“Two years of pandemic have passed without identifying adequate solutions to guarantee assistance to the most fragile patients such as oncology, cardiology and hematology. We are very worried about the block, in fact, of the planned surgical activity caused by the new pandemic wave caused by the Omicron variant. This paralysis risks causing serious damage to our patients, who number about 11 million in Italy “. This is the alarm of the Federation of oncologists, cardiologists and hematologists (Foce), which reminds us how “the postponement of surgical interventions can favor the development of tumors in more advanced stages, with fewer chances of healing”, and which asks for “immediate reform of hospitals and the restart of screening “. For specialists, “an urgent redefinition of the national health system is needed, modernizing and strengthening hospitals, re-establishing local medicine, with a clear separation between hospitals, areas of care and assistance for Covid and non-Covid patients”. In these 2 years “we have proposed operational documents to institutions with constant confrontation, but nothing has been done to protect fragile patients”, explains Francesco Cognetti, president Foce. In 2020, he points out, “there were over 1.3 million fewer hospitalizations than in 2019, even urgent ones were skipped. Oncological surgery hospitalizations saw a noticeable contraction and a decrease of about 50-80% of activity elective, ie scheduled, as communicated by the Italian Society of Surgery “. In 2021 part of these activities had been recovered, but the current situation marks a dramatic regression, we read in a note from the Foce. Even in the cardiovascular field, the experts continue, in 2020 the decline in hospitalizations was about 20% (for implants of defibrillators, pacemakers and major cardiac surgery) and even greater for myocardial infarction with increased mortality. The Italian Society of Cardiology is carrying out a survey to update these data, but on preliminary analysis it seems that the situation has not improved. “We have also repeatedly asked for the restart of anti-cancer screening throughout the country – remarks Cognetti – In 2020, compared to 2019, about 2.5 million fewer screenings were performed. The reduction in tests was equal to 45, 5% for colorectal screening (-1.110.414 tests), 43.4% for cervical screening (-669.742), 37.6% for mammograms (-751.879). In autumn 2020 some Regions managed to provide more tests than in 2019. However, data from 2021 is lacking to photograph the status of secondary prevention programs. An update at least every six months is needed to understand the critical issues to be addressed in real time. Screening is essential for identifying early-stage neoplasms and improving survival “. In 2019, ordinary hospital beds were 314 per 100 thousand inhabitants, compared to a European average of 500, placing our country in 22nd place in Europe for this parameter. There was also a very evident gap for beds in intensive care, with 9 beds per 100 thousand inhabitants in Italy, compared, for example, to 33 in Germany. Little or nothing has changed in these 2 years. “The shortcomings of the hospital sector, as explained in the programmatic document drawn up by the scientific societies gathered in the ‘Permanent Forum on the national health system in the post Covid – concludes Cognetti – are among the main causes that are causing extremely harmful effects during the pandemic. A revision of the ministerial decree 70 on hospital standards is needed as soon as possible. It is necessary to allocate more resources to nosocomial care, also drawing from the funds of the National Recovery and Resilience Plan and beyond “.
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