Coronavirus 'not something to take lightly' says Colombian doctor

BOGOTA, Colombia

With more than 117,700 confirmed cases of coronavirus, Spain recently surpassed Italy.

This figure put Spain in second place globally with the highest number of positive cases after the United States.

It is also second in the number of deaths, after Italy, with more than 11,700, according to data from Johns Hopkins University.

In the first line of combat against the disease are hundreds of doctors, nurses, and health personnel who have been facing the shortage of medicines, the lack of beds in the Intensive Care Units (ICU) and the lack of material for their security.

María Fernanda Solano Luque is a Colombian doctor in internal medicine and infectious diseases, and coordinator of the Tuberculosis Program at the Mataró Hospital, in Barcelona.

In an interview with Anadolu Agency, she described how they had to prepare and learn about the disease while tending to an increasing number of patients. The hospital, like many in Spain, has little access to diagnostic tests and doctors already have started to feel the emotional and personal strain.

"In the beginning, we didn’t expect to have as many cases as those reported in China, so we started by opening a unit with few beds," explained the doctor. At that moment, they had a team for infectious diseases that consisted of two people: an associate doctor and Maria Fernanda, who visited the few patients who were admitted. That was in early March.

As the days passed, the cases grew exponentially. The hospital began opening the other units, which are approximately eight. Now 80% of the hospital is treating patients affected by the coronavirus.

"The experience has been very hard," said Maria Fernanda. The hardest part, she stressed, is not being able to speak directly with the relatives of the patients.

"We have to inform how bad the patient through the phone, a relative that can be his father or brother. It’s hard to see how those people die alone, in isolation, because unfortunately, no one can go accompany them," said Maria Fernanda.

"You perceive the anguish the person feels. They ask you to save them, to do as much as possible, but sometimes you see that even if you do everything within your power, some do not make it”, said the specialist.

Doctors like Maria Fernanda also face difficulties to get the protective gear they need to prevent contagion. In Spain, the cases grew exponentially so fast that other doctors who were not internists, such as cardiologists or other specialties, had to enter the coronavirus area.

"Suddenly the demand for protective equipment throughout Spain shot up. For example, the hospital told us that we had to put another mask on the filter masks to try to prolong their usefulness. But that works for a day or two," Maria Fernanda said.

That doctor explained that even though the government wanted to do its best to provide the equipment doctors need, the response had so far been slow.

"I feel that they are trying to manage it in the best possible way. However, it has been slow and that cannot be denied," the doctor said.

To maintain a stock of medicines was another important issue. At the beginning of the rise of cases of COVID-19, the doctors at the Mataró Hospital had to update the protocol for patient care every three days, because when they already had it established, the medication ran out.

“Now we have the basic medicine to treat patients with coronavirus, but there are other common medicines that we need, for example, to sedate the patients who are intubated in the ICU and now are running out”, she said.

The first reports about COVID-19 indicated that the vulnerable were older adults, but now many countries are reporting that it also affects younger people, even causing death. “At first we thought that it affects only people over 70 years of age with risk factors, and it´s true that they have the most difficulty, but we have faced from the beginning that young people, between 30 and 50 years old, also get very sick and they are the ones we have had to transfer to the ICU. Fortunately, these young people that we have been able to transfer to the ICU, overcome the disease”, Maria Fernanda added.

Some hospitals in Spain, including Mataró Hospital, have had to make war triage: doctors have to evaluate which patients have the best chance of survival and assign them the most care.

"If there is a person with pathologies such as hypertension or diabetes and another 30-year-old without any disease, and you can only take one of them to the ICU, we take the person who is more likely to survive," said Maria Fernanda. “This is experienced in all hospitals and is one of the hardest things”, she added.

The World Health Organization has emphasized the importance of conducting mass tests to detect and isolate cases quickly. But Spain seems to be a long way from having the coverage it needs.

“I am sure that if we identified more cases and treated them early, we would decrease the risk of transmitting the disease. Unfortunately, access to diagnostic tests has been very low. Even for us, as health personnel”, she said.

The access has been so limited that sometimes even the health personnel weren't tested. "A few weeks ago if somebody had symptoms the hospital just told us: Go home, take 15 days of isolation and then come back”, she said.

The specialist said that if they had access to more and faster tests, this situation could be different.

All these professional topics add up with daily chores like going to the market, caring for children and other things that seem simple but, in this context, become more complicated.

"My husband is working from home, but my four-year-old daughter needs attention. His work performance has decreased by 50% because he has to take care of her, feed her, etc. For young children, being inside the house all day is hard and we have to manage all that energy," said Maria Fernanda.

Other daily tasks such as grocery shopping also take longer and become more difficult.

Based on her experience, Maria Fernanda emphasizes the importance of taking all preventive measures against COVID-19, like social isolation and preparing of hospitals and other health institutions. "This is not something to take lightly, people are dying," she said vehemently. She explained that staying at home is a key way to prevent the disease from spreading.

"Having the experience of China, Italy, and Spain that all indicate that social distancing is key, the most illogical thing would be not to put that strategy into practice."

*Maria Paula Triviño contributed to this story.