COVID-19 Global Perspective from Venezuela
Dr. Rosanna D'Addosio is a Professor of Family Medicine at the University of Zulia in Maracaibo, Venezuela. As part of our COVID-19 Global Perspective Series, we reached out to Dr. D'Addosio to hear how the COVID-19 pandemic is affecting Venezuela.
In what ways has your country's government responded to the COVID19 outbreak and pandemic? When did you start to see an answer?
Venezuela is a Federal Republic with 23 states and approximately 30 million inhabitants. Located in the north of South America.
In Venezuela, the forceful response of the government was given from March 15 with the declaration of national quarantine, social distancing, and closure of borders, although in early March there was already the regulation of the mandatory use of masks in public places, and the closing of schools and universities with a move to online distance classes.
The government has taken command and positive or suspicious cases can only be reported by authorized personnel from the health ministry. Likewise, the Venezuelan government has indicated four basic elements (www.mppre.gob.ve).
- Social Isolation
- Extended and personalized house-to-house screening for symptomatic cases.
- Guarantee the provision of treatment, including Chloroquine
- Ability to manage the pandemic at the national level.
14 sentinel hospitals were designated throughout the national territory to respond to all the population that so needs it, at the same time all the PCR tests are processed in a single place, "National Hygiene Institute" located in Caracas, the capital of Venezuela. The results can take a week depending on the geographical area (www.inhrr.gob.ve).
By April 10, 2020, 175 confirmed cases were reported, and 9 deaths (5.2%).
- To achieve the objectives, the government created an on-line survey through the “Plataforma Patria” with the symptoms of COVID-19 to detect possible new cases with responses from more than 11 million people out of 20 million users (www. patria.org.ve) for this and in order to increase the participation of citizens, compensatory salary bonuses are granted and as a requirement for access is the completion of the survey.
- Together with the United Nations and with a remote program, 355 health workers from different states of the country have been trained to protect against COVID-19.
- As of March 20, a program to disinfect streets and popular markets was started with calcium hypochlorite and chlorine washing, although the program was not maintained over time.
- By April 1, 1779 tests were performed with a rate of 8% of positive cases. The government claims to have 52,000 PCR kits and 1 million rapid tests thanks to bilateral collaboration with Russia, China and Cuba.
How do you anticipate that your country's health systems will be affected? What are you and your institution doing to prepare for COVID19?
The reality is that Venezuela is a country of great contrasts between the political and the social, where the people perceive that they have more duties than rights and live submerged in an environment of profound scarcity, looking with suspicion at the supposed health coverage that the government ensures. Multiple reports have pointed to the economic crisis in this scenario of COVID-19, especially UNOCHA (www.unocha.org) United Nations Office for the Coordination of Humanitarian Affairs in a recent report indicates that, the lack of medical supplies or the their availability can be a drawback. It is estimated that the shortage of gloves is 25%, of masks is 45%, and of soap 65%, to this we must add other deficiencies such as cuts in the electricity supply, lack of water, fuel and means of transportation, which makes it difficult to meet goals under regular conditions and much more in unexpected pandemic scenarios.
To increase the controversy, the Zulia State Medical College released a statement the fourth week after the quarantine declaration, highlighting that 69% of medical personnel do not have gloves, 36% do not have masks, 80% do not have soap, which increases the risk of contamination. At the same time, they point out the exclusion of the medical union in handling case information, ignorance of protocols for rapid tests, failures or shortages of medical supplies, creating an environment of disinformation or sometimes false security.
The institution where I work is a private cardiovascular disease hospital, which places me in a privileged setting considering the impossible to imagine difficulties that the public sector finds itself in. Because it is a health center, it must follow the norms that the government gives by law, so to ensure the integrity of its personnel, protective equipment such as gloves, mask, and clothing storage is provided. Likewise, before entering the hospital, everyone must clean their hands with antibacterial agents, both patients and medical personnel, only the patient is allowed to enter unaccompanied, medical and administrative staff were assigned a schedule by guards twice a week, the doors, chairs and tables are cleaned every hour with water and chlorine. Each patient is called by phone confirming their appointment. To ensure staff assistance, the hospital set up a bus with a free downtown route.
How will your country / city / community be affected in a unique and different way from other places in the world?
- The city, which is a reflection of the country, is paralyzed in part by the pandemic and in part by the lack of gasoline and transportation that, paradoxically, could contain the spread of the virus, but at the same time creates other isolation problems such as difficulty in accessing health centers if necessary.
- The measures taken by the government seem to be correct, but they have not been maintained over time.
- Many people are confined to the home, which can lead to domestic violence, depression, unemployment and poor nutrition, among other problems. In addition, as a result of the migration of young people, there are older people who are left alone in their homes in a state of abandonment, facing isolation with less family friction and more difficulties in making decisions.
What are people doing locally to generate support for the most vulnerable community members, neighbors and family members?
- Social networks have provided remote support, from telemedicine to conversations with groups such as WhatsApp or Zoom. Door-to-door delivery has also been created that takes food to the homes of those who pay for the service from abroad.
- Homemade cloth masks are made voluntarily within companies or communities for community use.
- Churches lend their spaces to prepare food and give it to the poorest and most vulnerable people with the participation of volunteers and donations.
What have you seen in your community that gives you hope or solidarity to obtain positive results?
- Work for the common good and not for the individual.
- Respect the rules and
- Interest in learning about COVID-19,
- For example, a neighbor donated cloth to make the masks and others through a YouTube tutorial carried out the project so that all the neighbors have the masks.
Why is collaborating with global partners more important now than ever?
- Resources are quickly depleted and only teamwork ensures positive results, with this pandemic we learn that I am fine as long as my neighbor is fine.
- Venezuela is currently in economic blockade, which makes it even more difficult to face the challenge of the pandemic. Separating the health system from the political and economic platform is almost impossible, I hope I have managed to give a real approach to an otherwise very complex situation.
COVID-19 Global Perspectives
Our COVID-19 Global Perspectives Series features insights and updates from our global health partners around the world.