Wednesday, August 5, 2020
There’s a chance that Cusco will return to a full quarantine starting on August 10. The request is being made to the Council of Ministers, but this is where it gets a little unclear.
At the moment, there is no Council of Ministers since Congress did not give the Prime Minister and the previous Council a vote of approval yesterday. Once the Prime Minister resign, President Vizcarra has 72 hours to appoint a new Prime Minister and a new cabinet. (I’m not sure that the outgoing Prime Minister has officially resigned yet as is immediately required, but he has given no indication that he won’t.)
A great deal of Congress’ disapproval with the previous cabinet was the perceived lack of focus on public health issues over business concerns. How that will influence any decision of the new Council in regards to the request of the Cusco authorities is uncertain.
Read below to see what they are proposing as well as the latest new on the drastic increase in COVID cases reported for Monday.
As always, I’ll be watching closely and will report ASAP.
You can wait for the daily updates to be posted in the late afternoon/early evening, or your can follow me on Twitter (@ExploreCusco) to get immediate updates on breaking news during the day. I use Twitter to share big news that occurs during each day (and a lot is happening right now) and I strongly recommend that you follow me on Twitter to get immediate updates.
You can also follow me on Instagram (@SouthAmericanTraveler) for great photos, but I use Twitter for news updates.
Cusco to Return to Full Quarantine?
Cusco’s regional government and the regional COVID-19 Command are requesting that Peru’s Council of Ministers return Cusco to a full quarantine for 14 days starting on August 10 in response to the rapid increase in COVID infections.
They are proposing:
- Control measures will be strengthened in interprovincial, urban transport and in the markets and supermarkets of the city.
- Markets will operate from 6 am to 2 pm.
- Urban transport will be reduced to 50 % capacity but all units of all companies will circulate to avoid crowds in whereabouts.
- Restaurants will only use delivery.
- More intermediate care beds will be implemented.
- The quick response of district health establishments will be strengthened and medication kits for Covid-19 will be delivered for detected cases that are mild and that keep quarantine at home.
- Accamana hospital will be enabled to transfer patients in the last stage of contagion to relieve the city’s hospitals.
- Many business that had reopened will have to close to 14 days.
Daily COVID Update from Minsa
The Ministry of Health last night reported 6,790 new cases of COVID-19 and 196 more COVID-related deaths.
The positivity rate remained a terribly high 30.4%.
There are 13,798 patients hospitalized with COVID-19, of which 1418 are in ICU with mechanical ventilation.
So far 302,457 people have completed their period of home isolation or were discharged from a health facility.
As before, Minsa has not reported any regional data in quite awhile.
COVID in Cusco
Cusco’s Regional Health Directorate released staggering numbers this morning as they reported 1,096 new cases of COVID-19 in the region. The number of newly reported deaths (12) was relatively low compared to previous days.
While the testing rose dramatically to the highest level yet reported during the pandemic, the positivity rate also rose for the third day in a row to 20.9%.
There still remains only one available ICU bed in the region.
Cusco Receiving Oxygen; Lacks Oxygen Bottles
Yesterday the regional governor of Cusco, Jean Paul Benavente Garcia, met with representatives of the Cachimayo company, in order to inspect the facilities of the medical oxygen plant, which is authorized to provide 120 to 150 balloons per day, equivalent to 1000 cubic meters per day.
“In a joint effort since July 21, Cusco has been provided with an average of 4,000 cubic meters of medical oxygen. That’s the equivalent of more than 500 bottles,” Benavente explained.
Also present at the inspection were the director of the Regional Health Directorate (Diresa), Dario Navarro, and the president of COVID-19 Command, Victor Del Carpio.
Benavente added that for the supply of medical oxygen to public and private hospitals, there must be previous coordination with Diresa. “There must be a management of the distribution of bottles for all citizens. The private company has protocols and if we respect them we will be able to have more capacity in the delivery. We have to do a more effective job,” he said.
Diresa’s director, Dario Navarro, recommended that the population “not” attend the Cachimayo plant to acquire oxygen, because it is distributed through the hospitals and clinics.
Navarro was emphatic in pointing out that Cusco does have oxygen, but the lack of availability is due to the shortage of this oxygen bottles. “We ask the people to join the ‘Breathe Cusco’ campaign by donating bottles or cash to buy the necessary bottles,” he said.
