The main challenge facing the health authorities of the Dominican Republic at this time is to avoid the appearance of the first local case of COVID-19 and to present itself, identify it in time, to avoid rapid community propagation, after confirmation this past March 1 of First imported case.
To do this, rigorous educational programs must be put in place that allow for a true change of culture among Dominicans that includes sowing the habit of handwashing, because it is well known that although the majority of the population knows about its effectiveness, it is a tool that has been impossible to apply 100 percent even among doctors, nurses and other health servants, although they have a higher level of prevention information than the general population.
Studies by the National Health Service (SNS) indicate that handwashing by health professionals in the country in 2018 was 28% and in 2019 that index increased to 54%, a situation that is a problem difficult to break in all countries, since the world average is 50%.
Shake hands
In addition, in a society that is characterized by the warmth and closeness in the treatment, another challenge of the health authorities is to achieve a change, even if temporary, in the way of greeting, reducing the usual handshakes, hugs and kisses , so used in greetings of arrivals and farewells between friends and acquaintances.
This, because the form of propagation of this respiratory disease caused by this new strain of coronavirus, which so far no one has antibodies to fight it, is from person to person through droplets of saliva from coughs and sneezes.
Cover your mouthto
To this is added that very few people in the country take into account the official recommendations to cover their mouth with a tissue or with the bottom of the elbow when sneezing or coughing (never using their hands), avoiding very crowded places or resting at the home until recovering when they have respiratory conditions.
The orientation and training of health personnel on manifestations, behavior and management of patients with suspected virus, as well as ensuring their protection is also part of the urgent actions that authorities must pay attention, especially in hospitals and centers located inside of the country, where some of them say that until yesterday nobody has spoken to him about the subject.
Shortage and speculation
Given the constant circulation of false and real, alarmist and optimistic information about this new virus, avoid panic and that this leads to unnecessary shortages of medicines and supplies, as well as speculation in the health care services themselves, is another of the challenges
The experience of other epidemics, such as what happened in 2014 with that of chickungunya, where the shortage of acetaminophen resulted from the unusual demand that unleashed the disease, which led to its cost reaching up to 50 pesos per pill, which Normally it is bought at six pesos in private pharmacies and less than one in the People’s Pharmacies.
This reality has begun to emerge at the moment with the price of the masks that from 130 pesos the box has risen to 250 pesos. Perhaps those are some of the reasons that have led the Minister of Public Health, Dr. Rafael Sánchez Cárdenas, to be emphatic in pointing out that there will be no trade with the evidence confirming or discarding COVID-19 and that at the moment the only place authorized to This is the Dr. Defilló National Laboratory.
Massive places
The rapid expansion that the virus has had in more than 70 countries and especially among the populations of China, where it was isolated for the first time last December and Italy, its second exporting country, forces the Dominican Republic to look from now in vulnerable places, especially where overcrowding or confinement prevails, including prisons, nursing homes, nurseries and boarding schools.
Recent histories of epidemics due to infectious and contagious diseases in the country, thus advise it, as is the case of cholera, which following the arrival of the first case imported from Haiti in 2010, subsequently recorded the first local case in the Dique sector and spread, generating outbreaks in populous sectors such as La Puya de Arroyo Hondo, where dozens were infected in a single day. In 2016, in La Victoria Prison there was an outbreak that left four deaths and about 75 inmates affected.
Priority
Working on these and other challenges became a priority because last Sunday, March 1, the Dominican Republic formally announced the first case imported from the COVID-19 coronavirus in a 62-year-old Italian who had arrived in the country on February 22 and that he had presented the first symptoms of fever, cough, malaise two days later while staying at a hotel in the East.
Yesterday the Ministry of Health reported that at least 40 people identified within their contacts are under surveillance, within the epidemiological map of direct contacts that is carried out to detect in time any suspicious febrile-respiratory symptoms.
First imported case
The first case imported from COVID-19 in the Dominican Republic is an Italian from Pesaro, Marche Region in Italy, arrived in the Dominican Republic on February 22, without symptoms, intending to leave on the 29th, but on the 24th he began respiratory symptoms characterized by fever, nonproductive cough, malaise, and with vesicular murmur, with no added noise in pulmonary auscultation. He underwent pharmacological treatment of the symptoms, strict measures of isolation and respiratory sampling that when processed at the Dr. Defilló National Laboratory. COVID-19 tested positive for influenza B Yamagata virus.
Latin America
The Dominican Republic became the 62nd country in diagnosing cases of COVID-19, in this case imported, and is part of the first four in Latin America to notify its presence, such as Brazil, Mexico and Ecuador. Yesterday they had also been detected in Chile and Argentina.
Actions
The Dominican health authorities have announced within the surveillance and preparation actions against the virus: the search for direct contacts to the positive patient, the strengthening of the surveillance structure, expedite the installation of a greater capacity for isolation, as well as in the actions of recruitment, isolation, laboratory test, confirmation and confinement of potential patients.
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