Health May 16, 2020 | 8:07 am

Doctor believes Dominican Republic’s economy could open in two weeks

Dr. José Rafael Yunén, an infectologist, and intensivist, considered yesterday that if the behavior of covid-19 continues on the same trajectory in the country, the gradual opening of the economy can begin in two weeks. He assured that the low mortality from covid-19, less than 1%, could be due to multiple explanations, genetic or of treatments that have been applied.

“If the behavior of the epidemic in the country does not change in the next two weeks, we could gradually open the confinement, always protecting vulnerable people,” he said. He believes that the opening of the economy should be started using intelligent measures of social distancing, and penalizing if they are not carried out through the use of continuous surveillance.

The critical medicine expert assures that the case fatality rate in the Dominican Republic has not increased, even with a high positivity rate.
When analyzing the number of patients in intensive care units, based on real-time, it is 1.8%. The expert and member of the high-level commission that manages the issue said that the opening process should be carried out, protecting vulnerable people.

Yunén considers that everything must be done evaluating the number of cases, the percentage of occupancy of beds, and the percentage of lethality, in a systematic and constant way.

The main hypothesis is that the behavior of covid-19 could be related to issues such as climate, previous vaccination against tuberculosis with BCG, cross-reaction with other viruses such as zika, dengue, and chikungunya. It could also be explained in the use of such criticized treatments as Hydroxychloroquine or Ivermectin.

Could the disease and lethality behavior of covid-19 be due to vitamin D levels? asks the specialist.
“Is it also the genetic factors, is the stability the result of appropriate early quarantine or the sum of all?” He asks.

Yesterday’s report from the General Directorate of Epidemiology reported that the country already registers 11,739 positive cases (419 new ones), of which 1,885 people are in hospital isolation and 5,873 in-home isolation; visits are made to the latter for face-to-face monitoring, as well as telephone assistance and delivery of the indicated medications.

Only 127 of hospitalized patients are in intensive care units (ICU). The positivity rate in the samples processed during the last four weeks is 21.30%. Measures the specialists and authorities keep in place are the recommendations to the population to maintain a distance of at least one meter between two people. Also, the use of masks in work and public spaces. Care and isolation at the home of people with mild signs and symptoms.

It is recommended to seek care in health centers if you have a fever, headache, sore throat, diarrhea, loss of smell, malaise, cough, and respiratory distress.

To doctors, Yunén warned they refrain from doing ego-based medicine, and instead employ an evidence-based medicine.
He assured that the low mortality, less than 1% by covid-19, could be due to multiple explanations, genetic, environmental, measures, or treatment regimes, in Dominicans.

The critical medicine expert referred to the warning made by his infectious colleagues about the use of treatments such as Ivermectin and other therapeutic options to treat covid-19. “There is no justification right now for sending letters between medical societies without a proposal that offers solutions,” he said.

In his opinion, what should be done in the medical community is to evaluate the protocols that are currently being applied and then, according to the lessons learned, carry out clinical trials to guide their effectiveness. “Otherwise we would be promoting an ego-based medicine and not evidence-based collaborative medicine,” said the expert. 

It was asked what use is the state of confinement to which the country’s regulatory bodies have subjected the population if medical practice is frequently reversed. The lethality has not been so excessive.

The Society Infectious Diseases group expressed concern about the possibility that Ivermectin could be used as one of the therapeutic options to treat covid-19. Most Society of Infectology members state that the use of parenteral Ivermectin should not even be weighted for the regular treatment of covid-19.

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