The academic of the Department of Public Health of the Catholic University and president of the Society of Epidemiology of Chile spoke in Agenda País about how our country, companies and the general population are facing the coronavirus. He also highlighted the data and studies being developed by scientific societies and academia to overcome the pandemic and keep people informed.

“Data show that there has been a very dangerous increase in cases being reported under the current definition of the Ministry of Health. And I say dangerous mainly because we only see them go up and up in a short term”, says Sandra Cortés in interview with El Mostrador.

The academic of the Department of Public Health of the Catholic University and president of the Society of Epidemiology of Chile is concerned about the level of contagion that exists in our country of coronavirus, which has already passed the 100 thousand infected and a thousand deceased by Covid-19.

“I don't know if we're reaching peak, I can only say that the trend keeps growing with a fairly high slope in a short time and that in practice was what we didn't want, what shouldn't have happened because it just results in a collapse of a hospital capacity”, Says.

There is concern in the medical and scientific world because measures such as total quarantine in some parts of the country, especially in urban areas, they're not getting the expected results.

“One of the fundamental things that epidemiology teaches us is that analyses have to be contextual. If we look at the country like everything, it seems that there is some out of control, but different is the situation of what happens in large cities with what happens in smaller communities where there is a certain opportunity to be able to make effective controls”, holds.

That's why he's optimistic about some achievements like the Atacama Region., where there was “clearly an ideal scenario because there is a fairly well-organized surveillance system, from the Seremi Health, where good testing and analytical skills have been made”.

However, remembers that the necessary measures go beyond confinement. “Here it is not only whether a quarantine is established or not, which is one of the strategies that is available from public health, but also if the three key recommendations that the World Health Organization has said are effective”, i.e., Testing, isolation and follow-up.

“WHO said it tested not only those who are hospitalized but in asymptomatic population because we know that the virus can also be transmitted in people who are apparently healthy”, explains.

“The second component is effective insulation, it's very difficult cities where there's overcrowding, in communities where we have serious habitability problems, which is what happens in much of the big cities”.

On case-tracking, raises the need to support “positive people but also to contacts we know have a high chance of developing the disease”. The problem is that “there are habitability conditions that make it very difficult to insulate a case in a house, then what happens is that there is an infected person who then transforms their family into an outbreak”

The drama of the last bed

In the face of the increase in cases infected in our country and the collapse of the hospital already in some, there has been talk of the ethical dilemma of prioritizing the care of some patients over others.

“Medical specialist associations are very concerned and have expressed this concern in every possible way because right in the Metropolitan Region we have some hospitals that have already reached 90 – 95% of beds occupied on a medium-severe level. We are clearly witnessing and we are in the right time to be able to do a much more efficient management of everything that happens with these people from the mildest to the most advanced degrees of the disease”, says Cortés.

Specialist believes we are still in time to move hospitals with mild sickness levels to health homes “where you can control early the symptomatology you have”.

It also clarifies that “the ghost of the last bed” cannot be moved automatically based on experience such as Italy or Spain “because those events occurred in a very different demographic scenario”. In both European countries, much of the deceased were the elderly with whom the disease is more aggressive. “But we have another demographic structure and our hospitalized cases are concentrated in the middle ages”, explains.

That's why it's critical “use health care homes that can, for example, leave people who are suspicious in effective isolation while waiting for the PCR result”.

In turn, there should also be health residences for those who are coming out of the disease.

Care for basic service workers

There is uncertainty in workers and their families who must move to their workplaces. That's why the expert says that “peace of mind has to be taken with effective measures”. For Cortez “there's a critical point that has to do with transportation. We need all buses and the subway to be disinfected not only once a day and we need companies of any level to generate shifts that allow people to have different entry times so that there is no collapse in public transport”.

“It is also necessary for companies to develop protocols not only to ensure minimum hygiene conditions but to carry out effective monitoring of workers so as to know who they are positive and so that they can effectively isolate their workers if they are suspected or confirmed cases”, Adds.

Cortés highlighted the case of Aguas Andinas that is doing confinement shifts for healthy workers but are essential to be able to supply water and make the wastewater treatment plants walk. “Confining healthy workers from companies essential to keep them healthy are policies that need to be established in all basic services companies”, Says.

The epidemiologist also argues that small businesses also need support in order to be able to have peace of mind and that translates with bonds that guarantee the effective conditions “so that the physical distance within the workplace can be maintained, alcohol gel can be available, shorter shifts can be generated so that places are vented”.

Clear messages and reliable spokesmen to prevent

To finish, Cortés calls for further informing the population, especially the work that scientific societies are doing, universities and specialists in general.

“It is proven in the literature that people adhere better to recommendations when they have reliable spokesmen who deliver clear and concise messages. And there we have a lot to do using reliable sources properly”, Stresses.

“Today's message is: ‘Lower fear and instead of worrying, let's take care of that the messages we're getting in our workplace, from our neighbors or reliable sources, be measures that we take so much at home, in our workplace and in the public space”, argues about the urgent need to maintain physical distance and “take care of each other as a collective”.

“We're not going to get to herd immunity, forget about that concept in this particular case, but we do need to reinforce all self-care measures, all awareness-raising measures for our entrepreneurs and our mipyme managers to be creative and take care of ourselves. We don't know when this is going to end so we need this strategy to be taken and we are aware that we need to work collaboratively.

We have to prepare at least until we have a vaccine and we have to prepare and start working collaboratively not forgetting that we have at least two Chile: one who has better access to health and has a better chance of staying at home, but we also have to think about the other Chile living in overcrowded conditions, precarious work, inequity of pay and that needs action today”.

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