La pandemia de covid-19 en Colombia: una visión desde la salud pública
DOI:
https://doi.org/10.56050/01205498.1539Palabras clave:
Covid-19, Pandemia, Inmunidad, letalidad, mitigación, supresiónResumen
La pandemia por el virus SARS-CoV-2 y la enfermedad que produce (COVID-19) afecta virtualmente a todos los países del mundo; el número de individuos afectados se incrementa y cambia constantemente; la población con mayor riesgo son los individuos ≥70 años con comorbilidades de base como diabetes mellitus, hipertensión arterial, EPOC, obesidad, entre otras. El 17 de marzo de 2020 se declaró en Colombia el “estado de emergencia económica y social”, y quedó consignado que el país se debía preparar para afrontar cerca de 4 millones de contagios por SARS-CoV-2. Al 25 de agosto de 2020, más de 500.000 casos confirmados y alrededor de 20.000 muertes, hacen parte del espectro de la distribución de la pandemia en nuestro país, una realidad que denota una menor tasa de letalidad y de mortalidad respecto a otros países. Algunos factores que pueden explicar lo anterior son el cierre de escuelas y universidades, el cese de algunas actividades de trabajo presencial, la ausencia de viajes nacionales e internacionales y el autoaislamiento para personas mayores de 70 años, entre otros. Esta revisión describe los aspectos básicos en términos de la salud pública que deben tenerse en cuenta en la pandemia por COVID-19.
Biografía del autor/a
Hernando Vargas-Uricoechea, Universidad del Cauca
Médico especialista en Medicina Interna y Endocrinología, MSc en Epidemiología, Doctor (Hon.) en Ciencias de la Salud, PhD en Ciencias Biomédicas. Director del Grupo de estudio en Enfermedades Metabólicas, Departamento de Medicina Interna, Universidad del Cauca, Popayán-Colombia.
Hernando David Vargas Sierra, Universidad del Cauca
Médico Residente del programa de Medicina Interna, Departamento de Medicina Interna, Grupo de investigación en Enfermedades Metabólicas, Universidad del Cauca, Popayán, Colombia.
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https://www.dane.gov.co/files/investigaciones/boletines/ech/ech_informalidad/bol_ech_informalidad_nov19_ene20.pdf
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2. Novel Coronavirus (2019-nCoV) situation reports [Internet]. Organización Mundial de la Salud. 2020 [consultado 16 de marzo de 2020]. Disponible en:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports.
3. Paules CI, Marston HD, Fauci AS. Coronavirus Infections—More Than Just the Common Cold. JAMA [Internet]. 2020 [consultado10 de marzo de 2020]323(8):707.; Disponible en:
https://jamanetwork.com/journals/jama/fullarticle/2759815.
4. Cyranoski D. Mystery deepens over animal source of coronavirus. Nature. 2020;579(7797):18-19.
5. Cui J, Li F, Shi Z-L. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 2019;17(3):181-92.
6. Linton NM, Kobayashi T, Yang Y, Hayashi K, Akhmetzhanov AR, Jung S et al. Epidemiological characteristics of novel coronavirus infection: A statistical analysis of publicly available case data. medRxiv [Internet] 2020 [consultado 18 de Marzo 2020];2020.01.26.20018754. Disponible en:
https://www.medrxiv.org/content/medrxiv/early/2020/01/28/2020.01.26.20018754.full.pdf.
7. Riou J, Althaus CL. Pattern of early human-to-human transmission of Wuhan 2019 novel coronavirus (2019- nCoV), December 2019 to January 2020. Euro Surveill.2020;25(4):1-5.
8. Coronavirus disease (COVID-19)- Organización Mundial de la Salud [Internet]. Who.int. 2020 [consultado 14 de marzo de 2020] Disponible en: https://www.who.int/emergencies/diseases/novel-coronavirus-2019.
9. Principles of Epidemiology | Lesson 1 – section 11 [Internet]. Cdc.gov. 2020 [consultado 14 de agosto de 2020]. Disponible en:
https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section11.html.
10. Madad S, Moskovitz J, Boyce MR, Cagliuso NV, Katz R. Ready or Not, Patients Will Present: Improving Urban Pandemic Preparedness. Disaster Med Public Health Prep. 2020;:1-4.
11. Koonin LM. Novel coronavirus disease (COVID-19) outbreak: Now is the time to refresh pandemic plans.J Bus Contin Emer Plan. 2020;13(4):1-15.
12. Hamer WH. Epidemic disease in England—the evidence of variability and of persistency of type. Lancet.1906;1:733-39.
13. Peeples L. Rethinking herd immunity. Nat Med. 2019;25(8):1178-80.
14. Wallinga J, Lipsitch M. How generation intervals shape the relationship between growth rates and reproductive numbers. Proc Biol Sci.2007;274(1609):599-604.
15. Liu QH, Ajelli M, Aleta A, Merler S, Moreno Y, Vespignani A. Measurability of the epidemic reproduction number in data-driven contact networks. Proc Natl Acad Sci U S A. 2018;115(50):12680-12685.
16. Fox JP, Elveback L, Scott W, Gatewood L, Ackerman E. Herd immunity: basic concept and relevance to public health immunization practices. Am J Epidemiol. 1971;94(3):179-89.
