One of the indicators that makes it possible to measure the crisis that Cali is experiencing due to the Covid-19 pandemic is the high occupancy of the ICU, which currently oscillates at 96%.
Faced with this situation, the Municipal Health Secretary, Miyerlandi Torres, assures that many patients infected with this disease are not coming to the health system in a timely manner, which is generating complications that leads them to be hospitalized in critical condition.
Likewise, the official indicated that with the restrictions that have been implemented in the city, it is expected that infections may decrease during the next two weeks.
Another weekend with a curfew and dry law in Cali, while the city’s ICUs are at the limit of their capacity, what is happening?
There are several factors that may be generating an increase in the referral of patients to the Intensive Care Units: we are finding that only between 20% and 30% of the people who are hospitalized in an ICU arrive with a diagnostic test for covid . This can be for two reasons: it is not taken in a timely manner or people are not consulting the doctor in a timely manner, that is, they have symptoms and do not believe it could be coronavirus, so they only refer to an emergency service in critical condition or when they feel very drowned or very suffocated.
Nor do we have a clear picture of what is happening with the virus transmission speed (Rt). What we have discussed with the statistics of the Ministry of Health, the National Institute of Health and the departmental and municipal health secretariats, is that there was a delay in the reports of infections during the first week of January that could have affected the calculation of the transmission speed (which is calculated daily), so we do not have a really reliable picture of that indicator.
In the late diagnosis of covid, who is failing: the community or the EPS?
We are failing part and part. There is a high percentage of the community that believes that covid does not exist and if they have respiratory symptoms they think that it is nothing or that they will heal by taking something. There are also people who do not believe in the provision of health services and in health professionals. These factors may be generating a late ICU referral when the disease is already advanced. On the other hand, we also have the problem of the lack of opportunity in taking samples and, therefore, in the delay of diagnosis. That is precisely why we have just finished a work table with all the EPS in Cali, with which, despite working every eight days on a containment strategy, we have found an increase in the number of complaints due to a lack of timely response.
The Municipal Health Secretary confirmed that the new strain of the covid has not yet reached Colombia.
The Mayor’s intention that the Municipality acquire some vaccines against covid has generated a lot of interest among people, how is this issue progressing?
We had a meeting with AstraZeneca and we have already requested permission from the Ministry of Health and the President to authorize us to purchase vaccines. What we want is for this acquisition to be a complementary strategy, in which if the Government is going to send us a number of vaccines, that Cali can provide resources to buy more doses and thus, in a faster way, be able to have the expected coverage to achieve an economic opening as soon as possible.
AstraZeneca told us that all the doses were prioritized to be acquired from the country entity in order not to disperse the purchase due to the production capacity it has, but it also told us that it agrees that the vaccines can be acquired without any problem with resources of the territorial entities.
In addition to AstraZeneca, have you talked to other pharmaceutical companies?
We are looking forward to meeting with the Pfizer regional manager and we are also looking forward to speaking with Janssen. Let us remember that Cali has just finished its participation with the vaccine from this last laboratory, which was being tested in phase three at the Ceip (Center for Studies in Pediatric Infectology), in such a way that we have an open door with this pharmaceutical.
If all the sectors of Cali do not register the same incidence of covid, why has not thought about making sectorized closures, as has been done in other cities of the country such as Bogotá?
If we look at the heat map of Cali, we can see that we are in a high situation of dispersion of cases, which does not allow decisions to be made by micro-territories as was done at some point. What strategy are we using then? We are making a presence with pedagogy and delivery of masks in those sectors with a high number of cases that, therefore, have a high referral to ICU.
In addition to that, we are making a containment strategy in which we are calling and visiting at home the relatives of the patients who were admitted to an ICU in the last 48 hours and the relatives of the patients who are today on the waiting list to occupy some of those beds because they are already infected or have a symptomatology that warrants this type of hospitalization. This is due to the fact that a person hospitalized in an ICU for covid may have other relatives infected at home and, possibly, some of them may be high-risk patients who could also be referred to an ICU, so we are giving them timely treatment in their homes. What we have observed is that we have siblings in ICU, father and son in ICU, mother and son in ICU, etc. Apparently, in addition to the home being a high contagion site, it also seems that there was a family relationship of predisposition to refer to ICU and get worse.
Is this the most difficult time that Cali has gone through during the pandemic or were the months of July and August more complicated?
I think this is the most difficult time because in July and August the quarantine and the giant fear that we had of the covid allowed people to adhere a little more to public health strategies. However, with the economic opening came the need to go out to work, to enroll the children in school, to meet with families in December, etc. All that high number of physical contact and spaces where so many people congregated, as it was much more difficult to control than in July and August. This obviously generated all this referral of patients to the ICU that we are currently experiencing and it is what has caused us stress in the provision of health services.
When will this peak of infections begin to decrease?
We hope that with the regulatory measures and public health strategies that we have implemented, we can reduce, not only the speed of infections, but the occupation of ICUs in the next two weeks.
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In Cali an accordion model is being applied, to reduce infections on weekends and to be able to have an economic opening during the week.
What final recommendation do you want to give to Caleños?
That this weekend that the curfew was decreed we stay at home with our closed family nucleus. This is not the time to rent farms, or to visit the sick aunt, or to go and stay at our parents’ houses.