Rome, general practitioners and hospitals in difficulty between Covid and flu: “Doctors and nurses are needed but the region pays for private beds”

A million Italians flu and a still growing number of respiratory infections, especially in children. Thanks to family reunifications, a certain relaxation in Covid surveillance and prevention and, above all, the structural deficiencies of the national health system, which are even more noticeable in some regions. But the virus is also hitting Rome hard and is causing health care facilities to falter. For the Polyclinic pediatric child Jesus In the capital's capital, admissions to the emergency room increased by 50% between Christmas and New Year: “From 300 daily admissions to the emergency room, we also reached peaks of 450-480 admissions.” “Our facilities in Palidoro and Gianicolo have been busy during the holidays “We have worked at an impressive pace to treat young patients, especially those under 5 years of age, with respiratory problems and high fever,” he explained Sebastian CristaldiHead of the emergency room of Bambino Gesù.

In the last days Fabio De Iaco, the Italian Society of Emergency Medicine (Simeu), had reported a “siege situation” with 1,100 people waiting in emergency rooms for hospitalization in Lazio alone (compared to 500 in Piedmont and even Lombardy, where hospitalizations were suspended due to overcrowding) . On Wednesday, around 600 patients were still waiting for treatment in the emergency rooms in the Lazio region, and 2,000 were treated. L'Higher Institute of Health It has already turned Lombardy, Friuli-Venezia Giulia, Emilia-Romagna and Campania red and is in the flu incidence range that is considered “very high”. Lazio is not yet represented in this ranking, but here, in addition to the usual seasonal peak in respiratory diseases, there are structural deficiencies that are exacerbated by deaths: the fire on the 8th-9th. December at the San Giovanni Evangelista Hospital in Tivoliresulting in 300 beds being unavailable.

“The problems lie in the departments” – The buildings in the eastern part of Rome as well as the Umberto I in the center of the capital and the Sant'Andrea in the north are particularly affected. For the Casilino Polyclinic The situation is “permanently chaotic,” according to internal health sources who have reached the organization Completed, with ambulances no longer waiting to unload patients and long queues at entrances. “The problem is not so much the emergency rooms, but the inability of the structures to accept patients in the specialist departments,” explains al Completed Giancarlo Cenciarelli, Secretary General of CGIL Public function of Rome and Lazio. From the union's perspective, the deficits are primarily due to structural reasons.

To curb overcrowding in emergency rooms, the region implemented Francesco Rocca In May, the company acquired 350 beds in private healthcare facilities (mainly RSAs) for €24 million for one year. Just before Christmas it increased the offer by another 178 beds for 10 million for 6 months. The latter could not yet be put into operation due to the technical time required to recruit staff. “Increasing the number of beds is of little use if there is a lack of staff to ensure care, so they remain just numbers on paper.” The region itself explained this in recent meetings with union representatives The theoretical number of beds given in public facilities does not correspond to the actual number of beds. There were no calls to hire new doctors, even if the money was there. The health homes or new structures planned by the Pnrr never got off the ground. In fact, we lack preventative medicine in the region and the offerings are constantly decreasing. For this reason, citizens are choosing to opt out of improper access to emergency rooms.”

“Children’s access tripled” – What is particularly congesting emergency rooms, both Roman and national, is the fact that this year, in addition to seasonal respiratory infections, there are also pathologies that specifically affect boys and girls. There are various pathogens that contribute to the current crisis situation, he explains Anna Teresa Palamarawho heads the infectious diseases department of the Istituto Superiore di Santià: “There are SARS-CoV-2 which has now become permanently established among us and continues to circulate in quantities with the influenza virus and the respiratory syncytial virus, which is responsible for bronchiolitis in younger children. Fabio MidullaHead of the pediatric emergency department Umberto I Polyclinic in Rome and President of the Italian Society of Infant Respiratory Diseases (Simri), confirms: “Visits to the emergency room have tripled in the last month. And 90% of children hospitalized are due to bronchiolitis.” Bronchiolitis is an acute viral infection that affects the respiratory tract of children under one year of age, particularly in the first six months of life, and is the leading cause of overcrowding in pediatric emergency rooms, in particular, according to health workers between November and March. Crystals of the Child Jesus offers a case study by age group: “In Range 3-6 years Flu, Covid and Rhinovirus hit hard; under two years, Instead, syncytial virus (RSV), which is the cause of seven out of 10 bronchiolitis, is a cause for concern.”

There is a shortage of family doctors – There is also a shortage in Lazio General practitioners. “The peak of influenza is expected every year. The high number of Covid infections and other respiratory infections has been worrying us for more than three weeks. We are particularly concerned about the lung infection. Today alone I treated 6 out of 50 patients in my practice“, he agrees Completed Pier Luigi Bartoletti, Provincial Secretary and National Deputy Secretary of the Italian Association of General Practitioners (Fimmg). The reason for the high numbers this season, according to GP, is that Covid has now joined the most typical seasonal ailments as a structural pathology, increasing the pressure on health facilities. “Covid joining other viruses. Now the system is no longer in crisis because of deaths, but because there are a lot of sick people in a short period of time. But in 20 years services have not increased, they have declined: the number of GPs has fallen from 4,800 to under 4,000, hospital services have declined and now, with emergency support no longer available, we have also taken steps backwards compared to the progress made what was done during the pandemic in terms of managing and connecting services.”

The climax is still ahead of us –“Syncytial virus is increasing, especially in children under 5 years old, including in hospitalizations – he confirms Rino AgostinianiVice President of the Italian Society of Pediatrics (SIP) – While the peak trend had shifted somewhat during the pandemic, this year the virus is behaving again as in the past, with an outbreak towards the end of November, December and is expected “It will last a little longer, with high numbers in January and then falling numbers.” For the epidemiologist Gianni Rezza It is also a fact that Italians' immune defenses have weakened after two years of pandemic prevention: “It was the end of the measures against the pandemic that led to the viruses infecting more.” So it has nothing to do with vaccines or diseases, but rather with the fact that, apart from Covid, there have been no viruses circulating for two years. “Among other things, measures like masks are more effective against the flu than against Covid,” he explained in an interview with republic.

According to all experts, the peak is expected in the coming weeks. But the problem is also that many people, including frail or elderly people, arrive at the appointment unprepared. In fact, flu vaccinations have been steadily declining in recent years. According to data from Ministry of Health, The vaccination rate among those over 65 is around 56.7% in 2023 and has fallen continuously in recent years (in 2015 we were at 65.3%). As schools reopen after Epiphany, infections will increase. Cristanti from Umberto Polyclinic THE confirmed: “We cannot yet predict whether this peak will be reached in the last week of January or the first 15 days of February, but the data shows us that access to the emergency department is stable.”

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