Boom of positives to operate. 'Protocols are missing'

The growth of cases is bringing out a new criticality, that of asymptomatic Covid patients who need to be operated on, for example for a tumor, a fracture or a hernia, but who test positive for the virus at the time of admission to hospital. To focus attention on "a neglected phenomenon" is the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care. "This is a population that is growing exponentially these days - explains Antonio Giarratano, president of Siaarti - for which we need dedicated protocols and spaces that today are not codified. The result is that every company organizes itself as it sees fit: in some cases they are operated on, in others there are dangerous delays, and in the meantime beds are often occupied in this way in wards destined for critical Covid ".

The problem is, explains Roberto Balagna, Siaarti's head of critical emergency medicine, that in many cases, "we are forced not to operate on patients who would need surgery of a certain importance and necessity, for example cancer patients. , increasingly numerous, of vaccinated patients, often with three doses, asymptomatic and who test positive for the swab performed at the time of pre-hospitalization ". In many regions, Angelo Gratarola, head of anesthesia and perioperative medicine of Siaarti explains in a note, "there is consequently a risk of territorial orange for patients hospitalized not because of Covid, but only for the incidental positivity discovered in the emergency room. The Ministry della Salute should, after hearing the scientific societies,offer indications and operational guidelines to be able to subject patients simply positive for the virus to surgery ". In the absence of well-defined indications at national and regional level, the clinical, logistical and organizational management of these paths is becoming" increasingly critical "." We need - asks the president Siaarti Giarratano - clear indications to avoid collapse ".

The growing number of coronavirus positives who are in hospital for reasons other than Covid related, also affects the delivery rooms. Women in childbirth "are still too often exposed to contagion from Sars-Cov-2, because they are still largely unvaccinated. Labor or obstetric urgency in general, however, cannot be postponed and this entails pressure on the structures, which can compromise the safety of the birth path ", explains Maria Grazia Frigo, responsible for mother and child care at Siaarti. In previous pandemic waves, he explains to ANSA, "we had far fewer positive women in labor, but with Omicron the numbers have increased a lot in this population as well. We must be very careful, because positive women can have preterm births and complications of various kinds. .The children of positive are generally born negative but there have also been some cases of maternal mortality in pregnancy and abortion due to Covid-19 in Italy. Therefore, as indicated by the Istituto Superiore di Sanità and the scientific societies, it is very important that they get vaccinated ". Moreover, continues Maria Grazia Frigo," if a woman arrives positive at the time of giving birth, absolutely separate paths are needed, because there is a risk of outbreaks. among babies and other mothers. This - he concludes - greatly complicates the organization in the department and requires many more resources to be dedicated ". (ANSA).it is very important that they are vaccinated ". Moreover, continues Maria Grazia Frigo," if a woman arrives positive at the time of delivery, absolutely separate paths are needed, because there is a risk of outbreaks among newborns and other mothers. This - he concludes - greatly complicates the organization in the department and requires many more resources to be dedicated ". (ANSA).it is very important that they are vaccinated ". Moreover, continues Maria Grazia Frigo," if a woman arrives positive at the time of delivery, absolutely separate paths are needed, because there is a risk of outbreaks among newborns and other mothers. This - he concludes - greatly complicates the organization in the department and requires many more resources to be dedicated ". (ANSA).