Daños colaterales de la pandemia por COVID-19: ¿consecuencias inevitables? / Collateral damage from the COVID-19 pandemic: inevitable consequences?

Esta revisión narrativa describe el daño colateral de la pandemia de COVID-19, tanto en aspectos de la salud, como también sociales, educativos o económicos. Comunicamos el impacto mundial y local. Consideramos que varias de estas consecuencias eran inevitables, especialmente las sucedidas durante los primeros meses de una pandemia que se difundió a gran velocidad y con graves consecuencias directas en la morbimortalidad de la población. Sin embargo, luego de seis meses de su llegada a la Argentina, es oportuno revaluar la situación y replantearse si no se debería cambiar el enfoque para balancear la minimización del impacto directo de COVID-19 junto con la del daño colateral que las medidas para paliarlo produjeron. Es un desafío que no debe limitarse al sistema de salud. Debe encararse con un abordaje intersectorial amplio y con participación activa de la sociedad. Así como aplanamos la curva de COVID-19, cuanto más nos demoremos en aplanar las otras curvas de problemas sanitarios y sociales que se están generando, mayor será su impacto, tanto en el corto como en el largo plazo. (AU)

This narrative review shows the collateral damage of the COVID-19 pandemic, whether in health, social, educational or economic aspects. We report on the impact at the global and local levels. Many of these consequences were inevitable, especially in the first months of a pandemic that spread at great speed and with serious direct consequences on the morbidity and mortality of the population. However, six months after the arrival in our country, it is an opportunity to reassess the situation and rethink whether the approach should not be changed to balance the minimization of the direct impact of COVID-19 with that of the collateral damage that mitigation measures produced. This is a challenge that should not be limited to the health system. It must be addressed with a broad intersectoral approach and active participation of society. Just as we flatten the COVID-19 curve, the longer we delay in flattening the other curves of health and social problems that are being generated, the greater the impact, both in the short and long term. (AU)

Respuesta al brote de COVID-19 en la Región de las Américas / Response to the COVID-19 outbreak in the Region of the Americas

La OPS ha emitido un llamado a los donantes y socios para ampliar la capacidad de los países de las Américas para responder a la COVID-19. La estrategia de respuesta descrita en este llamado tiene dos objetivos principales: frenar la transmisión del virus y mitigar el impacto en la salud del COVID-19 en la Región. Se necesitan inicialmente 94.8 millones de dólares para apoyar los esfuerzos críticos de respuesta en los países que más necesitan ayuda hasta septiembre de 2020. A medida que este brote evolucione, es probable que las necesidades aumenten y los requisitos financieros estimados se ajusten acordemente.

Salud y Economía. Una convergencia necesaria para enfrentar el COVID-19 y retomar la senda hacia el desarrollo sostenible en América Latina y el Caribe / Health and Economy. A necessary convergence to face COVID-19 and resume the path towards sustainable development in Latin America and the Caribbean

Varios países de América Latina son el epicentro de la pandemia de COVID-19. La región, la más desigual del mundo, es especialmente vulnerable a la COVID-19 por sus altos niveles de informalidad laboral, urbanización y débiles sistemas de salud y protección social.

Salud y economía: una convergencia necesaria para enfrentar la enfermedad por coronavirus (COVID-19) y retomar la senda hacia el desarrollo sostenible / Health and the economy: a convergence needed to address COVID-19 and retake the path of sustainable development in Latin America and the Caribbean

América Latina y el Caribe se ha convertido en el epicentro de la pandemia de enfermedad por coronavirus (COVID-19) y encabeza las estadísticas mundiales de casos. La pandemia ha devenido en una inédita crisis económica y social y, si no se toman medidas urgentes, podría transformarse en una crisis alimentaria, humanitaria y política. Tanto para las acciones de control de la pandemia como para las etapas de reactivación y reconstrucción, es imprescindible aumentar la inversión pública en salud hasta alcanzar los parámetros recomendados, de modo de asegurar el fortalecimiento de los sistemas de salud, ampliando y reconfigurando los servicios de salud de calidad, con un enfoque de atención primaria de salud, y abordar de manera inmediata y acelerada las necesidades de salud insatisfechas, reducir inequidades y mejorar las condiciones de acceso a servicios esenciales, incluida la protección financiera.

