End of the quarantine in Colombia: achievements for the health system – Salud


Tomorrow, after 159 days, the country ends the mandatory isolation that began on March 25. During this time it went through different stages, from the general restriction of mobility to progressive flexibilisations to allow the reactivation of the economy.

And although many said that these five months were one of the longest quarantines in the world, the Government and health authorities consider that it has been a necessary time to reach the indicators that They will allow, from September 1, the almost complete reopening of Colombia with the rigorous conditions.

The Minister of Health, Fernando Ruiz, has insisted that this isolation was not intended to eliminate the virus because what was sought, among others, was slow the spread of the pandemic and during that period adapt the health system to face it better.

(Also read: What is happening with the covid-19 tests in Colombia?)

In a true time trial situation, an estrategy to avoid saturation of intensive care units (ICU) so that every patient who got worse had attention, at the same time that the hospital system was expanded. This expansion plan has had two main components. The first was to increase the number of beds in critical areas with the eager purchase of fans, monitors and infusion pumps, which allowed the country to pass from 5,983 units in February to 9,922 today.

At the same time, human talent began to be trained to care for all patients with covid-19 and especially those who required intensive care. In this sense, the union of medical schools (Ascofame), the Pan American Health Organization (PAHO) and some hospital institutions developed training programs for general practitioners, nursing assistants, therapists and non-intensivist specialists, which, according to the Ministry of Health, they are around 45,000 in the country.

The portfolio states that without this trained resource, the achieved expansion and isolation, by mid-April all the ICUs would have been occupied and in mid-May the peak of the pandemic would have been reached without the possibility of treating thousands of patients.

(You may be interested: ‘Countries are not seeing the true magnitude of the pandemic’)

If only expansion had been left, but not isolation, the collapse of the system would have occurred in the third week of July, insists the Ministry of Health.

Another thing, which in the opinion of the authorities is another profit at this time, is knowledge about the proper management of patients in ICU and even the definition of strategies to anticipate its complications. In fact, Guillermo Ortiz, intensive care physician and director of the National University Hospital, says that emergency services are being more timely, there are risk stratification scales to make decisions such as who can go home or the level of hospitalization.

“Today we have learned other ways such as non-invasive ventilatory strategies, knowledge of pharmacological treatments and techniques to avoid severe lung damage,” says Ortiz.

Another element that was gained in this time is that the world is closer to a vaccine and it is known that the greater proximity between the peak of the pandemic and the arrival of the biological one translates into fewer lives lost.

(We recommend: Study would explain why women cope better with covid-19)

Key indicators

When the easing began, the Government set nine indicators to determine openings and closings. Today, most of them are favorable, although the infectologist Carlos Pérez clarifies that the pandemic has not ended.

The effective reproductive number of infections (Rt), for example, it went from 2.28 at the beginning of the pandemic to 1.11 today. The occupation of UCI, although it had critical moments in some capital cities almost reaching the top, today it has a general availability of 35 percent and no department is above 80 percent of capacity. The rate of duplication of cases has slowed and today it’s happening every 29 days. The fatality (percentage of deaths compared to total cases) went from being close to 5 percent a few months ago to 3.18 percent today.

And in other indicators that complete the panorama is the index of recovered in 72.75 percent of the total of cases, in contrast to the assets that are 24.07 percent.

Although these indicators are favorable, there are things to improve, such as optimizing the diagnostic capacity and conducting active searches, concludes Pérez.

(See: Underestimation of covid infections in the country would be 82%: study)

The challenge is not to lose what you have won

“The extreme quarantine measures cannot be eternal, they are unsustainable and that is why we must change the general isolation for an individual one,” Martha Ospina, director of the National Institute of Health (INS), said this week, insisting that The achievements obtained this time allowed better responses that must be maintained with the responsibility of all.

In that sense, Carlos Álvarez, national coordinator of covid studies for the WHO, affirms that this responsibility is double, because, on the one hand, there is the prevention of personal infection, which in turn helps to avoid cases in the environment.

And it draws attention to the fact that employers adopt the percentage of infected workers as an indicator and thus determine the quality of the measures applied by all. “If there are symptoms, the first thing to do is isolate yourself and then call the EPS and hope that everyone understands that they must act accordingly,” insists Álvarez.

HEALTH UNIT
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