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A situation recognized by the doctor Francisco Sánchez Cárdenas, member of the Advisory Council to tackle the novel coronavirus SARS-CoV-2, who stated that with a population “ really sick“Like the one that exists in the country, every infectious virus finds” the necessary grass“Spread. His concept is that countries with a health system focused on prevention do better to take care of the new coronavirus pandemic.
Indeed, international reports show that primary care patterns exist in countries such as Costa Rica, Uruguay Y Cuba helped manage the pandemic more efficiently.
According to Sánchez Cárdenas, if Panama will have a primary care system “ sturdy“, The number of deceased and sick would be lower, because there would not be so many individuals with hypertension, diabetes, kidney failure, heart disease among other noncommunicable diseases that can be prevented and right now it is they who are increasing the fatal figures of the COVID-19.
The director of the Social Security Fund (CSS), Enrique Lau Cortés, for his part, expressed that a strengthened network of primary care would have made it possible to better organize the response to the COVID-19 pandemic, knowing the place of residence of patients and their contacts, as well as the comorbid diseases of the population, depending on where they live.
In this aspect the Preventive Health Center for people over the age of 40, which has been carried out in the last five years, revealed that there are provinces with a higher prevalence of diseases, such as renal failure in Coclé and high blood pressure in Colón, to name a few .
Lau Cortés added that a good primary care network would help better outpatient control of chronic patients and home care for them, a direct link with the population to provide health education and greater community participation and not just as patients, but also as vehicles of social change.
The medical expert in Social Protection in Healthcare and Management of Services, Rigoberto Centeno, believed that a strengthened preventive health network would help to better control disease and reduce mortality, that is, it would save lives.
Centeno based his argument on the fact that the community response would be broader, earlier, more specific, with a greater focus on community transmission, and chronic disease, a factor behind mortality, would be more controlled.
Meanwhile, the former technical secretary of the High Level Commission for the Improvement of the Public Health System, Luis Vega, considered that with a functional primary care system, the approach to COVID-19 would be more efficient, because prevention measures, such as: wearing masks, washing hands and maintaining a distance of two meters would be easy to comply with in a population educated to take care of his health.
However, Vega praised the work health authorities are doing locally to find people infected with coronavirus SARS-CoV-2, through the traceability.
In turn, the coordinator of the National Medical Commission, Domingo Moreno, said maintaining a primary care network is equivalent to managing the population by sector, which improves the way any disease that emerges in the country is dealt with.
To exemplify this situation, Moreno spoke of the island of Cuba which has “ a network of public health services ranging from the most basic to the most complex“Which has helped them reach all sectors of their population with strategies for dealing with the COVID-19 pandemic.
Moreno, like Vega, highlighted the work done by the Panamanian authorities to counter the spread of the virus, despite the limitations of the public health system.
Basic health care
The World Health Organization (WHO) defined primary care as “ essential health care accessible to all individuals and families in the community through means acceptable to them, with their full participation, and at an affordable cost to the community and the country“. This international body goes further and qualifies it”. as the heart of the country’s health system and is an integral part of the community’s overall socio-economic development“.
In this sense, the member of the Advisory Council to participate in the novel coronavirus SARS-CoV-2, Francisco Sánchez Cardenas, stated that in the 1970s Dr. José Renán Esquivel – as Minister of Health – established primary care as the primary program which remained in place for about ten years, but after that time more importance was given to cure the disease.
Preventive medicine has not disappeared in its entirety and are examples of programs for monitoring the development of children and the control of pregnancies, but in parallel with these preventive actions, the construction of hospitals has begun, because treatment is more profitable than taking time and avoiding the arrival of diseases such as hypertension or diabetes, for example, indicated Sánchez Cárdenas.
However, in the other aspects of prevention and well-being of the population “ this was lost because curative medicine is more commercially profitable and unfortunately medicine has been overrun by commercial influence. In a health center the costs are minimal compared to the construction of a hospital“Sánchez Cárdenas condemned.
For his part, the former secretary of the High Level Commission for Improving the Public Care System, Luis Vega, said that 80% of health problems can be addressed by monitoring patients in primary care, which means that this (primary care) should be “ cornerstone on which the public health system must rest, but unfortunately and for many years we have a model based on disease and not on prevention and maintenance of health“Of the population.
Vega stressed that in this task, in addition to the institutions and professionals of the public health system, the population plays a fundamental role as “ the enormous degree of participation that the individual has in their state of health“.
Proposals
The deficiencies that COVID-19 has exposed in primary care are not unknown and were discussed during the last government administration in High-level commission to transform the public health system, which concluded that it should be strengthened for the benefit of the entire population.
In this regard, the director of CSS, Lau Cortés, indicated that they are reorganizing the whole system and strengthening primary care so as not to wait for people to arrive sick at health facilities, but to go out and look for them to keep them healthy in the their environment, which is achieved by consolidating home care.
For Lau Cortés, the way doctors’ performance is evaluated must be changed “, Instead of measuring how many patients they attend, we need to worry about how much population they keep away from complications and hospitals“.
He added that he prefers doctors and health teams who speak and educate the population rather than seeing people who are sick due to the neglect of the care model that prevails in the country.
“ But COVID-19 has arrived and the world has changed, and so have the plans. All the interests of groups and groups have appeared and this keeps us in a permanent war. Now you need to change the strategy“said the director of the CSS.
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