The beginning of 2021 has been like an extra time of 2020. Although hope is in the air that vaccines are close, the numbers of infections are not encouraging at all and various experts consulted by EL TIEMPO are pessimistic about it. coming. They point out that we are paying the price of “getting too relaxed” in December. But what to do? TOAlthough the responses of the majority of those consulted walk on the same side, the levels of pessimism and disappointment vary.
For example, Andrés Vecino, a health systems researcher at the Johns Hopkins University Department of International Health, says, disappointed, that “We shouldn’t have gotten to this point.”
And he warns: “I believe that, unfortunately, at the point where we are, these general quarantines are the only way (…). These are measures that I don’t like, but we have to set our sights on avoiding a third peak like this one and that implies the same as always: strengthening contact tracing, continue to make people aware of how serious this virus is and, of course, to implement the vaccination program ”.
In this regard, Gina Tambini, representative of the Pan American Health Organization (PAHO) in Colombia, says: “The vaccine that we have at this moment is to use a mask well, distancing ourselves, washing hands to cut the chains of transmission.” Already turn warns that it is necessary to “take more drastic measures”, but clarifies that “not throughout the country, but quarantine by cities, by municipalities, depending on the occupations of the Intensive Care Units.”
Unfortunately, the evidence shows that there is not much that can be done to stop what has already started in terms of this pandemic. That is, in December people met as a family, traveled, se relaxed in terms of care measures and the consequences are being seen at this time. Or, at least, this is how Luis Jorge Hernández, an expert in public health and professor at the Universidad de los Andes, points out.
“The room for maneuver is little in the sense that everything we do today will have an effect two weeks later, we are now receiving the harvest of the day of the candles and some of Christmas, we are missing the great harvest of New Year. That’s the serious thing although that impact is still missing, we are already in saturation”, Warns the expert, and, disappointed, says that this is partly due to the lack of adequate preparation.
“That’s what the first quarantine was for, to enlist, but that was not fully used and now we pay the consequences. Now we just hope that the impact is not very strong… ”, he adds.
According to the professor, Measures like curfew at this time are going to do very little in the sense that results are going to be seen within 15 days. What should be done at this time is a more agile and sectorized epidemiological analysis, instead of doing it by locality, the data should be reviewed by zonal planning unit (UPZ), by neighborhood, almost than by block, he says. “In this way, much more selective sanitary cords could be made.”
Silvana Zapata, epidemiologist, says that decision makers must monitor daily the indicators that allow verifying possible collapses of the system, such as the percentage of ICU occupancy, mortality rates, the percentage of positivity, in addition to identifying the monitoring of the chain of contacts through the PRASS strategy (Sustainable Selective Testing, Tracking and Isolation), that is, knowing the name of the infected person in each city in order to know if the isolation principle is being met, “which is the most important” .
“If these indicators are on the rise in recent weeks, they should take stricter measures as we are currently seeing”, says the expert, but in turn clarifies: “We should no longer speak of general quarantines, but sectorized quarantines, as long as this is seen as the last option, after exhausting more specific measures, and for this it is essential to monitor the indicators and people’s behavior ”.
As Zapata highlights and experts have also done so since the beginning of this quarantine, people’s behavior is fundamental. Zulma Cucunubá, an epidemiologist at Imperial College London, finds in part the answer to this second wave along the same path and says that it is necessary to encourage the substantial reduction of contacts of all citizens.
“That must be premise number one. Until a few days ago we talked about safe contacts in certain environments, but at this time the most prudent thing is for everyone to temporarily suspend non-essential contacts outside the home, until they return to a more stable situation, which may take a few weeks “, explains Cucunubá.
And to the question of what is the most effective way to reduce or temporarily suspend these contacts, he answers that “in some places they have suggested the peak and ID for certain activities, curfews, limitations on mobility. Hopefully this is enough. This is something that each city should value and monitor. This implies a very clear message to the public about the role that each person has in reducing contagion and a role for governments tosupport the social and economic measures necessary so that people can effectively reduce their contacts in the coming days”.
The question is summarized by Carlos Álvarez, infectologist and national coordinator of covid-19 studies for the World Health Organization, in self-care, biosafety protocols and government guidelines adjusted to epidemiology indicators. “Quarantine is not the only way; it is one more that must be implemented and, in my view, it is the last measure in those cases in which the speed of contagion becomes very important despite the other measures implemented or when it is not enough ”.
SUNDAY DRAFTING AND HEALTH UNIT