RESUMEN
RESUMEN La pandemia por COVID-19 está afectando también a los trabajaderos de salud, observándose informes de la susceptibilidad que tienen de infectarse durante su jornada laboral. Las políticas ya establecidas y la implementación de las tres medidas de control de infecciones: administrativas, ambientales y de protección respiratoria, requieren de un gran involucramiento que va desde los tomadores de decisiones hasta el personal que brinda la atención directa al paciente infectado; es por ello que el trabajo en conjunto es determinante para el éxito de estas estrategias. Cabe resaltar que cada establecimiento de salud tendrá una necesidad distinta para el control de infecciones, dependiendo de ello se puede considerar como principales medidas administrativas la conformación de un equipo de control de infecciones y la evaluación de riesgo del establecimiento de salud. Dentro de las medidas ambientales, la desinfección de superficies y ambientes es clave, por lo cual es necesario promover la adecuada distribución de espacios que favorezca la ventilación cruzada con el uso de ventilación natural o mecánica; además de la posibilidad del uso de luz UV germicida para la desinfección de ambientes. Con respecto a la protección respiratoria, es indispensable contar con los elementos de protección necesarios, según el nivel de riesgo en el que se encuentre el personal de salud. La aplicabilidad de estas estrategias en el contexto actual de trasmisión ocupacional de COVID-19 permitirá reforzar las capacidades ya instaladas en los sistemas sanitarios claramente afectados por la pandemia.
ABSTRACT The COVID-19 pandemic affects healthcare workers as well. Reports are available of the susceptibility of these workers during daily practice. The policies in place and the implementation of three infection control measures: administrative, environmental and related to respiratory protection, require great involvement of all healthcare professionals, from decision-makers to the personnel in direct contact with infected patients. This is the reason why teamwork is decisive for the success of these strategies. It should be pointed out that each health institution will have different infection control needs, but the main administrative measures in all of them are the formation of an infection control team and the implementation of risk assessment actions. The key environmental measure is the disinfection of surfaces and environments. It is therefore necessary to foster an appropriate distribution of spaces facilitating cross-ventilation with the aid of natural or mechanical ventilation, besides the possibility of using germicidal UV light for environmental disinfection. With respect to respiratory protection, it is indispensable to have access to the protection equipment required by the level of risk to which the health personnel are exposed. Application of these strategies in the current context of occupational COVID-19 transmission, will make it possible to reinforce the capacities already installed in health systems clearly affected by the pandemic.
RESUMEN
In this study, we aimed to assess the relationship between tuberculosis case rate and COVID-19 case fatality rate (CFR) among districts within a tuberculosis-endemic metropolitan area. We analyzed data from 43 districts in Lima, Peru. We used districts as the units of observation. Linear regressions were used to investigate the relationship between COVID-19 CFRs and tuberculosis case rates. The mean COVID-19 CFR in each district for reporting Weeks 5-32 was used as the dependent variable. Independent variable was the mean rate of confirmed pulmonary tuberculosis cases for 2017-2019 period. Analyses were adjusted by population density, socioeconomic status, crowded housing, health facility density, and case rates of hypertension, diabetes mellitus, and HIV infection. The mean COVID-19 CFR in Lima was 4.0% ± 1.1%. The mean tuberculosis rate was 16.0 cases per 10,000 inhabitants. In multivariate analysis, tuberculosis case rate was associated with COVID-19 CFR (ß = 1.26; 95% confidence interval: 0.24-2.28; p = .02), after adjusting for potential confounders. We found that Lima districts with a higher burden of tuberculosis exhibited higher COVID-19 CFRs, independent of socioeconomic, and morbidity variables.
