"Latin America is in a good position to face the coronavirus"

Florence Cunzolo

03/06/2020 - 14:56

• Clarín.com
• Good Life

China notified the first group of cases of severe pneumonia on the last day of 2019. On January 7, it was identified that it was a new coronavirus and five days later it communicated its genetic sequence, key to developing diagnostic kits. Despite the siege imposed by the largest quarantine in history, drip cases began to be reported in other countries and then the pace accelerated. The first in Latin America was notified in Brazil, only on February 26. Two days later, researchers from that country had already sequenced the genome, even before in Italy, where the infected patient had come from.

"In Latin America, the virus arrived very late and is in a very good position to take precautions to prevent the situation from getting out of control, " says María Valeria Fabre, an Argentine epidemiologist specializing in infectious diseases at the prestigious Johns Hopkins Hospital in Baltimore, United States. United.

To date, there are confirmed cases in Argentina, Brazil, Chile, Mexico, Ecuador, Peru and Costa Rica.

Fabre - who graduated from the University of Buenos Aires and settled 13 years ago in the United States where she is a professor at the Johns Hopkins University School of Medicine and associate medical director of the Antimicrobial Stewardship Program - estimates that “if we continue with this level of alert, if the guard is not lowered, if there is an order, a process to identify and isolate cases, this epidemic will not have the dimension of the influenza pandemic ”.

And he adds: “Based on what we are seeing now, I believe that one of the main consequences will be given by the impact on the economy. The activity has been paralyzed a lot. Here most of the congresses were canceled, companies are recommending that all who can do so work from their homes. In Italy the situation evolved very quickly and suddenly they had many cases - today there are more than 4,600, with almost 200 deaths - and they are very affected, with all their universities and schools closed. How long will it take for tourism to recover, for example? ”He asks.

Worldwide, they estimate that only airlines could lose up to 113 billion dollars . The blow to the economies of China and other Asian powers is still difficult to estimate.

At the health level, the epidemiologist argues that the experience can vary greatly from one country to another. “In China it was terrible. At one time, Iran and South Korea had the same number of cases. However, in Iran half had died, while the percentage of deaths in Korea was 1%. So, clearly the difference is in how a country addresses the issue. "

Policies, protocol design, the attention they are given and the speed to act, he says, are factors that can make a difference. and that in these cases it is extremely important to anticipate.

In that sense, it highlights that the fact that the virus has entered the region late opens a window of opportunity. "It was a long time until the first case in Latin America appeared, that puts it in a very good position to implement strategic plans so that what happened to Italy and other countries does not happen. The most important thing is to have the channels of open communication, that the health centers before the appearance of a case communicate quickly to the governments, something that seems to me that is happening. And that each hospital, each community, has a plan before the appearance of an eventual case ".

It also underlines the need to comply with specific protocols in people who come from countries with high transmission. "They do not necessarily have to be checked by a doctor at the airport: it can be a letter, an information, a message on the plane that gives clear measures of how to act in the event of symptoms and to reduce the risk of transmission to other people." Emphasize

Rational use of resources

Fabre answered Clarín by telephone during a stop in activities at the Johns Hopkinks hospital operations center, which is activated in emergencies and in the need to design strategies for an imminent threat. The focus is on developing a plan for the potential increase in cases in the United States (with 241 cases today). The activity there intensified about a month ago - he says - and, although in the state of Maryland, no cases had been confirmed at the time of communication, they had to discard a good number.

"People are quite calm, but very anxious because everything changes very quickly," he acknowledges. The most complicated day was Wednesday, after Vice President Mike Pence announced that the country had the ability to offer universal testing for coronaviruses, that is, that anyone with a medical order could access a test. The promise was short-lived, yesterday he had to admit that they did not have enough tests.

“We don't have the reagents yet. We are not prepared for that, says Fabre. Common sense must be used and the case definition always helps. There are very low risk areas. Most cases are related to travel, so a person with respiratory symptoms without this antecedent or epidemiological link, is most likely not a case of COVID-19. It is important to make rational use of resources ”, the specialist analyzes.

In that sense, a tool that is very useful for them is a dashboard developed by the university, a map that allows you to follow live the number of cases worldwide and state by state within that country.

“We receive calls from many outpatient centers or hospitals that are within our system asking about the appearance of symptoms in people who were not in areas that have registered cases. Showing that map to doctors and patients serves to give them more peace of mind. ” The board includes the number of total cases since the beginning of the epidemic, of deaths, but also of recovered people.

“You can see a lot of photos of people in the airports with the mask and there is no evidence that this will prevent contagion. The use of chinstraps in asymptomatic population is a waste of resources . These masks should be reserved for patients who develop symptoms and mainly for health workers who are really going to be exposed. Pity of this chinstrap in the street or at the airport is very bad, because once the infected person sneezes or coughs, the virus can remain in the door handle, on the telephone, on all surfaces, that is why it is so important the respiratory tag to prevent transmission (cover properly) and handwashing, ”he concluded.