Metto qui brevemente alcune cose di oggi a conforto e bibliografia dei discorsi della settimana passata sulla necessità di avere un progetto e sugli errori fatti. Ne cito dei passaggi, ma vale leggerli interamente.
Dal New York Times, due articoli:
– Come sapremo quando si potrà riaprire?
Any date that is currently being thrown around is just a guess. It’s pulled out of the air.
Since the virus appears to be everywhere, we have to shut everything down. That’s unlikely to be the way we’ll exit, though.
– Hospitals in the state must be able to safely treat all patients requiring hospitalization, without resorting to crisis standards of care.
– A state needs to be able to test at least everyone who has symptoms.
– The state is able to conduct monitoring of confirmed cases and contacts.
– There must be a sustained reduction in cases for at least 14 days.
– L’isolamento non può durare per sempre. Ecco come superarlo
A formal framework is needed, with an explicit rationale grounded in science, for determining when and how and based on what factors to relax restrictions — and how to reapply some or all of them should another epidemic wave hit again.
And so to see us through the next year or more, we must all prepare for several cycles of a “suppress and lift” policy — cycles during which restrictions are applied and relaxed, applied again and relaxed again, in ways that can keep the pandemic under control but at an acceptable economic and social cost.
For starters, one needs robust data. Policy must not be determined based on the daily count of reported cases — the tallies you read about constantly in the news — because those are unreliable. What’s needed instead is the coronavirus’s real-time, effective reproduction number, or its actual ability to spread at a particular time. And one needs to understand that number properly, in context.
Trying to see our way through the pandemic with this “suppress and lift” approach is much like driving a car on a long and tortuous road. One needs to hit the brakes and release them, again and again, to keep moving forward without crashing, all with an eye toward safely reaching one’s final destination.
E qui in Italia:
– La lettera della Federazione Lombarda degli Ordini dei Medici
Non è questo il momento dell’analisi delle responsabilità, ma la presa d’atto degli errori occorsi nella prima fase dell’epidemia può risultare utile alle autorità competenti per un aggiustamento dell’impostazione strategica, essenziale per affrontare le prossime e impegnative fasi.
Ricordiamo in generale come, a fronte di un ottimo intervento sul potenziamento delle terapie intensive e semi intensive, per altro in larga misura reso possibile dall’impegno e dal sacrificio dei medici e degli altri professionisti sanitari, sia risultata evidente l’assenza di strategie relative alla gestione del territorio.La situazione disastrosa in cui si è venuta a trovare la nostra Regione, anche rispetto a realtà regionali viciniori, può essere in larga parte attribuita all’interpretazione della situazione solo nel senso di un’emergenza intensivologica, quando in realtà si trattava di un’emergenza di sanità pubblica. La sanità pubblica e la medicina territoriale sono state da molti anni trascurate e depotenziate nella nostra Regione.
Aggiornamento: Aggiungo un’altra cosa dal New York Times.
– C’è bisogno di una “quarantena intelligente”
Evidence from around the world shows that stay-at-home orders are likely to take us only so far.
Four key measures, on top of treating the ill and maintaining physical distancing, must be in place not just to slow the rise of Covid-19 cases, but also to bend the curve downward. These are: test widely, isolate the infected, trace the contacts of those infected and quarantine appropriately.