La chirurgia al tempo del coronavirus
Michele De Angelis *
Dopo un doveroso quanto sentito ringraziamento al Presidente del nostro Club per l’opportunità concessami vediamo, pur mantenendo uno sguardo al panorama nazionale, come è stato affrontato il problema della attività chirurgica nel nostro territorio in un momento così difficile. Partiamo da alcune semplici considerazioni che sono state alla base delle scelte adottate.
- È stato molto complesso all’inizio avere anche semplicemente un’idea chiara di cosa dovessimo affrontare per la novità del contagio, l’andamento clinico altamente polimorfo della patologia (casi asintomatici e casi rapidamente mortali), la diversità di vedute spesso molto discordi anche tra gli addetti ai lavori: virologi, pneumologi, infettivologi e rianimatori.
- Le notizie provenienti dalla Lombardia con la loro la drammaticità nota a tutti voi ci mostravano in maniera incontrovertibile alcune priorità:
- creare percorsi separati tra patologie covid e nocovid evitando che gli ospedali divenissero nuove fonti di contagio;
- ridurre al minimo il carico di lavoro per gli anestesisti-rianimatori che dovevano essere impiegati in prima linea per combattere le complicanze letali del virus;
- aumentare a dismisura i posti disponibili nelle terapie intensive ed in subordine nei reparti specialistici di infettivologia e pneumologia;
- garantire in ogni caso i trattamenti chirurgici oncologici o prioritari che insieme alle patologie tempo-dipendenti (infarto ad esempio) non potevano essere in qualche modo differiti.
A quanto detto si aggiungeva nel nostro territorio, come a livello nazionale, la carenza proprio di medici anestesisti (solo 2 settimane prima della emergenza covid era andato vacante un bando nazionale per 8 posti di anestesia per l’Azienda Sudest) che per gli ovvi motivi rendeva improponibile l’utilizzo di presidi ospedalieri periferici dipendenti dalla Azienda stessa.
La provincia di Arezzo rispetto ad altre della stessa Toscana ha potuto usufruire della presenza nel proprio territorio di strutture, come il Centro Chirurgico Toscano, già convenzionate col sistema sanitario nazionale e regionale, di ottimo livello tecnologico e professionale che hanno potuto accogliere le attività chirurgiche, anche le più complesse come quella robotica. Voglio solo elencare quali vantaggi tale spostamento abbia prodotto in termini di economia –sanitaria e in ultima analisi di salut
e per i nostri cittadini:
- gli interventi oncologici e prioritari non sono stati mai interrotti come avvenuto in altre provincie.
- Il sistema robotico a cui i cittadini di Arezzo tramite il Calcit hanno così pesantemente contribuito, è rimasto fermo solo per 2 giorni quando in altre realtà è rimasto inattivo per mesi con l’immaginabile danno economico e di prestazioni.
- Nella nuova sede operatoria, per gli importanti controlli e separazione di percorsi realizzati, non abbiamo registrato neanche un caso di positività al covid (si tenga presente che i casi di infezione postoperatoria dovuti al coronavirus sono segnalati in letteratura mortali pressoché nel 100%).
È evidente che in questa rimodulazione dell’offerta chirurgica siamo stati in qualche modo aiutati dall’esperienza negativa degli amici della Lombardia in cui una minore disponibilità della rete della sanità territoriale rispetto a quella Toscana ha portato al rapido intasamento e infezione anche dei centri di eccellenza ivi presenti (Humanitas, San Raffaele etc.) che sono divenuti essi stessi fonte di contagio. Anche la modesta difesa della salute degli operatori sanitari, oltre che a un notevole tributo in termini di vite, ha contribuito in maniera importante alla diffusione del virus.
Credo che questi in sintesi siano i motivi del miglior andamento dell’infezione in Toscana con Arezzo risultata la provincia col minor numero di ricoveri per patologia virale specifica.
Mentre vi scrivo ci apprestiamo a riportare le nostre attività presso il San Donato ritenendo di aver contribuito tutti insieme, operatori sanitari e direzione della Azienda sudest, in un momento di gravissima crisi sanitaria ed economica, a scrivere una bella pagine della nostra sanità locale con una integrazione tra pubblico e privato sino ad ora impensabile.
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Socio del Club |
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