In the last week of October 2020, Regions have mostly resorted to home isolation of new cases (95%). Specifically, 156.5 people per 100,000 inhabitants have been isolated at home, 8.1 have been hospitalized in ordinary wards and 0.8 have been hospitalized in ICUs (ALTEMS, 29 October).

Guidelines released on 15 March 2021 by the National Health Institute (ISS) state that, given the impossibility of clinically identifying all patients with (or carriers of) new viral variants, cases are to be sought among:

• contacts of a confirmed COVID-19 case from a suspected/confirmed variant;
• those arriving from an area or country with known circulation of variants;
• those arriving from an area with a cluster of an initial case of COVID-19 and numerous secondary cases, suggesting increased viral transmission.

Although, at present, no scientific evidence calls for a single room isolation of patients with viral variants, in the presence of a suspected or ascertained diagnosis, the guidelines suggest to proceed with single-room isolation or grouping patients infected with the same variant, if known.

Tuscany

With Resolution 744/20 of 15 June, Tuscany launched a regional program for the reorganization of clinical pathways for residents with a Covid-19 related clinical situation; this program also includes the launch of studies targeted to better understand medium and long-term consequences of the disease. By the end of June, a surveillance program will be active for those who have contracted COVID-19 and are now clinically cured, in order to ensure that they are taken care of by the Regional Health System (SSR). Such surveillance allows identifying post-acute effects or medium and long-term complications that may, however, still require health interventions.

Cases may include either patients discharged from hospitals or individuals who were treated at home or in social or health facilities and organizational procedures have established that all COVID-19 patients who have been hospitalized in Tuscany are contacted and engaged by the hospital itself which will work in close contact with the patients’ GP to share results and decisions-making on necessary interventions. On the other hand, non-hospitalized patients will be tracked and identified through regionally implemented platforms and contacted directly by their GP. Recruited patients will undergo a series of anamnestic investigations (mainly questionnaires and blood tests) and, at this stage, Special Units for Continuity of Care will be engaged. Consequently, they will be addressed to the most appropriate specialists (pulmonologists, neurologists, cardiologists, intensivists, nephrologists, psychiatrists, psychologists, otolaryngologists, ophthalmologists, diabetologists, physiatrists, geriatricians, physiotherapists, professional dietetics staff, etc.).
Furthermore, specialised COVID-19 surgeries will be activated in all healthcare facilities for multispecialistic day services and all costs will be borne by the SSR without out-of-pocket payments. The program also includes regional training for the involved professionals.

The figure of the GP will be crucial in the management of non-hospitalized patients and they will also be responsible for delivering clinical questionnaires, requesting blood tests and referral to specialists.

By mid-May 2022, the COVID-19 pandemic situation is showing promising results. Although the number of COVID-19 cases is still very high (more than 900 000), the number of patients hospitalized in ordinary beds is around 8000 and decreasing, while patients in intensive care are about 350 and stable.

Recommendations still urge people to keep following behavioural measures (use of masks, ventilation of spaces, hand hygiene, reduction of physical contact and paying particular attention to keeping safe at gatherings). Italy’s death toll was one of the highest in the world. Since the beginning of the pandemic in February 2020, many people who contracted the infection died. The number of deaths amounted to 165 244 as of 15 May 2022.

As no data on long covid is available for the Italian population, the burden of disease is not yet assessable. In fact, the National Institute of Health (ISS) is coordinating a research project called “Analysis and strategies of the response to the effects of Long Covid”, with the aim to assess the size of the issue, to enquire on dedicated services, to define good practices and promote surveillance and knowledge. The Ministry of Health plans important preventive health measures in this regard, releasing recommendations to evaluate, for example, medical fitness for competitive sports, such as specific cardiological and pulmonary diagnostic tests required to prevent cardiopulmonary complications.