The Solinas plan
Let’s see why, starting from the Solinas plan. The governor of Sardinia said that: We ask that travelers certify before leaving its negativity to the virus. In a simple way and without prohibitive costs, which we will then reimburse, people should be able to perform tests in the laboratories of their city or by their family doctor which are then validated by the health authorities. Now it’s up to the government to do its part and simplify access to tests. If this is done, it will be of little importance that you arrive from this or that region, because your personal status will be certified with respect to the virus. If the government does not give answers, Solinas has already prepared a plan B for ports and airports: We will use an app for the registration of entrances, an epidemiological questionnaire for access and a self-certification as well as the ordinary temperature controls.
The tests (which are not yet there) on saliva
What is the problem with the certificate of negativity, which continues to please even the governor of Sicily Nello Musumeci? Solinas talks about trapid molecular est on saliva, which in Europe and Italy are not available and validated and have started to circulate only in the United States, in New Jersey. There are companies and consortia of companies that have announced that they are ready to market their tests in Europe too, but certifications are lacking.
What about serological tests?
If, on the other hand, a serological test was asked to provide “security”, and some regions made tourists do it to ensure that they welcome people without problems, alone would not be enough. First of all, the most reliable test (and the only validated one) that is performed with a blood sample in a laboratory and performed using CLIA and / or ELISA diagnostic technology (see the relevant ministerial circular, HERE). The response is therefore not immediate but it takes a couple of days (very variable time, of course depending on the diagnostic capacity of the laboratories and the queue to be disposed of). As we know, the test certifies the presence of two types of antibodies, the IgM tell us that we have come into contact with the virus recently, the IgG in the past. The response that would serve a tourist to be negative for IgM and positive for IgG that photographs the fact of having contracted the infection in the past. But – we wrote – it is not enough, because this past is not quantified: the infection may still be present and therefore the person is contagious and to know it you need a swab.
The problem of the duration of protection
It must be said that the presence of antibodies does not even indicate if they are neutralizing (even if it seems to be) but above all how long the protection lasts: some people may have become infected in January now almost five months ago, are we sure they are still immune? We are not sure, although based on other coronaviruses we think so. So the tourist, to be sure not to infect anyone, must at least have a serological test with negative IgM and positive IgG and a negative swab. But the problem comes on the pads. Most of the regions that have liberalized the tests carried out through private individuals, in the face of the presence of positive IgG antibodies force the buffer and here the times are longer: if even the same private laboratory can do it, you have to wait days (also here it depends on the clogging of the lists), or it must be done via ATS and here too you need to get in the queue (it depends on the individual territories). But not over: private laboratories have the obligation to report the positivity to the test to the ATS or general practitioners and the person must wait for the outcome of the buffer in quarantine, so certainly not on the beach among the others with all that came out in the past months on the speed of diagnosis by swab.
The free zone
It is no coincidence that the initial proposal of the Sardinia Region was to manage everything by itself trying to speed up the times: tests and swabs made on site with a free zone in the hotel in which to wait for the results. A complication which hospitals have also struggled to manage (the safe division between Covid people, Covid and non-Covid suspects) and which risks generating chaos and various problems. Only tourists with both tests in hand (with all the doubts raised above) could enter, or do the whole process on vacation. But would it be vacation? And how many days would it take?
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