The anguish is perceptible in his voice, despite being a scientist: “We are in a complex moment in which more and more people require medical attention and our hospitals are unable to cope,” El Salvador’s best-known epidemiologist tells DW, Jorge Panameño. A situation that is getting worse, since “for two weeks the Salvadoran government decided to limit the tests to seriously ill patients and health or security personnel,” added the doctor, who expressed widespread uncertainty due to “the lack of total transparency in managing the pandemic ».
According to the Government of El Salvador, as of June 19 there were 4,329 confirmed cases of coronavirus in the country and 86 people had died. According to official figures from this Central American country with almost 6 and a half million inhabitants, 2,419 tests had been carried out the day before. For Panamanian, a member of the Technical Committee for the Preparation of National Standards for the Care of Patients with HIV / AIDS, the reality is that there is a veil over official information: “There is an increase in burials of people who die for an alleged ‘ atypical pneumonia ‘», as death records state.
While the authorities keep the account that from Germany one case of infection has been imported and that from Guatemala and the United States each 20, the Salvadoran epidemiologist highlights that «El Salvador did not take advantage of the time since the first case on March 19 to raise the attention span that is so low that it collapses even with the relatively low number of cases. ” At least, officially registered ones.
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But the almost “overflow” of the pandemic in El Salvador also has to do with individual behavior. “After 90 days of quarantine, people began to be forced out of the necessity of subsisting in a country where 60% of the population lives on informal trade,” says the expert on Immunization Practices. But the worst, assures the epidemiologist, is that “the authorities did not present any protocol to prevent infections after the reopening of the economy.”
Cleaning of informal business streets in San Salvador after coronavirus outbreaks
Peak or plateau? Mexico in “unhealthy closeness”
“The situation in Mexico is not very different in terms of lack of control after the gradual reopening of the economy,” Rosa Maria Wong-Chew, an infectologist at the National Autonomous University of Mexico (UNAM), tells DW. “Also in Mexico, for example, the ‘Susana Distancia’ campaign that urged mutual protection disappeared,” says the scientist specializing in childhood pneumonia, who warns that “in Mexico we are already at a peak of infections that we do not know if it is going to go higher or we will go to a plateau ».
With more than 120 million inhabitants, the dimensions of the crisis in Mexico are greater, although the Government of Andrés Manuel López Obrador (AMLO) does not have to fight against the clash of the three powers that has virtually paralyzed decision-making in El Salvador. . According to official figures, until June 19 in Mexico there were 165,455 confirmed cases of infections with coronavirus, plus 59,778 suspects.
There is no lunch without taking temperature. Street artists in Mexico City attend a popular dining room for people without resources.
Mexico, the country of comorbidities
Brazil and Mexico have the highest number of cases in the Americas, after the United States. But there is a serious aspect to the situation in the Aztec country: “COVID-19 has an 11.11% fatality rate in Mexico, the highest in Latin America and one of the highest in the world,” adds the scientist, for whom this This aspect is especially noteworthy, given that at the start of the Chinese pandemic it gave 2.4% of lethality as a reference. Professor Wong invites to compare the lethality in different countries to understand the severity of the problem in Mexico: «In Germany, for example, it is 3.8%. And in other Latin American countries such as Peru of 3.17, in Argentina 3.45, in Colombia 3.24 and in Uruguay 2.71 percent », the latter, along with Paraguay and Costa Rica, noted for better management of the pandemic.
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To date, in Mexico, there were officially registered 19,747 deaths from COVID-19. Why is the proportion of people who develop COVID-19 in Mexico so much higher? “We lead the world in the rankings of overweight, obesity and diabetes mellitus, there are also high rates of high blood pressure,” is the scientist’s response, recalling that these are “just four comorbidities that can be fatal in the development of COVID- 19 ».
But the bad news for the Mexican population does not end here. “While the average age of people with severe development of COVID-19 in the world is 55 years, in Mexico it is 45”, concludes the professor at UNAM.
LifeFactors Plans to Produce “Anticovid Human Immunoglobulin-19”
The human body, producer of a proven therapy
How to help patients while a vaccine arrives? Until now, there is also no evidence that the medications used are safe and effective. The global race to develop therapy is feverish, and the “recoveries” or “survivors” of a coronavirus infection play a vital role.
The German Paul Ehrlich Institute for Vaccines and Biomedical Medicines recently approved a first clinical trial with convalescent plasma COVID-19 (CAPSID). An initiative in which Colombian scientists are also working, aiming at the development of additional therapeutic alternatives to that of convalescent plasma infusion.
«Physical distance», but not social in Medellín.
Recovered Battalions Can Save Other Lives
“For 100 years, it has been known that after an infection with a virus, the organism produces antibodies,” Carlos Julio Montoya Guarín, a doctor in immunology at the University of Antioquia, in Medellín, tells DW, recalling that “the antibodies have already been used in other epidemics such as the Spanish flu, Ebola and other coronaviruses ».
“Once the blood has been cleaned, donated by the growing battalion of people recovered from the contagion with coronavirus, the antibodies are extracted from the plasma. So the patient would receive only the purified antibodies, “explains the medical and scientific advisor to LifeFactors, a biopharmaceutical laboratory, based in Rionegro, Colombia, which has international support.
With this acquis, LifeFactors has already presented to INVIMA, the Colombian regulatory entity, the protocol of a clinical study that, once the field work was approved and carried out, would allow, in addition to the use of convalescent plasma, to manufacture «a product with much greater efficiency and safety: human immunoglobulin anticovid-19 ».
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The doctor Montoya Guarín explains where this “greater effectiveness” would lie: “While other initiatives have remained in the application of all the plasma from a single person, we mix the plasma of 100 or 200 convalescents, and through a biochemical process we separate antibodies ».
What is the advantage of immunoglobulin?
The immunologist Montoya talks about a “specially enriched” product. The answer is that “he has the immunological experience of 100 or 200 people who have already overcome the disease.” In addition, adds the professor at the University of Antioquia, “for your intravenous infusion it is not necessary to be admitted to a hospital, but it can be done in an office or medical center.” An advantage, which, in effect, could be useful for rural and urban populations in Latin America that suffer the full impact of the pandemic.
Not in vain, in view of the serious situation, the Salvadoran doctor, Jorge Panameño, calls on DW to the international community to help the people of El Salvador who urgently need, among others, the construction of temporary hospitals. ” Efforts to combat the pandemic also come from the region. The anticovid-19 human immunoglobulin production project is considered by experts to be a small therapeutic revolution, far from the noise of large Chinese, American or European pharmaceutical consortia.