Latin America and the Caribbean is now the epicenter of the COVID-19 pandemic, with the highest number of cases of any region in the world. The pandemic has produced an unprecedented economic and social crisis, and it could generate a food, humanitarian, and political crisis if urgent measures are not taken. The policy options for addressing the pandemic entail consolidating national plans and achieving intersectoral consensus. The response should be structured in three nonlinear and interrelated phases­control, reactivation, and rebuilding­involving the participation of technical actors representing not only the field of health but also other social and economic areas. Measures implemented to control the pandemic as well as measures for the reactivation and rebuilding phases will require increased public investment in health until the recommended parameters are achieved. It is necessary to ensure the strengthening of health systems and the expansion and reconfiguration of quality health services with a primary health care approach and to immediately address unmet health needs, reduce inequities, and improve conditions for accessing essential services, including financial protection.

Clinical decision making in older adults with COVID-19 in developing countries: looking beyond chronological age

ABSTRACT Background: The coronavirus disease 2019 (COVID-19) has been declared a global pandemic. Older adults have been found as a vulnerable group for developing severe forms of disease and increased mortality. Objective: The objective of the study was to propose a pathway to assist the decision-making process for hospital resource allocation for older adults with COVID-19 using simple geriatric assessment-based tools. Methods: We reviewed the available literature at this point of the COVID-19 outbreak, focusing in older adult care to extract key recommendations for those health-care professionals who will be treating older adults in the hospital emergency ward (HEW) in developing countries during the COVID-19 pandemic. Results: We listed a series of easy recommendations for non-geriatrician doctors in the HEW and suggested simple tools for hospital resource allocation during critical care evaluation of older adults with COVID-19 in low- and middle-income countries. Conclusions: Age must not be used as the sole criterion for resource allocation among older adults with COVID-19. Simple and efficient tools are available to identify components of the comprehensive geriatric assessment, which could be useful to predict outcomes and provide high-quality care that would fit the particular needs of older adults in resource-limited settings amidst this global pandemic.

Early public research funding response to COVID-19 pandemic in Brazil

Abstract INTRODUCTION: This study investigated the role of early public research funding regarding the COVID-19 pandemic in Brazil. METHODS: We examined the budget for research projects relating to the number of cases and deaths and the relationship between each federal unit, gross domestic product (GDP) per capita, and the national GDP per capita. RESULTS: Using data from the websites of official funding agencies and the Brazilian government, we found that, in the first four months since the first case in Wuhan, China (December 31, 2019), around US$ 38.3 million were directed to public funding for scientific investigations against the COVID-19 pandemic. However, only 11 out of 27 federal units provided funding during the initial stages of the outbreak, and those that did provide financing were not necessarily the units having the most inhabitants, highest GDP, or the greatest number of cases. The areas of research interest were also identified in the funding documents; the most common topic was "diagnosis" and the least common was "equipment for treatment." CONCLUSIONS: Brazilian researchers had access to funding opportunities for projects against COVID-19. However, strategies to minimize the economic impacts of COVID-19 are crucial in mitigating or avoiding substantial financial and social shortcomings, particularly in terms of an emerging market such as Brazil.

A pandemia de COVID-19 para além das Ciências da Saúde: reflexões sobre sua determinação social / The COVID-19 pandemic beyond Health Sciences: reflections on its social determination

Resumo Este artigo possui o objetivo de realizar uma reflexão teórica sobre os fundamentos histórico-sociais da pandemia de COVID-19. A partir da matriz teórica materialista histórica, evoca-se as categorias da "mundialização do capital", "capital-imperialismo", "compressão espaço-tempo" e "crise estrutural do capital" traçando um percurso que ultrapassa os limites das Ciências da Saúde a fim de entender a saúde global, da qual a pandemia de COVID-19 é expressão. Posteriormente, faz-se o retorno ao campo da saúde, quando a categoria da "determinação social da saúde" permite elucidar as bases da pandemia estudada. Demonstra-se que, para além das características próprias do SARS-CoV-2 ou da dinâmica de rápido trânsito de pessoas e objetos pelo mundo, há outros elementos típicos da atual fase do capitalismo contemporâneo que se tornaram universais, unificando o processo de determinação social da saúde.

Abstract This paper aims to perform a theoretical reflection on the historical-social foundations of the COVID-19 pandemic. The "capital worldization", "capital-imperialism", "space-time compression", and "structural crisis of capital" categories are conjured from the historical materialistic-theoretical matrix, outlining a course that transcends the limits of Health Sciences to understand global health, of which the COVID-19 pandemic is an expression. We then return to the field of health, when the category of "social determination of health" allows elucidating the bases of the pandemic studied. We show that, other elements typical of the current phase of contemporary capitalism have become universal besides the SARS-CoV-2 characteristics or the dynamics of the rapid movement of people and objects around the world, unifying the health social determination process.

