In San Antonio de Areco, Buenos Aires province
An integral epidemiological approach programme successfully avoided the community virus circulation of COVID-19
- The incidence rate of COVID-19 infection was 216 per 10,000 inhabitants, with a fatality rate of 1.7% and specific mortality of 3.9 per 10,000. Compared with 2019, excess mortality was negative, with 6 fewer deaths during 2020.
- At the peak of hospitalization, occupancy of beds in isolation rooms for infected patients was below 70%. The occupancy of ICU beds was extremely low, with only four patients admitted between March and December.
- Buenos Aires, December 2020.- After more than eight months of work, Mundo Sano Foundation, the University of Buenos Aires (UBA) and the Regional Association for Sanitation Development (ADeSaR) present the results of the model for the integral approach to health management in response to COVID19 emergency, along with the municipality of San Antonio de Areco.
The model, based on the systematic and early detection of infected people, either with or without symptoms, allowed the detection of the “transparent links” of the contagion chain, and the consequent isolation, monitoring and early treatment. The program also included the intensive epidemiological surveillance of groups at high risk of infection, such as the health care staff, in this case of the “Emilio Zerboni” Hospital of the municipality of San Antonio de Areco.
Symptomatic patients and their contacts are subjected to conventional tests; in turn, for asymptomatic populations in the surveillance program, the pool method is used at the Laboratory of Virology at the José de San Martín Clinical Hospital, led by Dr. Marcelo Rodríguez Fermepín. To date, more than 8,000 tests have been performed, with a cumulative positivity percentage of 7%.
“Early detection of symptomatic patients allows us to provide them with the advantage of different specific treatment options, depending on the stage of the disease at that moment”, states Favio Crudo, from the medical group of Mundo Sano Foundation, and responsible for the project. “Starting an early indicated treatment might avoid complications, such as ICU admission and mechanical ventilation”, he said.
The model is complemented with a permanent telephone assistance system and home monitoring, a network of epidemiological trackers and an app that enables the coordinating medical team to follow the evolution of all the monitored patients on the screen.
Results obtained in the municipality of San Antonio de Areco
- Community virus circulation was avoided by characterizing the origin of each of the contagions, with almost a total of 600 cases.
- Occupancy of the beds in the isolation room of the only hospital in the area was less that 70% in the weeks of peak admissions, with ICU occupancy (by COVID19 patients) of 0.8 of use of days/available ICU beds and 0.7% if the use of mechanical ventilation is considered
- The incidence rates were 216 per 10,000 inhabitants for an average of the health region of 287, and of Buenos Aires province of 337.
- COVID19 infection fatality rate was 1.7%, being 2.7% for the health region and 3.3% for Buenos Aires province.
- Specific mortality per 10,000 inhabitants was 3.9% in the municipality, 8.6% in the health region, and 11.7 in Buenos Aires province.
It should be noted that during the 8-month period of the project, 10 deaths due to COVID19 occurred, half of which corresponded to elderly patients institutionalized in nursing homes, and no deaths were recorded in people below 74 years of age.
This public-private cooperation project has yielded excellent results and might be replicated in other localities and institutions with similar characteristics to those of San Antonio de Areco.