which instead confirms itself in the yellow zone.
In agreement with the Ministry, and in line with what has already been done by other Regions, Piedmont has added others in the medical area 970 placed at 5. 824 who were already part of the potential . In particular, 500 new posts are the result of the collaboration with the private health system and the others of the reorganization in the health companies envisaged by the regional pandemic plan.
Because asymptomatic positive cases must still be counted
Just the day before the Ministry’s decision, the ISS spoke of the importance of monitoring cases through surveillance, which should not be confused with the criteria by which indications for cases and contacts are decided, and of the fact that positives also asymptomatic are still counted.
But why does the surveillance case definition have to contain positives even asymptomatic and not only the cases with symptoms more indicative of Covid, such as respiratory symptoms, high fever, altered taste and smell etc.? The ISS explains that SARS-CoV-2 infection gives a variegated and evolving symptomatology also due to the appearance of new viral variants that interact in a different way with our organism. This makes it very difficult to clinically recognize a symptomatic SARS-CoV-2 infection in the absence of laboratory confirmation .
Experience has also shown that most infections, particularly in vaccinated subjects, proceed asymptomatically or with very nuanced symptoms. Not monitoring these cases would limit the ability to identify the emerging variants , their characteristics and the status could not be known clinical consequence of infection in different populations, for example by age, vaccination status, comorbidities.
Not only. Nor would it make it possible to monitor the trend of the circulation of the virus over time and, consequently, the risks of a detrimental impact on the ability to maintain adequate levels of health care even for diseases other than Covid.
What changes for self-monitoring and quarantine
Some have retorted by trying to argue that the definition of case used in epidemiological surveillance defines the new self-surveillance and quarantine measures. But is not so.
As the ISS always explains, the definition of the case used for the national epidemiological surveillance does not include the contacts of the confirmed cases and the same surveillance does not monitor their progress over time. Therefore, the definition of case used in surveillance plays no role in defining self-monitoring and quarantine measures (here the new quarantine rules in force).
Same goes for the rules concerning isolation . Although they have in common a need for diagnostic confirmation using antigenic and molecular tests, a positive case according to the definition of surveillance is evaluated according to a series of criteria to define the different modalities of isolation.
Towards syndromic surveillance?
As proof of this, the $pean ECDC last January 7 updated its indications relating to quarantine and isolation , without changing the case definition used for epidemiological surveillance.
ECDC did not change the case definition used for surveillance of SARS-CoV-2 infections and / or cases of illness. In fact, it has always been the same since December 2020 and is available online on the website of the $pean Center for Disease Prevention and Control.
What at the moment the ECDC has only suggested , in a dated document 18 October 2021, with a view to returning to normality after the end of the pandemic emergency, is the future transition to a syndromic surveillance system , similar to what currently used for influenza.
That is, surveillance systems based no longer on the diagnosis of the disease, but on the presence of a set of signs and symptoms, which constitute a syndrome. It also applies to other diseases, such as measles: instead of reporting cases of suspected measles, all patients with fever and skin rash are required to be reported, which will then be investigated with appropriate laboratory investigations to confirm the etiology.
This type of surveillance is less specific but at the same time it is much more sensitive, because it also takes into account all cases of uncertain diagnosis that otherwise would not be reported by doctors.