Chronic patients are at risk for not wanting to go to hospitals

The president of the College of Surgeons, Dr. Víctor Ramos, maintained that he has “serious concern” about the number of people with chronic diseases who are not following their treatment for fear of catching the dangerous Covid-19 coronavirus if they go to hospital centers , doctor’s clinics or laboratories.

“The main problem is getting patients to get (to clinics and hospitals). They are afraid of going to the hospital, and they are running out of their treatments, ”Ramos said. “They are staying at home, they are not calling their doctors.”

“And they are people with chronic conditions, with cancer, with lupus, who are not being given their proper treatment. The hospitals are empty. That worries us greatly, “insisted the doctor.

He commented that, if this situation is not attended to quickly, a scenario similar to that of the months after the scourge of Hurricane Maria could be seen, when hundreds of people with chronic conditions died as a result of not receiving their treatments, or not being able to receive them adequate.

“We fear that it will happen as with Maria. And back then the hospitals were full. Now we are seeing that they are empty ”, indicated the doctor.

“What we want to say is, yes, stay at home, but contact your doctor,” Ramos insisted.

“It is that they do not want to go to any hospital or medical office. But there is telemedicine. Have them talk to your doctor, to tell you how you are, if you need anything. That they are not left without treatment, “urged the doctor.

Ramos reiterated in alerting that “the death situation due to deterioration of chronic conditions can be worse than (the deaths by) the Covid (-19). We have a larger population with chronic conditions. It would be disastrous if those deaths increase. ”

“My concern is with chronic diseases. You cannot neglect the treatment, ”insisted the doctor. “The doctors are trying to do their job, even if by teleconsultation. They will attend to you in one way or another. But you must continue the treatment. ”

He added that when he talks about chronic diseases, it includes diabetes, asthma, hypertension, cardiovascular diseases, rheumatic diseases, lupus, cancer, multiple sclerosis, mental health diseases, “and any disease that is classified as chronic.”

In fact, Dr. María Conte Miller, commissioner of the Bureau of Forensic Sciences, endorsed the concern of Dr. Ramos and maintained that they have observed an increase in deaths of people in their homes, who had chronic diseases.

“From an analysis we made of people who died in their homes, we compared the month of March 2020 with the month of March 2019, and we observed an increase of 53 deaths of people in their homes,” explained the doctor. “They are people with chronic diseases, cancer, diabetes, heart conditions, strokes, Alzheimer’s.”

In March 2019, 97 people died in their homes. In 2020, the figure was 150.

The pathologist commented that although all deaths are important, it should be noted that Puerto Rico, in comparison with other jurisdictions, has had few deaths due to Covid-19, “and we do not want that achievement to be clouded by an increase in deaths by another side”.

The Commissioner of Forensic Sciences made the observation that “we still have limited data. But that is already a trend. Those 53 additional deaths are somewhat flashy. ” He added that he hoped that the figure would serve as much as possible to draw attention to the matter and help establish public policy deemed necessary to be able to attend to it.

“All patients must follow their treatment, with the appropriate protections, without exposing themselves unnecessarily, but they must do so,” Conte urged. “You are not going to take care of the Covid, and leave the other. Because it is so dangerous to stop attending to you ”.

“It’s like going back to work. You must return under the necessary security conditions. You should still see your doctor again, with the appropriate protections. You can not neglect “, insisted the pathologist.

In another matter related to Covid-19, Dr. Ramos endorsed the massive use of rapid tests as a resource to screen the extent of contagion among the general population, even though it is reported that such tests give enough results that end up resulting in false positives. and false negatives.

“That happens with any test. We also have false positives in influenza and mycoplasma tests. That can happen with any approved test. And at Covid we do not have any approved tests, they are only ‘clear’ by the FDA (Federal Food and Drug Administration). All Covid tests, serological (rapid) and molecular, have been preliminarily approved by the emergency. So it was also with the tests of Zika. And every day there are other tests that become ‘clear’, and there are some that never entered because they have not demonstrated any effectiveness, and others that are leaving ‘clear’ because they did not prove to be effective, ”Ramos explained, adding that that reason “the people who are buying have to be sure that they are ‘clear’ by the FDA”.

“That false positives thing is going to happen with the tests. However, this does not replace the physical examination of the doctor. That is why there are deaths that the doctor puts Covid on the medical certificate, even if he does not have a test, “Ramos added, emphasizing the experience and knowledge of the doctor to detect the symptoms that point to contagion with the virus.

“The tests must be continued. And false positives and false negatives are going to come out. The most worrisome are those false negatives, “added the doctor, explaining that those people with a false negative could end up infecting others without even knowing that they are sick.

“But yes, continue the rapid tests, the tests by servicarro. It depends on what you want to use them for, but it is valid for the general screening to do the massive tests ”, Ramos insisted. “You are not going to use it (the rapid test) in the hospital, if you are going to leave someone with the suspicion of Covid. You will not be using rapid tests for elective surgery patients. In those cases, you do the molecular test. “

However, the doctor recommended that for businesses that are going to resume operations after several weeks closed, if possible, do the molecular test and not the rapid test, at least on that first occasion when they return to work.

“Molecular testing is better, because if it is in the window period, it could be contagious and contagious to others,” he explained, although acknowledging that molecular tests are more expensive and there is not as much availability of them as with rapid ones.

Instead, “if the business was already open, you can see who developed symptoms, and rapid tests would do.”

On the other hand, Ramos said that the problems that doctors and other health workers had confronted with the lack or shortage of personal protective equipment in their work centers is something that seems to have been overcome.

“From the beginning I was very vocal in that, in demanding that they be provided with all the necessary equipment. But I have to be honest and say that this has greatly improved. Perhaps there are some other problems out there with a supply, but that has greatly improved, “said the doctor.

Ramos indicated that, fortunately, in the last week, no other doctor infected with Covid-19 had been reported.

“The number I have is 19 infected doctors. We know that unfortunately one passed away. The others are either cured or at home. I do know that there have been more nurses infected, “said Ramos.

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