Who is responsible for updating patient records and therefore the green passes after an infection and subsequent healing, also in anticipation of a possible fourth dose? Secondly, how the absences from work of quarantined persons are justified in the absence of a provision to be reported in the certificate? Finally, i smart working subjects who are positive but asymptomatic have the same right to the disease?
These are the questions posed by the SIMG – Family Doctors with respect to some gaps still present in the legislation on ‘green passes’ and work permits.
The gaps in the legislation
Nobody knows their territory like family doctors ”, they write and this means knowing places, people and stories, a precious heritage of which the General Practitioners are custodians and guarantors. An even more significant added value in this phase of the pandemic, in which the epidemiological situation has become almost unmanageable due to the high incidence of new cases and the diffusibility of the virus currently in circulation. Consequently, the regulatory measures of the last few days have also been numerous and have created disorientation in public opinion due to difficulties in interpretation..
The continuous updates were inevitable in the face of a rapidly evolving epidemiological scenario, with the dizzying increase in infections, the relative difficulties in tracing and the risks also of paralyzing production activities for the now numerous subjects in quarantine or in isolation. For this reason the SIMG – Italian Society of General Medicine and Primary Care proposes an open collaboration with the institutions.
“The SIMG can support the Government, the Ministry of Health, the Higher Institute of Health, the Scientific Technical Committee to direct the choices towards the most effective strategies thanks to the knowledge of the territory built with direct contact with its clients. – underlines the Dr. Ignazio Grattagliano, SIMG Puglia Coordinator – This synergy can foster effective communication that can be conveyed by the family doctors themselves to their patients. The SIMG offers maximum availability to support the work of the CTS even only for issues that exclusively concern territorial medicine”.
THE DISPUTED RULES AND THE FIRST CLARIFICATIONS
Some recent measures that have made the legislation more complex have stimulated greater commitment.
“The latest Prime Ministerial Decree of 12/30/2021 differed on some points from the Circular 0060136 of the Ministry of Health – underlines the Prof. Claudio Cricelli, Presidente SIMG – Furthermore, both do not deal with some important points that General Practitioners face on a daily basis with their patients. Among the first controversial points, the SIMG noted the aspects related to the use of different swabs for diagnosis (antigenic of first and second or third generation), duration of isolation for positive patients and the difference between occasional and continuous contacts (cohabitants) . In the face of these reminders raised by the SIMG, some points were promptly clarified by the competent institutions”.
The clarifications also emerge precisely on the Council of Ministers website in the ‘frequently asked questions on the measures adopted by the Government’ and concern in particular the quarantine rules: from 31 December 2021, the preventive quarantine does not apply to those who have received the first two doses of vaccine for 120 days or less, to those recovered from Covid-19 for 120 days or less and to those who have received the third dose of the vaccine. Self-surveillance is applied to these categories of people, with the obligation to wear FFP2 masks until the tenth day following the last exposure to the Covid positive subject (therefore the eleventh day from the last contact). A rapid or molecular antigen test is expected to be performed at the first appearance of symptoms. Instead, it will be necessary on the fifth day following the date of the last close contact. The situation is different for close contacts with two doses of vaccine received for more than 120 days: if asymptomatic, a quarantine with a duration of 5 days is applied with the obligation of a negative molecular or antigen test on the fifth day. For subjects not vaccinated or who have not completed the primary vaccination course or who have completed the primary vaccination course for less than 14 days, the 10-day quarantine from the last exposure continues, with the obligation of a negative molecular or antigen test. on the tenth day. For infected subjects who have previously received the booster dose or who have completed the vaccination course for less than 120 days, isolation is reduced to 7 days, provided they have always been asymptomatic or have been asymptomatic for at least 3 days and following a swab molecular or antigenic negative. In all cases, a negative result of a rapid or molecular antigen test is required for the termination of quarantine.