Covid infections declining while flu cases on the up and hospital emergency situations constant

These days seasonal flu is more frightening than Covid-19. However, it’s not the mortality rate that is alarming—the data is in line with expectations and pre-pandemic averages—rather, the emergency situation in A&E departments across Italy is complicated compared with the usual scenario. Four years after the outbreak of the pandemic, this winter has seen a real paradox: Sars COV-2 infections and admissions for related respiratory and pulmonary syndromes have fallen sharply (except for isolated peaks in some areas of the country), but emergency departments are still overcrowded, and staff are stretched to the limit.

While the Federazione italiana delle aziende sanitarie e ospedaliere (Fiaso) reports that Covid-19 is currently almost statistically irrelevant among the respiratory pathogens circulating among the population, the Società italiana di medicina di emergenza urgenza (Simeu) is speaking of hospitals and health companies under siege throughout Italy, with a consequent increase in waiting times for patients. As ambulances wait to hand over patients to hospital doctors, average response times for new emergencies have also increased. In Rome, where the decrease in Covid hospitalisations was 43% compared to a year ago, emergency room activity is up by 30% compared to pre-Covid times. In the whole Lazio region, up to 1,100 patients have been waiting for a hospital bed—more than 500 in Piedmont, while in Lombardy normal admissions have been suspended due to overcrowding. But from north to south, the situation is critical everywhere. According to experts, this year’s flu has been one of the most virulent in recent decades, confining 15 million Italians to bed with fever and gastrointestinal problems, and causing a surge in 118 calls and hospital admissions.

The president of the Rome Board of Surgeons, Antonio Magi, explained that the problem of the increase in flu infection rates in January was also due to the abandonment of practices we were used to in previous years during the pandemic. A prime example is the use of masks, which has now largely been abandoned. In addition, as in every other winter, travel around the peninsula and abroad during the holidays, combined with close contact with children who returned to school in January, greatly accelerated the spread of the flu virus, affecting all age groups. Last month saw the peak of the epidemic almost everywhere, and only in the last few weeks have the numbers started to fall. In the meantime, however, many doctors and nurses went through a real ordeal between December and January, with gruelling shifts, stress and risks to their own health not seen since the days of lockdown.

Apart from the increase in the number of people in need of care, the main problem in hospital wards and emergency rooms is the chronic shortage of staff from which the Italian health system has been suffering for a long time. A worse-than-usual seasonal flu was enough to plunge operators back into the nightmare of 2020-2021, underlining once again the seriousness of the critical situation that has worsened in recent years. Even at the end of 2023, the Italian regional governments reiterated to the central government the urgent need to intervene. There are around 4,500 fewer doctors than the estimated need and more than 10,000 nurses to meet the minimum demand in all public facilities. These figures inevitably affect the quality of patient care and, as we have seen in recent months, the working conditions of the staff themselves.