Officials and prosecutors are currently trying to retrieve bottles that were provided to the sick in their homes, but which are not being returned. Some are even being reportedly offered for sale on social media.
Minsa Figures for Cusco Far Lower Than Local Reports
La República interviewed Dr. Miguel Palacios Celi, dean of the Peruvian Medical Association, who said that this gap is a constant in the interior of the country, whose reality reveals “generally twice as many” cases as the Ministry of Health.
According to him, the Minsa is not taking into account the serological tests carried out in the regions, because they have not been bought by the central government, but by the regional governments.
Thus, there would be three types of tests, two of which would not be registered in the Minsa Situation Room. On the one hand, the official figure of the Ministry of Health; on the other hand, the one presented by the Diresa and, finally, the “hidden tests”, applied by the population in a private way, either through clinics that offer them or by their own acquisition.
However, Dr. Javier Ramirez, deputy regional director of health in Cusco, explained to La República that “all the tests are provided by the Minsa,” and said that the Diresa has no supply problems in terms of rapid tests or molecular tests.
For Ramirez, the reason for the gap is a deficiency in updating the systems. He explained that the Regional Health Directorate reports daily the number of tests performed, whether rapid or molecular, as well as their results, to the government’s NotiWeb and SISCOVID systems.
“Each health facility has an entry code and feeds the system. What is published about us is what happens daily,” he said. However, the official figures do not demonstrate the reality that they report, which is why Diresa Cusco has presented its claims to the Ministry of Health.
La República contacted Alcedo Jorges Melgarejo, former technical coordinator of the Ministry of Health and current Regional Director of Health in Pasco. Jorges confirmed that the tests are provided by the State and by public and private companies, and that all are screened by the Diresa, so it is not related to the gap.
He also said that there cannot be a deficiency in updating the system, since this is done online and in real time. “Now we load a case into the system, and it is immediately seen throughout the country,” he added. However, he clarified that the explanation the Ministry of Health has for the gap refers to the type of result given by the screening tests.
“When you take the screening, you can get IgM positive, the combination of IgM and IgG positive, or just IgG positive. He explained that, in the first case, the test detects the active phase of the disease, that is, the person was infected a little over a week ago. In the case of positive IgM and IgG, it means that the person is in the second or third week of infection. However, the positive IgG result shows that the patient had the disease more than three weeks ago, so that he or she is no longer contagious.
For statistical purposes, continued Alcedo Jorges, the regions aggregate all results into the system. However, “the Minsa does not load the cases that are only IgG positive,” since they are infections that are not in the active phase.
In addition, he said that the health agency also does not report the results of “captive populations,” that is, the tests that are performed on workers in public institutions or private companies, “under the premise that it is in the context of economic recovery, and they measure the prevalence in the common population, transmission in the streets.
Finally, according to the last declarations of the Minister of Health, Pilar Mazzetti, “one can work in health when one has correct and complete figures”, and later she added: “There is a very important gap, in relation to this gap we have to act”.
Dean Miguel Palacios detailed the double importance of the Government presenting reliable figures on the coronavirus pandemic in Peru. First, “real data allows you to make real, reasonable proposals. And, on a second level, the truth allows the population to regain confidence in the State. “Now there is no trust because people think they are being lied to,” he said.
“We [the Peruvian Medical Association], who are making proposals for the pandemic, are interested in knowing the real data, because you cannot make proposals with false data, the proposal falls,” Dr. Palacios added. This point was also supported by representatives of the Regional Health Directorates of Cusco and Pasco.
“When you see the [former] premier who says there’s a ‘small outbreak’, he’s reading I don’t know what data, because even the Minsa is worried about the promotion,” said the dean of the Medical Association, emphasizing the misjudgment that people in charge of health policy planning could have.
Palacios Celi questioned the effectiveness of the targeted quarantines, noting that the institution is about to ask the central government to resume a general quarantine for 15 days, with a mechanism similar to that of a national census.
The purpose would be “to lock up the entire population and activate teams that go house to house doing the tests – molecular, of preference – to diagnose the positive cases, immediately treat them, isolate them and have a behavior in front of their contacts,” he explained. In this way, “the transmissibility of the virus would be cut off.
