New infections, yes, but for the moment the health system in Ticino is coping well

INTERVIEW

Paolo Galli interviews Dr. Paolo Ferrari, head of the EOC medical area

New infections, yes, but for the moment the health system in Ticino is coping well

New infections, yes, but for the moment the health system in Ticino is coping well

Yesterday there were 14 hospital admissions and one admission into intensive care. Numbers are not in away way comparable to those of March and April. Paolo Galli interviews the head of the EOC Dr. Paolo Ferrari.

Doctor Ferrari, where are we right now?

We are currently seeing an important increase in infections, but the number of hospitalisations remains surprisingly low if we were to compare them to those recorded during the first wave of COVID-19. This observation is confirmed by the data from France and Spain, where the ‘second wave’ of infections occurred as early as the beginning of September. In these countries the number of people tested positive for the swab is three times higher than the peak in March, but the number of patients admitted to hospitals and intensive care is a fifth of that of March or April..

But looking at figures could the exponential growth of positive cases still take us there?

The situation today is different from what we experienced last spring. The virus has not weakened. There is a difference in the number of people susceptible to developing severe COVID-19 that is less than we previously thought. This is due to protective levels of immunity, not measurable by serology alone and which are the result of a combination of a pre-existing immune response and a new modulated individual immune responses which are present in the population prevent an epidemic increase in severe forms of COVID-19 disease due to new infections. A series of studies have documented SARS-CoV-2 reactive T cells in people without exposure to the virus is raising questions about just how new the pandemic virus really is, with many implications. At least six studies have reported T cell reactivity against SARS-CoV-2 in 20-50% of people with no known exposure to the virus. Although these studies are small and do not yet provide precise estimates of pre-existing immunological responses to SARS-CoV-2, they cannot be ignored, as many have been published in the most prestigious journals such as Cell and Nature.

New infections, yes, but for the moment the health system in Ticino is coping well

So why do you think canton Schwyz is under so much pressure?

I would like to emphasise that the canton of Schwyz has not collapsed in terms of hospitalisations, but that this is an alarm that the hospital management has launched in light of a significant increase in infections that could result in a significant increase in admissions.

Is it really possible that such a lesson should be learned only through a direct and traumatic experience like the one we lived?

Staying within the borders of our country, the lessons learned from the cantons most affected at the beginning of the epidemic, such as Ticino, Geneva and Vaud, allowed the other cantons to be able to prepare themselves more adequately. It does not seem to me that at present there is evidence of a lack of readiness on the part of our and other cantons.

Where are the patients being looked after presently?

The EOC and the Lugano Clinic have maintained their commitment to welcome COVID-19 patients who need to be admitted. Currently at the EOC, at La Carità, we have 8 intensive care beds and 27 beds in hospital wards, while the Lugano Clinic has 7 intensive care beds and 20 ward beds available. Today (yesterday, editor’s note) there were 13 patients in the ward and one patient in intensive care. Both facilities are committed and have the ability to increase both intensive care and ward beds to the numbers that were available during the first wave.

What is the strategy that will be implemented, and how and when will the private sector be involved?

As mentioned, the collaborative commitment between the public and private sectors to re-establish, if necessary, the hospital structures with the corresponding number of beds to accommodate COVID-19 patients remains unchanged. So basically there is a plan to increase the number of ward beds by twenty to twenty, and that of intensive care beds by seven to seven. At the Charity it is possible to reach 45 intensive care beds and 175 ward beds, for a total EOC of 280, plus about sixty at the Lugano Clinic, which in turn can bring places in intensive care in addition to twenty. Twelve are possibly available at the Cardiocentro. But according to what has been seen in France and Spain, this «second wave» could lead to more hospitalisations in the ward and fewer hospitalisations in intensive care.

In terms of human resources, in recent months has the sector been able to recharge its batteries, perhaps recalibrating the forces also in relation to a possible second serious wave?

Our collaborators has shown in recent months that they have recharged the batteries by committing to take charge not only of urgent patients, but also of those patients whose care during the first wave of COVID had been deferred, thus in a sense recovering the lost work. This shows the dedication and professionalism of everyone, doctors, nurses and auxiliary staff.

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