TRENTO. Work in the infectious disease department of S. Chiara has never been lacking, but in recent years – due to Covid, climate change, migratory flows and wars – emergencies have multiplied. Since March 1st, the health authority has also organized itself to cope with it. What used to be a simple operational unit has become a complex unit.
To guide it is the Dr. Massimiliano Lanzafameborn in 1969, with years of experience in hospitals in the Veneto region.
Doctor Lanzafame, for two years you have had to deal with the Covid emergency. It’s over?
I would say really no. On Tuesday evening we met with the general practitioners for an awareness-raising action. The emergency is not over and we must expect the arrival of other variants in the autumn. The data say so and unfortunately the third and fourth dose vaccination rates are disheartening. I don’t want to be the Cassandra of the situation, but looking at what is happening in Israel and it is easy to assume that here too we will have a new wave in the autumn. I therefore hope for a greater propensity to take the fourth dose, especially with regard to the elderly and frail.
But many are waiting for the autumn and the new vaccines to do it.
The third and fourth doses that are available today have been shown to work against circulating variants, not so much in terms of the risk of infection, but still protect against hospitalization and death. It is true that Pfizer has announced that a new vaccine will arrive in September that will also protect against variants, but Covid is still there even now, cases are on the rise and for some, September could be late. And in any case there are 35 thousand people to be vaccinated, you have to organize in time.
Do you still have Covid hospitalizations in your ward?
Currently out of 15 beds we have 8 dedicated to patients with Covid and of these 7 are occupied. Two patients came in the other night as well. Not just Covid though. The infectious disease department is also busy on many other fronts.
The most important problem that will also involve us in the coming years will be that of antibiotic resistance. Unfortunately, Covid has slowed down the national plan project even if fortunately Trentino is a happy island on this front as we have little resistance here. But there is still a lot to do because it will be the problem of the future. As infectious disease specialists we also have the task of working at a preventive level to make medical culture, collaborating with all hospital operating units first but then also with local doctors, for an appropriate use of antibiotics.Covid and antibiotic-resistance but a third big problem it is that of AIDS. There is less talk of it, but the problem is still there.
What is being done to cope with it?
We do not talk about it because apparently no one dies anymore, but in reality the infections continue to exist with all the physical and psychological consequences that this entails. Furthermore, with Covid, many patients did not follow the treatments regularly and this led the virus to replicate and the subjects to be even more contagious. One of the first things I did when I arrived was to open a Prep clinic for pre-exposure prophylaxis, which involves taking anti-HIV drugs from HIV-negative people who have sex to reduce the risk of infection.
The arrival of so many migrants has also caused a greater circulation of some infectious diseases. How do you cope with it?
The issue of migration flows requires a preventive screening action. Thanks to the prevention service, we have established a path aimed at the infectious disease assessment of all these people who come from areas with a high incidence, for example of tuberculosis or protozoal infections, and therefore we have made ourselves finalizers of a work done on the territory by various associations to which there was no terminal part and patient management to treat any pathologies in progress, but also for preventive action.
Take tuberculosis, for example, Ukraine is among the 10 countries in the world with the highest incidence rate of this disease. Intercepting this disease in time is an advantage for the patient but also for the entire population.
Another open front is that of diseases carried by infected ticks and the latest news is monkeypox.
It seems that emergencies never end.In fact, there have already been some cases of tick-borne encephalitis since my arrival, while as regards monkeypox fortunately it seems that there is low risk for the population because to contract it it takes a prolonged physical contact and also the oral-pharyngeal transmission requires a prolonged and close contract, not like Covid, and this gives us good hope that it will not have a large spread.
You must always keep your guard up, I seem to understand.
New emergencies can arrive every day. Unfortunately, globalization and climate change will lead to new epidemics. Wars are also vehicles for infections and generate epidemiological problems. Never before has the infectious disease specialist played a central role in public health as in this moment.