The model focuses on the detection, isolation and home monitoring of COVID-19 patients, even asymptomatic ones, and on the intensive epidemiological surveillance of groups at higher risk of infections, such as health care staff.
At present, this model is being implemented in San Antonio de Areco district, province of Buenos Aires, and might be replicated in other localities with similar characteristics.
Mundo Sano Foundation, the University of Buenos Aires (UBA) and the Association for Regional Health Development (AdeSaR) designed and have been implementing a comprehensive health management approach to the COVID-19 emergency along with the municipality of San Antonio de Areco for two months now.
The proposal is based on an intensive and thorough epidemiological surveillance that enables rapid detection of infected persons, both in health institutions and the general population, and contact the people around them, isolate them and perform permanent clinical monitoring. At the same time, all the people with respiratory symptoms are identified and followed-up through a telephone system and an app designed for that purpose.
“This integral approach allows us to conduct intensive epidemiological surveillance of groups at higher risk of infection, such as health personnel, and to detect and isolate the asymptomatic infected individuals”, said Favio Crudo, medical doctor specialist in infectious diseases at Mundo Sano Foundation. “For those purposes, we decided to increase the number of swab tests by making pooled PCR tests on personnel of “Emilio Zerboni” Municipal Hospital and residential institutions, once a week, depending on the risk. Thus, we can detect any infection, even asymptomatic ones, early and, therefore, avoid contagion to other workers and patients”, Dr. Crudo explained.
A protocol for health personnel was designed in collaborative work between Mundo Sano Foundation and the University of Buenos Aires. Dr Marcelo Rodríguez Fermepín, biochemist and Professor of Clinical Microbiology at the School of Biochemistry and Pharmacy of the UBA, said: “The protocol that we validated in the Laboratory of Virology at the General San Martín Clinical Hospital includes sampling with a single swab, which in turn is processed together with samples from three other people. Thus, we can make a systematic control, reducing costs and without substantial alteration of detection sensitivity.”
“Using this method, the number of tests on asymptomatic individuals can be increased four times and testing of health staff can be standardized with prevention purposes. It should be noted that these studies are not aimed at diagnosis, which must be done with separate samples of each person”, Rodríguez Fermepín said.
The model is complemented with a permanent telephone attention system and home monitoring, both of the patients and their contacts, and includes an app that enables the care coordinating physician to follow the evolution of all the patients on a screen, with updates every 12 hours.
“This public-private cooperation project, which we have been implementing for two months in the San Antonio de Areco district with very favourable results, might be replicated in other localities and institutions with similar characteristics”, Favio Crudo said.
