translated from Spanish: Health care and pandemic lessons: “Since we don’t oust the first 400 infected, we finally ousted seven million”

Chilean health care doctor Catterina Ferreccio noted this Saturday that one of the lessons of the pandemic is the need to isolate and trace the first infected from a disease, something that did not happen in March 2020 with the coronavirus.
“If you isolate the infectious, don’t isolate the healthy,” said the senior UC professor and deputy director of the Advanced Center for Chronic Diseases (ACCDiS).
“Because we don’t ings them to the (first) 400 (infected), we finally ingies seven million. Rationality was not used to control the infectious.” In retrospect, “that forced us to a move that has caused damage that will last a long time,” he added in reference to the national confinement that is already a year old.
Ferreccio made the statements in the context of the talk “Latin America in front of the pandemic: Is it time for local science?”, within the framework of the scientific festival Puerto de Ideas, which takes place until this Sunday online, where he shared with the Uruguayan virologist Gonzalo Moratorio in a space led by journalist Soledad Onetto.
Strengths and learnings
The specialist began the talk highlighting the strengths and learnings of the pandemic in Chile. One of them has been, in his view, the dialogue between scientists and the authorities to deal with the health emergency, in a country that is “not accustomed to making public health decisions based on knowledge”. In fact, in his view, science is only one of the elements to consider, “and the effectiveness of decisions is lost.”
“That dialogue started very weakly. It has been improving, it has helped is that the Ministry of Health has invited researchers. A dialogue has been opened, which is about to be known,” he said, while asking that the relationship between science and public health managers not be lost in the future.
He also celebrated the collaboration of the newborn Ministry of Science, which served as a “bridge” between researchers and authorities. “The pandemic has approached scientists and politicians. There is closeness, but it has its tensions,” he admitted.
Moratorio, for his part, spoke of “political and non-scientific failure,” noting that this synergy between public health and science “came to stay, to face a world where these events are going to become increasingly frequent by climate change,” and that it even depends on us even going back to “old normality” in the future.
The Uruguayan also noted that the pandemic has been an opportunity to give more relevance to science.
“Children used to comment on footballers, today about scientists. The impact of scientists is to make everything more sustainable, in the environment, in renewable energy. Industrial development needs to be rethred. That there are policies that make large companies invest to make their products more sustainable. Insertion policies must be promoted in all fields, betting on public and private capital,” he said.
“Rich countries do not invest more in science because they are rich, but because at some point they made the decision to invest in science in the productive matrix, such as Scandinavia or South Korea,” he added, and assured that this decision, made in the 1970s, is now in its superior economic development.
Driving in Latin America
When asked about the management of the pandemic at the Latin American level, Moratorio said he believed “that we have not done well.”
“We became the epicenter of the pandemic. Being the last geographically beaten we could have taken information from countries like Italy to anticipate and avoid an ICU saturation destination, and get to the point of having to choose who lives and who dies,” which was what finally happened.
Although he admitted that “there are handling and handling,” with extremes like Brazil, he insisted that “we could have done things better.”
Ferruccio stressed that in the Chilean case there were some positive facts.
Specifically, he indicated that President Sebastián Piñera “has been on horseback from the subject, leading, listening and managing what he achieves to do. That’s important because the problem is given maximum relevance. He has been agile in managing Ucis, fans and vaccines. That allows us to have a lot of vaccinated people. We can’t deny that.”
Weaknesses of the Chilean case
However, he said the downside was public health.
“It was an area that was not heard. We could have been like Australia or Vietnam, because our borders are controllable. The first 400 cases in March came in Euclothing or the United States. What we should have done was isolate them so they wouldn’t spread around them. That wasn’t done because there was a vision of responding with hospitals. That caused the infection to spread,” he lamented.
“We were terrified of pollution from the east (from the capital) to the rest of the city, and we did. We felt that the epidemiology was not heard, everyone counted the fans. We could have done better. Today the variants function like another pandemic. Now it is being done better with examination at the airport, etc.” although it does not seem to be enough in terms of traceability.
He indicated that today traceability was two people, but within 48 hours an infected person may have 30 or 40 contacts, and that resources were lacking to stop transmission. “Winter is also a threat, because we are going to close the windows of buses,” he said, alluding to enclosed spaces increasing the chances of contagion.
The specialist put hope into the antigen test in primary health, to see if a person has the virus, even with saliva. The result is in 30 minutes and its traceability “is much better than calling 3 or 4 days later. I have a lot of hope with the antigen test.”
Another weakness, in his view, has been the risky communication towards the population, “why, when, how, so that people understand what is going on. Risk communication is a debt. Hopefully we can fix it in what’s left.”
Moratorio added that “this pandemic forces us to develop molecular surveillance, to know what is circulating, where, how it enters, to be able to read the genetic instructions of each virus, to discover new variants and their differences”, recalling that before the pandemic a million passengers flew per day around the globe.
Health systems, intercommunication, speed of alertness, communication, must be “rethred to conduct studies and evaluate measures. What is your action against the immune response, the vaccine, your stay in an individual? There are a lot of questions.”
The Uruguayan case
On the occasion, Moratorio was also consulted on the case of Uruguay, which at first appeared to be a success story, but whose rates have worsened in recent times.
At first , “good things were achieved, such as providing free PCRs across the country and border closure,” as well as alignment between scientists and politicians.
However, that same alignment then “began to falter, because we were victims of our own success. Victory was sung early.”
“Vaccines are not the end of the pandemic overnight, because waves of contagion can complicate these processes. Uruguay never had strict confinement, there was always freedom, only time for opening up commercial activity was regulated.”
He also said that at first there were few contagions, and that in November there were 900 cases per million: there were not even 3,000 cases.
“There was a false sense of success. Today we are on the podium in model vaccination, with 26% of those vaccinated and a decrease (of evil) in health personnel. It’s a delicate and difficult balance.”
However, he stressed that confinement impacts the poorest, “because others did very well.”
“States should not be afraid to borrow and support the vulnerable, such as informals who go out to gain weight day by day. In addition, insulation has a very large psychological cost. Studies will be very important to understand the impacts on education, parenting.”

Original source in Spanish

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