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After a growing number of “recovered” patients, the Minister of Health announced a tool to free them from quarantine. But experts questioned the measure. On the one hand, they warn of the need to use an exit test, which confirms that they are no longer infected, and, in addition, they explain that there are still no studies that would guarantee that a person infected with coronavirus is immune and not at risk of re-infection. Added to this is a case in point of the problem: a young man from Santiago passed a 14-minute PCR test and got a positive result, despite the fact that statistics in Chile already considers it written out. For his part, British Prime Minister Boris Johnson also spent 14 days with the virus and remains hospitalized with oxygen in London.
During the traditional balance of the Ministry of Health regarding the coronavirus, which takes place every morning in La Moneda, the head of the portfolio, Jaime Manyalich, again made an announcement that caused a burning sensation among specialists.
In addition to the 5,972 infected registered in Chile before this Thursday, he updated the number of recovered: a total of 1274 people (21% of the total)which are still issued “administratively” after 14 days without the need for field trials, but which are still considered “non-contagious”.
After reporting the numbers, he confirmed a new measure to solve the problem: “Since this number is growing (…) we are going to create an discharge card for people who have already completed and outstripped this disease or who have positive antibodiesHow are we going to start testing in another two weeks. And these people with this registration card will be exempted from all kinds of quarantines or restrictions, ”he assured.
It is very important that we have diagnostic confirmation of these recovered patients, and not as before, that there is an exclusively temporary criterion 14 days after applying the diagnostic confirmation to declare the patient recovered that may still remain asymptomatic or continue to spread. ”
– Cristobal Cuadrado, Technical Secretary, Department of Health Policy and Research, College of Medicine.
In particular, he pointed out the possible use of rapid tests, “which detect antibodies for people who do not understand that they have no coronavirus infection, that they have no symptoms, but they have protection, antibodies.”
In his opinion, recovery can be a huge contribution. As an example, he assured that “in a building where there is a person who went through this and pulled ahead – and therefore immunized – they will no longer get coronavirus, so it can be of great help to your community for your area.”
The above “either because they had symptoms and a positive PCR test, or because we found reliable antibodies (based on reliable tests, such as Minsala tests or ISP), to determine that these people are no longer at risk of contracting and spreading the disease “He assured.
But experts questioned the claim that the infected person is effectively protected and is not at risk of infection. Jeanette DabanchAn infectologist at the Clinical University Hospital of Chile noted that so far “There are no publications that would guarantee how long it lasts and how effective the immunity created by the disease itself is. Therefore, there is concern about how the post-pandemic period will go, thinking about other respiratory viruses that do not generate long-term immunity. Like flu, which requires immunization with a vaccine every year. “,
Experts also note that it is important to have diagnostic confirmation that the patient is effectively recovering with the PCR test, and not as before, that there is only a temporary criterion 14 days after applying the diagnostic declaration to declare how the patient has recovered, which may still be asymptomatic or continue to spread, “as noted Christopher Square, Technical Secretary, Department of Health Policy and Research, College of Medicine.
Cuadrado points out that, according to international experience, survivors are labeled as such after a new PCR test, which in Chile will only begin to apply to infected health workers to see if they have recovered or not from the disease.
In the same time, protocol for the provision of controversial “high” cards is not defined and as they explained from Minsal BiobiochileModality is still working.
According to government sources, it’s currently known that people will be entered into Carabineros databases, so if they are monitored, it will be reliably established that they have recovered from coronavirus and, in addition, they will be given a free document confirming that they are healthy,
However, Cuadrado indicated during the day that this measure was insufficient, because – in the light of Manaliha’s statements – it seems that they just want to have an antibody test (like an express test) that doesn’t guarantee the absence of viruses in humans and therefore, they cannot infect other people. Therefore, if this is so, in your opinion, you should not allow the release of the infected person from quarantine.
True to his style, the Minister of Health criticized the College of Medicine through his Twitter account: “I wonder what the proposal will be?” He asked.
Immediately after this, Cuadrado himself insisted that it was necessary “to first make sure that the person was truly a recovered person with PCR at the exit. If you also add an extra antibody test, ideal. But an antibody test, by itself, is not the right discharge criterion, ”he warned.
First make sure that this is a truly restored case with PCR output. If you also add an extra antibody test, perfect! But the antibody test, in itself, is not the right criterion for the high minister👇🏾 https://t.co/dRXA9K5wzQ https://t.co/sXHcBxCjku
– Cristobal Cuadrado (@CCuadradoN) April 9, 2020
Mail Quarantines
In the midst of this discussion, it was precisely the symbolic case of the problem posed by experts: Alvaro NunezA 28-year-old man who tested positive for coronavirus went to the Davila clinic for a PCR test 14 days after being diagnosed last Wednesday to confirm that he no longer has the virus. And amazing Although she no longer had symptoms, she had a positive result.
“I was sure that it would be negative, I no longer had a fever (…), they told me 14 days, I’m ready, you are healthy. I do not know what metrics the restored look at. In this case, I would not be restored. ”revealed in his testimony to the welcoming morning of channel 13.
Dr. Carolina Herrera, a program participant, emphasized that the young man’s cause is not surprising. “There is a chance that a person can spread the virus positive, and that’s why The World Health Organization (WHO) recommended two PCR tests after 14 days, over two separate days, and only those whose tests were negative were prescribed. ”confirmed by a medical professional.
“If he has not passed the test, like many others considered to be recovered, he is potentially a person who can violently spread the virus in the community where he lives”He warned that, fortunately, he remained isolated and escaped this situation.
“It’s not strange that a person has the spread of this virus, because not all organisms react the same way, and many need more time to deal with this viral load,” he explained.
In addition, he explained that the logic in the Veneto region in northern Italy is completely opposite to reality in Chile: there they tested all asymptomatic young people who could potentially infect vulnerable people as manipulators. nutrition, medical personnel, teachers, etc. And therefore, according to him, they found a large number of asymptomatic positive results, which after 14 days, many of them were still persistently positive.
He also made a distinction: a PCR test measures the genetic material of a virus, which means that the patient is contagious; which is different from taking an antibody sample (such as the rapid test that Manalikh mentioned), which will be positive and will reflect that the person has ever had an infection and already has its own defense mechanisms, but is not necessarily infectious.
Another case that has revealed the same problems around the world is British Prime Minister Boris Johnson.55 years old, who was already diagnosed with Covid-19 this Thursday, but last Monday he was hospitalized in a hospital in London. And although he left this department this Thursday, he is still hospitalized with coronavirus, receiving oxygen treatment and has not yet been declared “recovered.”
This is why both the United States Centers for Disease Control and Prevention (CDC) and WHO, as Dr. Herrera said, recommend an additional two weeks after symptoms stop or two PCR tests. negatives to effectively announce an extract.
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