School and Covid

Dear Director

I have read the document prepared by the ISS on the management lines of schools. I would like to give you some reflections that I hope will clarify and make you understand what are the needs of an intervention in a full and flourishing pandemic and not in the tail of an epidemic that presents rare and infrequent sporadic cases of infection. Surveillance is fine if the reference was “if it happens”.
But here we find ourselves in full bloom of numerous and ensuing infectious waves whose numbers transmitted by the Regions are far from the actual realities for numerous and critical reasons. The first, the absence of an infection prevention government and a thousand voices that contradict each other. The second is the wild feud of families.
As an outdated public health physician who had learned that epidemics do not spread, I have discovered proposals that define new boundaries in the management of infections in the modern era. But perhaps working on the head does not authorize, if honest, the otorine, to operate on the eyes, except for rare and exceptional reasons (and skills).
But, considering that I still believe in the few and correct things that the past has taught us, I do not see other useful and functional solutions to the problem, both for the reason that I have indicated to you, that we do not have such a stable condition to move on to the phase of mere surveillance, which we have all been hoping for for two years now, and which although, being a pandemic, bring us new experiences and expressive methods of the virus from other nations between variants and liberal methods of management.

For the situation of this condition we cannot yet do without filters – preschool – carried out at least twice a week, at home, by family members, which reduce to the minimum possible the presence of any positives (even if asymptomatic) that are spreaders of the infection . It is not enough to look them in the face. No doctor would do it, how can one expect a mother or a father?
The mask, much abhorred, has shown an extraordinary effectiveness so as to eliminate, in winter, more than 80% of the cases of influenza infection in our community. It is therefore absolutely useful, associated with other actions (which are not proposed by obligation) of
spacing and sanitation. The single data, and referred to the surgical mask, led to abatements of over
55% risk. More performing masks can reduce the risk by well over 90%.
And, I think, that’s what we all want. And I think it’s our goal, to eliminate viral circulation.

The distancing.
In the few lines that I published in February 2020 I inserted a number that I still believe to be correct, and which I have, of course, found subsequently confirmed among the indications of the CDC, their 6 feet that I had described in 2 meters.
Our breath “floats” and certainly does not decay at a distance of one meter, indeed, with the words and the strength of our breath, that of the neighbor reaches our airways directly. And, of course, not having even a minimum security device, it seems unlikely to be usable as a security tool. The lower distance becomes pure intimacy.

The air changes of the classrooms, created to reduce CO2.
Certainly nice models when Ricciardi explains that in the flight from India, with this variant of the virus, they all became infected while they took the meal by removing the mask. With only one positive present. But they don’t even bring them here.

The fragile and privacy.
Either privacy does not exist or the fragile ones must be well defined. The fierce debate of the early days about the sick has only brought harm. But people must always be guaranteed and protected. Here too we are in anarchy. And to the lack of respect for people.
And, forgive me, to the belief, which I think is completely imaginative, that by isolating a few people with a mask, they can avoid becoming infected in an environment that could (and yes, be saturated with viruses – as we have seen, considering that only one positive, today).
In addition to the fact that keeping children for hours in a limited and certainly not optimal environment puts them at risk, it has been amply demonstrated by long studies that it does not give any tangible and obvious safety results. And indeed it is a further strong moment of risk.
And we are talking about children without immune protection, including vaccination, which certainly has some effect and effectiveness on the community.
Naturally related to the entire mitigation system which instead has become, here, an infectious and uncontrolled “drowning” system.
The ISS data on the protection and vaccination coverage of children are true, since a very high and free viral interaction can only create a spread that intersects all possible and existing risk conditions. A very high level stress test, in fact.
The vaccinoliberatutti is pure economy of thought but not of serious real action of viral killing and significant reduction of biological interactions. Even a wall breaks, by dint of hammering it. Moreover, not very solid and with low resistance due to lack of
vaccinated. And I am surprised that we can be surprised.

The DAD. So hated and reviled.
Like the masks.
The DAD was an absolutely missed opportunity. If, as it should have been, the publishing companies could have prepared teaching units useful for all school levels, and therefore offer valid and high-quality support to our daily school teaching which would have become homogeneous at a national level and would have allowed a strong contraction of the present cultural disparities that everyone talks about and nobody does anything about. He would have stopped thinking about children’s webinars but created real interactive classrooms and pushed many teachers to relaunch remote research models as well. The repetition of technically adequate lessons and therefore repetitions without costs for families, today more than ever, in the need to be able to use a universal teaching method.
But when you look at things wrong you get a stiff neck, and you are no longer lucid.
And it could be a tool for those who, today, are at risk or for families in need of greater protection. If a boy, a child or a family are fragile, the Russian roulette wheel of the “special mask” cannot and must not be an instrument of protection from a condition of serious risk and, unfortunately, of damage, for a significant number of people.
The hospitalized and the deceased are not a sinecure or a statistic, but derive from the actual cases of infection we have on a daily basis.
And every day a plane crashes. And certainly not empty. And we always hope it doesn’t continue like this.
The school, and its cases, as we have seen in recent months, cause a strong spread in the family and with diseases and deaths that are at worrying levels in any community that wants to protect its citizens. Since then, the virus, very rude, does not stop at the front door. And, as we have seen since Wuhan, the number of new cases is multiplying in a turbulent way in their respective homes and not between gardens and companies. And the children, youngsters, all have the defect of going home every day.

Vaccination of infants and young children.
In some countries, including Germany, it has already been started and successfully. In particular for children who will then go to school communities from an early age.

The covid and its consequences.
It is not an influenza virus, it does not predominantly affect the mucous membranes but the interstitial structures. We have not adapted. There is no herd immunity. Determines relapses, now frequent. We now have a lot of damage, and deaths, post covid months later, not counted in the covid statistics, in the elderly and heart patients. And infiltrations and pulmonary fibrosis multiply which, unfortunately, will be followed by other chronic damage to other parenchymal organs. And children have developing organisms, with limits and consequences for what can happen.

The long covid.
It is not a well-defined pathology but in many cases it appears very critical and serious for those who suffer from it. But this is not an opportunity to investigate.

Except that avoiding infecting, getting infected and acting accordingly are the needs of this moment and the actions to be implemented.
And, for some preventive tests and essential masks we are putting our community at risk again with the certainty of thousands of new deaths, unfortunately true? Is that the ethics of the former not to harm or to prevent disease? Of the art. 32 of the Constitution?
There are rules and laws that must be respected to guarantee a community to be such, including that of avoiding the spread of infectious diseases. In 1800 they would certainly have done much better than now. With preventive and separation tools.
Then, a few days of true distancing are enough to avoid spread.
But the rules are either misrepresented or omitted.
And those on the safety of workers, as rigid in a construction site as non-existent in a community of workers and school-goers, as in this case, which are millions at the same time. And let’s not confuse cause with effect, asymptomatic positives are sick, unhealthy that can go around. And it is proven that these are the most insidious situations.
And it would also be enough to clearly separate the hospitals with covid patients from others, completely free, to have fewer cases, fewer patients and safer and more guaranteed staff.
Just keep them from getting sick.

Giuseppe Imbalzano, former medical director of USSL Melegnano- Asl Mi2- AO Legnano- Asl Lodi- AO Lodi- Asl Bergamo- Asl Mi1

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School and Covid-19: reflection on what is indicated in the Iss | lines Healthcare panorama