Javier Ramírez, deputy director of Diresa Cusco, said that given the situation in the imperial region, the government had been asked to return to quarantine. However, after the approval of Supreme Decree 135, phase 3 of Reactiva Peru was maintained. This allows businesses to continue to operate and people to continue to circulate, so these would not be “effective measures”.
“In the end, the only thing that is helping us is the immobilization from 8 p.m. to 4 a.m., which decreases the amount of movement of people, and on Sundays. But as we can see, the city in the other schedules from Monday to Saturday is constantly moving,” added Dr. Ramirez.
Minsa Distributes 51 tons of Supplies
Continuing with the actions taken by the Ministry of Health (Minsa) to confront Covid-19, the National Center for Strategic Health Resources (Cenares) sent more than 51 tons of medical supplies to Metropolitan Lima and 17 regions of the country on August 3.
The cargo transported by land included a total of 975,705 units of personal protective equipment (PPE), including N-95 type disposable masks, N-95 type nasal respirator, 95% filtering efficiency disposable masks, three-fold surgical disposable masks, jackets, aprons, pants, disposable masks, gloves, boots and disposable caps, polycarbonate protective glasses and polycarbonate masks.
In addition to the load, 25,000 rapid tests for Covid-19, 25,000 retractable disposable lancets, 277 medical kits consisting of adult and pediatric pulse oximeters, and 175,050 medicines, including ivermectin, hydroxychloroquine sulfate, azithromycin, as well as products for injection, such as rocuronium bromide, dextrose, propofol, atropine sulfate, vancomycin, water for injection, vasopressin, and compound sodium lactate solution.
Medical supplies were delivered to these regions: Amazonas, Áncash, Apurímac, Cajamarca, Callao, Cusco, Huancavelica, Ica, Junín, La Libertad, Lambayeque, Lima Region, Pasco, Piura, Puno, Tacna and Ucayali.
In Metropolitan Lima, a total of 327,020 pieces of personal protection equipment and 7,830 medicines were sent to the Arzobispo Loayza National Hospital, San Juan de Lurigancho Hospital, Cayetano Heredia National Hospital and the Directorate of Integrated Health Networks – DIRIS Lima Centro, Lima Este and Lima Norte.
Nine New Care Center Established in Cusco
Nine fixed care centers for cases of COVID-19 are being implemented by the Regional Health Directorate (Diresa) of Cusco in this city and in the capital of the province of Quispiscanchis where the diagnosis, treatment and timely follow-up of patients will be carried out.
According to Diresa’s deputy director, Javier Ramírez, this will prevent people infected with the virus from reaching hospitals in a critical situation and often ending up dying.
This measure has provided for the mobilization of inputs, such as rapid and molecular tests: in addition to drugs such as ivermectin, azithromycin and others, to the first response health centers.
Ramírez indicated that at these points, screening will be done to differentiate between common colds, respiratory infections and COVID-19, diseases that have similar symptoms.
The health centers that will start with care for mild patients with COVID-19 are San Jerónimo, San Sebastián, Santa Rosa, Ttio, Belempampa, Manco Ccapac, Wanchaq, Urcos and the hospital in Tupac Amaru.
Misc News Highlights
- Acción Popular congressman leaves open the possibility of asking for Martin Vizcarra’s resgination In an interview with RPP Noticias, Jesus Arapa said that this path would be a “sanction” if the government “continues to make a mistake in carrying out a policy…”
- The Ayacucho region recorded the highest number of cases of coronavirus in one day. According to the official report of the Health Directorate, 275 new infections were reported in the last 24 hours, and in this same period of time eight people died from the disease.
- The governor of the Cajamarca region, Mesías Guevara, announced told RPP Noticias that the first medical oxygen plant in the department will be inaugurated next weekend with the support of the Yanacocha mining company.
- The medical staff of the Hospital II de EsSalud in Huánuco will be holding a sit-in this Wednesday. They denounce the lack of implementation of the ‘white hospital’ for COVID-19 patients in the region and demand the installation of 20 ICU beds, the sending of specialist doctors, personal protection equipment, medicines and medical oxygen bottles.
- Health workers who care for COVID-19 patients demand payment of their wages. A group of 500 workers (nurses, nursing technicians, medical technologists, among others) claim that the Regional Government of Lambayeque owes them 4 to 5 months of their wages.
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