Fatores associados ao comportamento da população durante o isolamento social na pandemia de COVID-19 / Factors associated with people's behavior in social isolation during the COVID-19 pandemic

Resumo O artigo apresenta resultados da pesquisa de opinião realizada no Brasil sobre a percepção do isolamento social durante a pandemia de COVID-19. O questionário foi elaborado no Google Forms, disseminado por redes sociais, com questões sobre o perfil socioeconômico e fatores associados ao isolamento. Obteve-se uma amostra com 16.440 respondentes. Os dados foram analisados no software Stata 13. O convívio social foi o aspecto mais afetado entre pessoas com maior escolaridade e renda 45,8%, para pessoas de baixas renda e escolaridade, problemas financeiros provocam maior impacto 35%. Os que praticam atividade física revelaram menores níveis de estresse 13%, bem como uma maior normalidade no sono 50,3%. Pessoas que referiram residir em piores condições de habitabilidade, informaram disposição a permanecer menos tempo isoladas 73,9%. Dentre as pessoas que não estão isoladas (10,7% do total), 75,8% acredita que o isolamento social reduzirá o número de vítimas da COVID-19. Concluímos, que a percepção das pessoas quanto ao isolamento social como medida de mitigação da pandemia, varia conforme a renda, escolaridade, idade e sexo, porém a maior parte acredita que se trata da medida de controle mais indicada e estão dispostas a esperar o tempo que for necessário para contribuir com o enfrentamento à COVID-19.

Abstract This paper presents the results of an opinion poll conducted in Brazil on the perception of social isolation during the COVID-19 pandemic. The questionnaire was prepared on Google Forms, disseminated through social networks, with questions about the socioeconomic profile and factors associated with isolation. A non-probabilistic sample was obtained with 16,440 respondents. Data were analyzed using the Stata 13 software. Social interaction was the most affected aspect among people with higher education and income (45.8%), and financial problems caused a more significant impact (35%) among people with low income and education. Those who practice some physical activity showed lower levels of stress 13%, as well as greater normality in sleep 50.3%. People who reported living in worse habitability conditions reported willingness to remain isolated for less time, 73.9%. Among non-isolated people (10.7% of the total sample), 75.8% believe that social isolation will reduce the number of victims of COVID-19. We conclude, based on this sample, that the perception about social isolation as a pandemic mitigation action varies by income, education, age, and gender. However, most believe that it is the most appropriate control measure and are willing to wait as long as necessary to contribute to the fight against COVID-19.

Ensayo sobre la pandemencia: cuando los personajes y microbios de la ciencia ficción salen de la película / Essay on Pandementia: when the characters and microbes of science fiction jump off the screen and invade the planet

RESUMEN Este ensayo crítico acerca de las declaraciones sobre la técnica y la vida en el planeta COVID-19 propone una reflexión ético-filosófica de los efectos de la pandemia. Trata de entender, atribuir significados y criticar las referencias a la pandemia, especialmente en Brasil, en momentos especialmente dramáticos, debido a la sinergia entre la grave enfermedad que afecta al país y al planeta, y un gobierno que se destaca por su gigantesca incapacidad para hacer frente a la calamidad. Este texto fue escrito en el periodo de "cuarentena" brasileña, desde mediados de marzo hasta fines de abril de 2020. Es un momento en el que los hechos nos golpean y no dejan de atormentarnos, y se vive a diario bajo el terrible dominio de esta pandemia. Así, este texto se caracteriza por estar elaborado en medio de un contexto social marcado por los esfuerzos de control y atención de la salud de los afectados, a pesar del complejo marco político actual y de las profundas dificultades económicas del país.

ABSTRACT This essay intends to carry out an ethical and philosophical reflection on the effects of the emergency contingencies of the COVID-19 pandemic. With a focus on Brazil, it seeks to understand, critique, and attribute meaning to references to the pandemic, in particularly dramatic moments brought about by the synergy produced between the serious disease affecting the country and the world and a government that stands out for its remarkable unwillingness and inability to deal with this calamity. This text was written during the Brazilian "quarantine," which lasted from mid-March to late April, 2020. During this period, we were bombarded by facts that never ceased to haunt us, and lived each day under the terrible dominion of the pandemic. Therefore, this text was written in the midst of a social context marked by control efforts, with great attention directed at the health of those affected, despite the complex political framework and serious economic difficulties facing the country.