Pablo Sigal
04/02/2021 17:03
Clarín.com
Society
Updated 04/02/2021 17:03
An official communication sent by the director of Epidemiological Surveillance and Outbreak Control of Buenos Aires to the director of Hospitals in the district, reveals a bottleneck in
the ability to carry out swabs and
timely coronavirus
diagnoses given
the sharp increase in cases.
The document that
Clarín
had access to
bears the signature of Teresa Beatriz Varela to Juan Riera, who orders to
limit the use of tests
to confirm positive cases of coronavirus.
It speaks of "new guidelines and reinforcing those already in force in order to
optimize the use of diagnostic resources
in the resolution of suspected cases of Covid-19."
Among other issues, the measure stipulates to stop testing possible suspicious cases of coronavirus that are
asymptomatic
.
On that point is based one of the criticisms that the measure received from some infectologists.
For the detractors of the official decision, that criterion would be delicate because
it would allow the Covid to spread uncontrollably.
Varela's argument is "to
avoid the saturation of the
diagnostic
laboratories
, which may lead to the loss of opportunity in the issuance of the corresponding test results in the
recently configured
epidemiological context
."
The official explains that "in the last week there was a general increase in suspected cases for the province
close to 50%
, with an even higher proportion in the AMBA region that has doubled the number of samples received by the network of public laboratories for surveillance of COVID-19 in the province located in that region. This can be clearly seen with the confirmation of
8,063 cases on Friday, March 31
, which constitutes approximately half of the daily cases in the country. "
Swabs are a key diagnostic and isolating tool.
"In this context of a health emergency, all health teams are urged to confirm by
clinical epidemiological criteria
(do not take a sample - swabbing -) in those cases that comply with:
- Criterion 1:
every suspected case that meets 2 or more of the following symptoms: fever, cough, odynophagia, respiratory distress, vomiting / diarrhea / headache / myalgia and that in the last 14 days prior to the onset of symptoms has been close contact
of a laboratory confirmed case.
-
Criterion 2:
Any person who, in the absence of any other identified cause, begins with sudden loss of taste or smell.
They except the following groups:
- Patients who present clinical criteria for hospitalization.
- Patients with risk factors (age ≥60 years, diabetes, chronic cardiovascular or respiratory disease, kidney failure, cirrhosis, immunocompromise, obesity).
- Pregnant people.
- Health workers.
- Essential personnel.
- Deceased persons, with no known cause.
The communication indicates that "only those who constitute a suspected case according to the current protocol will be studied by laboratory. That is,
asymptomatic people will
not be studied by laboratory
, nor with symptoms that do not correspond to the case definition
.
"
And he adds: "It is essential to focus on the quarantine of close contacts for
14 days from their last contact with a confirmed case
, without this behavior being modified by any additional study, since this is the only effective mechanism to stop the chain of virus transmission ".
The controversy
Arnaldo Casiró, head of Infectious Diseases at Hospital Alvarez, warned that in the framework of the second wave of Covid
"this is a very dangerous measure
.
"
He said that "it is not clear what will happen to people who have two of the symptoms mentioned but
do not know
if they were in contact with someone positive. There is a gray".
Eduardo López, infectious disease specialist and member of the expert committee that advises the Government, said that "the definition of criterion 1
is incomplete
, because it leads to them stopping studying those who were in group parties and they do not know if they were in contact with a asymptomatic for example. And those parties are
the most common places of contagion
. "
López added that "if these patients are not investigated there is the risk that
the disease will continue to be transmitted
. Above all, it is when in these group encounters there are super-
transmitters
and super-spreaders of the virus."
The detection of
asymptomatic cases
during the pandemic has been one of the key strategies to try to
stop the chain of infections
.
The DetectAr plan is based on that logic.
That is, the detection of positives for their immediate isolation.
On the other hand, Casiró raised another problem: "The bottleneck that exists today to carry out diagnostic tests is
going to be in the medical human resource
. Health personnel trained to carry out a clinical evaluation are not the same as those who today only they just order a test ".
The third point that Casiró made was that with this measure "there is a risk that more cases of coronavirus
remain outside the SISA
(the system that centralizes all the information on the pandemic in Argentina). agree - and I say it because I verified it -, with this new criterion the problem can be deepened ".
Sources from the Hospital Directorate told
Clarín
that those cases that are diagnosed by a medical clinic and not by tests will still be incorporated into the SISA.
And they added that "
diagnosis by nexus has
been implemented for some time in places with community circulation of the virus."
$
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