Coronavirus in Colombia: the herd theory proposed by a Swedish epidemiologist can be applied or not – Other Cities – Colombia

After the statements of Johan Giesecke, Sweden’s top epidemiologist and who helped design the strategy to face the pandemic in that country, in which he assured that rigid quarantines do not work, A controversy broke out in the medium most accessible to Colombians, social networks.

There the division between two sides was noticed after Giesecke’s explanation, those who are in favor and those who are against the quarantine. Since the quarantine was decreed, gangs have always made themselves noticed and lit a debate like a bonfire, which was gradually extinguishing, but as new fuel to that campfire came the theory of herd immunity that the Swedish epidemiologist explained.

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Experts in epidemiology of the highest level in the country assure that this herd immunity theory is not wrong, but it is uncertain because it depends on variables still unknown to science. Furthermore, the measures applied in Sweden have little or absolutely nothing to do with the measures in Colombia. To the point that they declared that Satanizing a measure like quarantine is wrong and unwise.

This is explained by Ruth Aralí Martínez Vega, an epidemiologist and doctor of public health sciences with an area of ​​concentration in infectious diseases.

“One of the crucial steps in taking such a government measure is knowing the demographics of the region. Thus, the behaviors that can cause a larger reproduction of the virus can be understood. The second is to understand that the capacity of the hospital network in each country is also an important variable to decree quarantine, “says Martínez.

(In context: Swedish epidemiologist says “or whatever we do, we will all catch it”)

Three differences that show that The Swedish model is a mistake in Colombia is the weather or the seasons, economic conditions and social behavior. These three variables are shared by Laura Andrea Rodriguez Villamizar, PhD doctor in Epidemiology and director of research at the Faculty of Health at the Industrial University of Santander (UIS).

As for the climate and the seasons, in Sweden the four seasons of the year are presented and by itself it is already a cold climate during the rest of the year. Swedes, said by Giesecke himself in his report, are already used to social distancing, so a quarantine was not initially necessary.

Even during the winter it is much less frequent for people to leave their houses, the cold outside can reach temperatures of up to minus seven degrees centigrade.

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This social condition allowed less restrictive measures to be implemented in Sweden, as Giesecke describes: those over 60 stay at home and young people can go out to work and even go to bars or restaurants, always keeping two meters away, with masks and a maximum capacity of 50 people per site.

In Colombia, however, we do not have stations. According to the Risk Management Unit, the country is experiencing the rainiest and least rainy season, there are no marked seasons.

This means that Colombians, in addition to their culture, are not used to staying at home or keeping their distance. In fact, it is a usual behavior that, upon meeting someone, they already greet each other with a kiss, something prohibited in this new lifestyle dictated by the new coronavirus pandemic.

Therefore, and here Dr. Martínez and Dr. Rodríguez coincide, it was necessary for the National Government to impose the measure to prevent the contagion curve from suddenly increasing in the country.

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Second, working conditions are not the same. In Sweden, there is more opportunity to telecommute because its European economy allows it and, if the Swedish government makes the recommendation not to leave, the citizens do not have so many disadvantages; they can obey.

In Colombia, informality does not allow it. If the National Government recommends not going out, the people who live in informality and are part of the vulnerable population of the country may not stop and, again, the curve will rise. Different, although controversial, if quarantine is decreed and they appear in court, much fewer people leave because disobedience would lead to a fine.As a third variable, and possibly more important because it directly affects the lethality of the virus, is hospital capacity.

“If quarantine had not been decreed, the cases in the country would have been alarming and the hospital network would not have been able to cope. Mathematical models indicate that around 80 percent of the population, that is, some 40 million people, would have been infected, “says Dr. Rodríguez.

Of this huge number of infections, 20 percent would have required hospitalization, either in normal or ICU-type beds, with mechanical ventilators. That figure would be about eight million people and if we are positive, and only one percent of those infected dies, or 400,000 people., we would be experiencing a catastrophe.

Fortunately, the reality in Colombia is another. As of May 13, 509 deaths and 12,930 infections are reported. In Sweden, they have already exceeded 3,200 deaths and have registered more than 26,000 infections.

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Those data, and the demographic explanation that the doctors make, is a sample of how positive and pertinent the quarantine has been, at least in the health spectrum. Always remembering that this measure was not implemented so that there were no cases, but so that the infections were gradual and the health system did not collapse.

Dr. Giesecke points out that quarantine does not work because “we are all going to catch it.” Given this, Martínez and Rodríguez point out that it is possible, but still unknown and cannot work based on ‘what would have happened if’.

Quarantine as a time out

An example in which Martínez and Rodríguez coincide is that quarantine should be viewed as a time out at a basketball or baseball game.

When there is a critical moment in a game of these sports, either in the last minutes and in the final innings, the coach or manager asks for a time out to analyze the game and make a decision that changes the landscape. Once the time-out ends, the match is resumed and what was prepared in that minute applies and is expected to work.

This analogy is traced to the quarantine in the country. It was decreed as a time for the country’s hospital network to prepare to face the moment when, for reasons of economy and lifestyle, everything must return to its natural course.

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During this period, it is expected that there will be a certain number of beds to attend to all the sick, for example.

“We are all learning on the go. Right now there is no magic bullet for determining a strategy that will fix this pandemic in one go. Each country implemented its measures based on its reality. Therefore, it is incorrect and unwise to demonize quarantines, “said Dr. Martínez.

Does the herd immunity theory work and can some Swedish measures be applied in Colombia?

Dr. Martínez explains that the herd immunity theory refers to how many people are immune around a person who is not. Immune people cannot spread to those who are not, so the infectious chain disappears.

“Herd immunity is a good theory and it is known how it applies to other infectious diseases, that is, how much percentage of immune people must there be for it to work. However, with the covid-19 this percentage is still unknown, so it is very risky to remove people with the faith that they will become infected and become immune alone ”Martínez explained.

Under this idea, it was possible that in Sweden the younger people left and the older adults were quarantined. But it is not a possible measure in Colombia, warns Dr. Rodríguez.

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In order to carry out the Swedish protocol in Colombia, it must be borne in mind that these young people who go out and work are exposed to becoming infected and then coming home and infecting older adults who did remain in quarantine.

“If you choose that, you would have to break up the family, to find out who lives with elderly or morbid people to decide whether or not they can go out. On paper, the Swedish proposal is seen as a solution, but the reality and the work involved in doing that study is really difficult, “explains Rodríguez.

For now, the quarantine in Colombia continues, at least until May 25. So far, according to the experts, it has worked very well.

The next thing will be to evaluate how the contagion curve behaves once it returns to the streets. This May 26 the country will enter an experimentation phase, in which everything that happens while people use public transport or shop in a supermarket will be measured.

Based on what the experts see at that time, new measures will be taken to protect the health of Colombians and the integrity of the system. It is possible that there will be one or more quarantines in the near future and as long as there is no vaccine.

For now, the experts’ call is in part equal to that of the Swedish epidemiologist Giesecke, that is, wash your hands and keep your distance. But, the other part of the message is to understand the importance of quarantine and not to believe that a foreign model can serve in Colombia. The sophism that being European works better than Colombia must be eliminated.

DUVAN ALVAREZ D.
NATION editor
TIME