COVID-19 and dengue, together: the dreaded “syndemic” that worries doctors

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In anthropological medicine, when two or more epidemics act simultaneously in a population, with common social characteristics and interact with each other on a biological, psychological and social level, we are facing a synergy or epidemic.

Until now, academic theory has been applied to health problems with comorbidities such as malnutrition, obesity, cardiovascular problems, among many others. This forces several countries to develop conceptual frameworks to improve the understanding of risk factors, in order to implement prevention and intervention programs to address comorbidities.

But since the world knew the new coronavirus and COVID-19 disease generated, the academic theory had to be updated facing the common pandemic that runs through all countries, where each of these must also face the local or regional health problems they suffer.

In the case of Argentina, the outbreak of the new SARS-CoV-2 virus started when the epidemic of dengue was already circulating. And also when diseases like measles They became news again as a result of the low vaccination in the population experienced in recent years.

The doctor Pablo Elmassian, infectious medicine doctor (MN 95,804) at Stamboulian Health Services, explained to Infobae that beyond COVID-19 today in the country there are other diseases that coexist and are a serious health problem.

“First, you have to be informed and know that there are several serious epidemic diseases. The population must become aware that they are diseases that they are not yet gone and they are among us. And about those that are circulating, it is important to be aware of the symptoms of each one of them in order to quickly go to the doctor, “said Elmassian, who pointed out that” in Argentina we are going through the pandemic of the new SARS-CoV-2 coronavirus, the Dengue fever is still circulating strongly, and there are other diseases like measles or tuberculosis that are worrisome. And that is also missing, because just we are going to enter in may the seasonal flu or common flu

Regarding the care and actions of the medical community, the specialist indicated that it is important for health professionals not to be overlooked for all these diseases, to know which ones are working and not to overlook diagnoses and test to identify them correctly in order to start treating them.

“I have a patient who called me concerned because he had a fever over 38 degrees and a sore throat and cough. But since the high fever lasted only one day, in his private health coverage they told him he was in a gray area and I had to wait to do a test for COVID-19. That’s crazy, because minimizing symptoms is not the right thing to do. What they have to do is isolate it and take the test. It may be an asymptomatic patient or with a mild condition that can continue to spread, “said Elmassian with concern.

“AND Regarding dengue it is very important to inform and educate people about the symptoms and explain that when the temperature drops, or you have bleeding from the gums, nose or abdomen, the disease can be complicated. You have to anticipate people what can happen to them, “he added.

The expert specified that “it is extremely important not neglect basic diseases such as cardiovascular disease or diabetes, for example, since they are a risk factor against COVID-19 and others. People should be encouraged to continue with the routine medical check-ups or dialysis they should have, indicating the precautions to take when they go out to the doctor: use a mask, maintain a social distance and do not touch anything or do not bring your hands to your face after touching any surface, until we wash our hands with soap and water or apply gel alcohol ”.

“Months ago We were free of measles, but now that has changed and there are records of non-stop cases of coronavirus. Measles is a disease much more contagious than respiratory COVID-19. It’s funny, we ask for vaccines against COVID-19 but we don’t use the one we have for measles or others. According to the tuberculosis today we have a treatment and also the vaccination of BCG vaccine for babies“, Concluded the specialist.

Roberto Debagg, infectious medicine doctor Pediatrician, agreed with Elmassian and stressed that in the country today we have mainly two epidemics in circulation in Argentina: COVID-19 and dengue.

“The thing is that there are two very important ones that are circulating a lot and They can be combined with others such as measles and seasonal flu. The problem is that their coexistence can generate problems to identify them and a person can have various symptoms and believe that they suffer from something they do not have or not attend to something they do suffer from. A test for COVID-19 takes a few hours. But the positive dengue result can be in 2 or 3 days. In addition, the common influenza or flu has symptoms similar to COVID-19 and will generate much confusion when it begins to circulate from May or June, “warned the expert.

And I add: “No one can predict what will happen this winter. Further, bronchiolitis, a disease caused by the respiratory syncytial virus, will be added which is responsible for more than 30% of pediatric hospitalization cases in winter. And it constitutes the first cause of hospitalization in children under two years of age. We are experiencing two epidemics with COVID-19 and dengue and two other diseases can be added, such as bronchiolitis and seasonal flu ”.

Miguel Carlos Sangiovanni, (M.N. 78.412) doctor specialist in High Blood Pressure at DIM, Health Centers, affirmed to Infobae that the anthropological terms the Sindemia is medically associated with non-communicable diseases. “In the past, humans died of non-communicable diseases, such as infections because medicine was not developed and there were no medical treatments such as antibiotics or vaccines.”

Today, 70% of the pathologies we have are non-communicable, such as chronic diseases such as obesity, diabetes, smoking, hypertension, addictions, etc. Non-communicable diseases influence a certain economic context of a population. And those same diseases in people with low incomes, without health coverage and with a low cultural level, generate increased distress, stress and depression“Added Sangiovanni.

And he continued: “If I have more access to health and knowledge I will be able to cope with different diseases. And with respect to the new coronavirus, this has a clear and objective impact, since Today, not only is an epidemic of chronic non-communicable pathology suitable for an economic framework, but also a communicable one such as COVID-19 or dengue

The expert stressed that it is important to highlight, apart from the socio-economic aspect of a country, its cultural level in the face of a pandemic. “A clear example are currently United States and New Zealand. Two countries with high economic power that tackled the SARS-CoV-2 virus differently and with diametrically opposite results. Today the US is suffering from a fierce pandemic, while in New Zealand they warned from the outset that it was a very serious issue, with some risk, and they took effective executive measures to curb it. There we see how in two countries with the same resources, the disease had different behavior“He compared.

Eduardo Chilelli, Clinical doctor at the Model Homemade Sanatorium, located in the province of Buenos Aires, indicated that there is a lot of work to do regarding the communication that needs to be done in the community, from the state party to the doctors and the media. And people have a key role in preventing these diseases that we travel from diminishing or being eradicated. ”

And he left as a central idea: “If you quarantine properly at home it is very likely that you will not get COVID-19. If you don’t accumulate water in pots and the government fumigates, the dengue mosquito is unlikely to circulate. AND if you get vaccinated against measles and other diseases it is very probable that you never suffer from them ”.

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