Título

EDITORIAL

REVISTA DE LA FACULTAD DE MEDICINA HUMANA 2020 - Universidad Ricardo Palma
DOI 10.25176/RFMH.v20i4.3043

COVID-19: THE WORLD ON PAUSE. HOW DO WE FACE THIS NEW PANDEMIC?

COVID-19: EL MUNDO EN PAUSA. ¿CÓMO NOS ENFRENTAMOS A ESTA NUEVA PANDEMIA?

Gabriel Lapman1,a

1Hospital Diego Thompson, Buenos Aires-Argentina.
aNephrologist, Cardiologist, and specialist in arterial hypertension.

The Covid-19 pandemic, popularly known as coronavirus, was announced in an article by the American Society of Microbiology(1) that already in 2007 warned about the dangers of consuming exotic animals in the different Chinese communities. The background of SARS(2) and MERS(3) help us understand that humanity is not prepared for such severe contingencies. The global economy is out of control and there is no clear leadership. The health systems are deficient as the result of years of underinvestment, low salaries, and a shortage of qualified personnel to care for, monitor, control and manage infectious diseases.

What happened in Argentina? The first case in the country was discovered on March 3, 2020, and it arrived in Argentina with a passenger who was traveling on first-class of an Italian flag airline. The next day, sanitary controls began at the Ezeiza Airport and 11 people were quarantined. On March 5, the second case of a 25-year-old man who had arrived from Rome appeared, and then Argentinian airlines decided to suspend trips to Italy. From this moment, the population began an escalation of social isolation of those who came from Spain or Italy. A few days later, the government decided to expand the measures by suspending classes, closing schools, and restricting general public transportation. Four days after these measures, the government imposed a mandatory quarantine for the entire country. it is forbidden to go out more than is necessary, keeping the distance of one and a half meters between people, taking care of hand hygiene, and restricting the number of people circulating in food courts, pharmacies, supermarkets. This represents a suspension for the economy Argentina, since all recreational activities, clothing commercial activities and other items were forced to close their doors. Then the government decides an even more drastic measure which was the closure of borders to "flatten the curve" of cases and reduce infection. Argentines stranded around the world, some repatriated foreigners, chaos, and uncertainty - that's how the virus finds us.

In the context of Argentina, the challenge is insurmountable, since previously the country was going through one of the worst economic crises in its history, with its poor health system, exorbitant public spending, a mega devaluation of the dollar and galloping inflation. Understanding that the presidential measures were timely and severe, the social, economic and labor context jeopardizes the "vaccine" proposed by the WHO: social isolation. Argentina has more than 40% of its population below the poverty line, a consequence of the slowdown in the economy and payment chains. Added to this panorama is the lack of articulation between the public-private health sector, and the lack of validation of “remote” care methods, such as video calls, WhatsApp inquiries, and others, causing deficiencies in care as well as in the collection of benefits. The paranoia generated by the Covid-19 causes clinics and sanatoriums to have idle beds, waiting for the epidemic and with the problems that institutional financial support entails. The lack of health personnel is another issue to be resolved in the midst of this crisis. The few personnel that is available is exposed and at risk of infection, given the working conditions, the lack of supplies, and the necessary tests.

The social panorama also represents a challenge. Overcrowding in popular neighborhoods, the lack of sewers and drinking water, the lack of beds and respirators jeopardize hygiene strategies, hand washing, social isolation, and general hygiene measures generating areas of massive foci of infection, almost impossible to detect. The current case numbers clearly do not reflect what is actually happening; because it is not tested or computed. At the moment Argentina has 1054 cases with 27 deaths in total, as of the writing date of this article.

The world is wondering which path to take, separation and nationalism, or international cooperation. Today we must all concentrate on providing the health system with those elements necessary to act. The fundamental participation of the population with essential care to reduce the circulation of the virus and the articulation between different sectors for this to happen. The pharmacological vaccine and drug industries are constantly working and we see results in a possible hopeful treatment of hydroxychloroquine(4) in conjunction with azithromycin(5), which could be an option for seriously ill patients. However, vaccination would be the solution to this problem in months or years away.

How do we deal with this pandemic? Do we have tools? Yes, but they are not the best which are social responsibility, distancing, and recurring hand hygiene. Why are they not the best? Well, they depend exclusively on people’s consciousness. These are the tools that are available today until we have a vaccine we must act in our behavior. Hygiene is a complex tool, it depends on access to drinking water, soap, alcohol, bleach. For this reason, we must reinforce the tools that we have which are our conscience and responsibility.

What does the future hold for us? Who would have thought a few months ago that the world would be paralyzed, that we could not travel, work, study, exercise, do our shopping, live freely? Everything looks uncertain, bleak, with fear, insecurity, and concern of a massive contagion in the midst of this global economic crisis. We have always known it, but we did not understand it. This pandemic shows us how fragile and ephemeral we are. It only remains for us to emerge strengthened and empowered as individuals and as a global society.


Correspondencia: Gabriel Lapman.
Dirección: Wenseslao tata 4726 caseros, 3 de febrero, argentina.
Teléfono: +5491153076341
Correo electrónico:drlapman@cetec.com.ar

REFERENCIAS BIBLIOGRÁFICAS

    1. Cheng VC, Lau SK, Woo PC, Yuen KY. Severe acute respiratory syndrome coronavirus as an agent of emerging and reemerging infection. Clin Microbiol Rev. 2007;20(4):660–694. doi:10.1128/CMR.00023-07
    2. Perlman S, McIntosh K. Coronaviruses, including severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 155.
    3.World Health Organization website. Middle East respiratory syndrome coronavirus (MERS-CoV). www.who.int/csr/disease/coronavirus_infections/faq/en. Updated January 21, 2019. Accessed February 4, 2020
    4. Colson P, Rolain JM, Raoult D. Chloroquine for the 2019 novel coronavirus SARS-CoV-2. Int J Antimicrob Agents. 2020 Mar;55(3):105923. doi: 10.1016/j.ijantimicag.2020.105923
    5. Philippe Gautreta et al Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an openlabel non-randomized clinical trial nternational Journal of Antimicrobial Agents – In Press 17 March 2020 – DOI : 10.1016/j.ijantimicag.2020.105949

http://www.scielo.org.pe/scielo.php?script=sci_serial&pid=2223-2516&lng=en&nrm=iso


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