17. Marcus C, Pontasch J, Duff J, Khambadkone T, Fink B, et al. Developing “Herd Immunity” in a Civilian Community Through Incorporation of “Just-In-Time” Tourniquet Application Training. Prehosp Disaster Med. 2019;34(5):481-485.
18. Dudley MZ, Privor-Dumm L, Dubé È, MacDonald NE. Words matter: Vaccine hesitancy, vaccine demand, vaccine confidence, herd immunity and mandatory vaccination. Vaccine. 2020;38(4):709-711.
19. Schwingel JM. Exploring Infectious Disease Outbreaks and Herd Immunity Through Simulations with a Visual Appeal. J Microbiol Biol Educ. 2018;19(2).: jmbe-19-85.
20. Sanche S, Lin YT, Xu C, Romero-Severson E, Hengartner N, Ke R. High Contagiousness and Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2. Emerg Infect Dis. 2020;26(7):1470-1477.
21. Moghadas SM, Shoukat A, Fitzpatrick MC, Wells CR, Sah P, Pnadey A et al. Projecting hospital utilization during the COVID-19 outbreaks in the United States. Proc Natl Acad Sci 2020;117(16):9122-9126.Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. JAMA. 2020;..
22. Yang S, Cao P, Du P, Wu Z, Zhuang Z, Yang L et al. Early estimation of the case fatality rate of COVID-19 in mainland China: a data-driven analysis. Ann Transl Med. 2020;8(4):128-128..
23. Leung C. Clinical features of deaths in the novel coronavirus epidemic in China. Rev Med Virol. 2020;30(3)..
24. Li LQ, Huang T, Wang YQ, Wang ZP, Liang Y, Huang T et al. 2019 novel coronavirus patients’ clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol. 2020;92(6):577-583.
25. Chowell G, Viboud C. Is it growing exponentially fast? Impact of assuming exponential growth for characterizing and forecasting epidemics with initial near-exponential growth dynamics. Infect Dis Model. 2016;1(1):71-8.
26. Jung SM, Akhmetzhanov AR, Hayashi K, Linton NM, Yang Y, Yuan B et al. Real-Time Estimation of the Risk of Death from Novel Coronavirus (COVID-19) Infection: Inference Using Exported Cases. J Clin Med. 2020;9(2):523.
27. Madhav N, Oppenheim B, Gallivan M, Mulembakani P, Rubin E, Wolfe N. Pandemics: Risks, Impacts, and Mitigation. En: Jamison DT, Gelband H, Horton S, Jha P, Laxminarayan R, Mock CN-et al, ed. por Disease Control Priorities [Internet], 3a edición.. Washington DC: The World Bank; 2017[consultado 18 de marzo de 2020]. P.315-345. Disponible en:
http://dcp-3.org/sites/default/files/chapters/DCP3%20Volume%209_Ch%2017. pdf Ferguson NM, Laydon D, Nedjati-Gilani G, Imai N, Ainslie K, et al. On behalf of the Imperial College COVID-19 Response Team. Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand. [Internet]. Imperial.ac.uk.2020 [consultado 25 de Marzo de 2020]. Disponible en: https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf
28. Jarvis CI, Van Zandvoort K, Gimma A, Prem K, CMMID COVID-19 working group, et al. Quantifying the impact of physical distance measures on the transmission of COVID-19 in the UK.[Internet]. 2020 [consultado 13 de abril de 2020]; Disponible en:
https://www.researchgate.net/publication/340427835_Quantifying_the_impact_of_physical_distance_measures_on_the_transmission_ of_COVID-19_in_the_UK. 020].
29. Nussbaumer-Streit B, Mayr V, Dobrescu AIulia, Chapman A, Persad E, et al. Quarantine alone or in combination with other public health measures to control COVID-19: a rapid review. Cochrane Database of Systematic Reviews 2020; 4(4):CD013574.
30. Ahmed F, Zviedrite N, Uzicanin A. Effectiveness of workplace social distancing measures in reducing influenza transmission: a systematic review. BMC Public Health. 2018;18(1):518..
31. DANE. Medición de empleo informal y seguridad social. Trimestre móvil noviembre 2019 - enero 2020. Boletín Técnico Gran Encuesta Integrada de Hogares (GEIH). [Internet] Departamento Nacional de Estadística. 2020. [consultado 24 de Marzo de 2020]. Disponible en:
https://www.dane.gov.co/files/investigaciones/boletines/ech/ech_informalidad/bol_ech_informalidad_nov19_ene20.pdf
32. Cardinot M, Griffith J, O’Riordan C, Perc M. Cooperation in the spatial prisoner’s dilemma game with probabilistic abstention. Sci Rep. 2018;8(1):14531. .
33. Babajanyan SG, Melkikh AV, Allahverdyan AE. Leadership scenarios in prisoner’s dilemma game. Physica A: Statistical Mechanics and its Applications. 2020;545:123020.
Cómo citar
[1]
Vargas-Uricoechea, H. y Vargas Sierra, H.D. 2020. La pandemia de covid-19 en Colombia: una visión desde la salud pública. Medicina. 42, 3 (oct. 2020), 425–438. DOI:https://doi.org/10.56050/01205498.1539.
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2020-10-03
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