2023-05-27 03:01:00
Come this time of year, activities tend to take place behind closed doors, and respiratory viruses are rampant. The guards are crowded with people seeking to calm the stable list of symptoms: fever, malaise, nasal congestion, cough and listlessness. At present, the disease that stands out is bronchiolitis. In fact, Nicolás Kreplakhead of the Buenos Aires province Health portfolio, forcefully described the current scenario: “We are facing the worst bronchiolitis epidemic of which we have a record”. One of the most worrying features is that it usually affects children under one year of age; since if the picture worsens, the lungs are compromised and may end up hospitalized. According to a study published in the journal The Lancet in 2019, the disease is responsible for 100,000 annual deaths in children under five years of age.
At the domestic level, according to the latest epidemiological bulletin issued by the Ministry of Health, there have already been more than 34,000 cases of bronchiolitis so far this year. The cases of the respiratory syncytial virus that causes the disease are 56 percent higher than the 2019 record, the close antecedent of greater circulation. “We are in the presence of an early bronchiolitis epidemic, because we usually have it by the end of June or July. There is an explosion of cases that is reflected in the delays in care in emergency guards and in the lack of hospital beds in a large part of the hospitals in Buenos Aires and CABA as well.”, observa Georgina DiGenaropediatrician who works in private clinics in Olivos and Lomas de Zamora.
“We are seeing a logical increase in cases, but with a seasonality that in recent years has not been met due to the pandemic. Due to the confinement of the boys, the virus did not circulate as it usually does. There are many boarding schools and the feeling is generated that there is a lack of structure to be able to care for all the children”, points out the pediatrician Gonzalo Pérez Marc. Then complete: “The most vulnerable are those with few resources. In general, these are the most compromised patients, to the extent that they cannot connect with the health system quickly enough”.
Apparently, the situation is fundamentally motivated by the low circulation –and therefore, the low immunity to this virus– during the covid pandemic. In this way, boys and girls are not protected as in previous seasons. Di Genero gives his opinion on the matter and presents a nuance: “Last year we had an atypical year in relation to respiratory viruses; the leading hypothesis is that it was due to a lack of immunity to many viruses. However, The reality is that today we have babies born a few months ago who did not go through the pandemic and who have bronchiolitis, the first bronchospasm in life.”. Given this scenario, the peak of infections might arrive at the beginning of winter.
Lessons left by the pandemic and can be useful
One of the recommendations that specialists and health authorities usually communicate is to avoid going to guards, unless the situation truly warrants it. The virus is transmitted through direct contact with contaminated hands and surfaces, as well as through nasal discharge or saliva droplets that travel through the air when someone who is sick talks, coughs, or sneezes. For this reason, It is also essential that babies/children do not attend educational establishments, or carry out socialization activities outside of school if they show signs of respiratory problems.. Likewise, if necessary, the chinstrap –an ally during the coronavirus– might serve to stop the spread of this respiratory virus (with the exception of children under two years of age).
As an additional request, the doctors consulted by this newspaper ask the parents do not medicate on your own. A relative’s medication can often mask the symptoms, confuse the diagnosis and, therefore, the treatment to restore health.
Although the disease can be caused by different viruses, in this case, the person in charge of promoting the epidemic is the respiratory syncytial virus. Upon entering the body and replicating, it affects the airways, makes breathing difficult, and causes agitation, coughing, and weakness. Although there are no syrups or antibiotics, patients usually recover within two weeksalthough they remain susceptible to recurrent respiratory symptoms in the future.
“These viruses also cause problems in older children, especially in those who are predisposed to allergic-bronchial symptoms. I am referring to those who are in kindergarten or those who are going through the first years of school and face serious infections that require hospitalization”, highlights the pediatrician. And she continues:While there are no vaccines available for the viruses that cause these respiratory infections, there are for the flu. The flu campaign began in March, but people can start receiving it following six months”.
Hygiene, hand washing and ventilation of spaces, from here, continue to be some of the lessons that the pandemic left behind and function as learning keys for this case.
A claim that also requires attention
The Argentine Society of Pediatrics issued a harsh statement on Thursday. The text details how the increase in respiratory infections and the collapse of guards serve to expose a series of structural problems facing the sector. “We are in a difficult scenario for the professional practice of Pediatrics. There are unacceptable working conditions, high workload, job instability, lack of stimulus for growth, situations of violence, low pay, need for multiple jobs to make ends meet and lack of opportunities to update in the profession,” the entity said.
One of the main problems observed both in public hospitals and in private clinics –in keeping with what is referred to in the text– is the lack of health professionals. It must be taken into account that doctors specializing in pediatrics require training that is close to 13 or 14 years of age. Once the State invests money in their training, entering the labor market becomes an obstacle to the extent that they are not usually highly paid professions. In this way, professionals sometimes do not complete the specializations, or they drop out along the way. “There is a crisis in pediatrics. Fewer and fewer people dedicate themselves to this specialty, while there is a growing demand for the physical presence of professionals during the week. Many change their specialty, or decide to stop doing care”, comments Pérez Marc.
This phenomenon, far from being a specific problem in Argentina, stands out throughout the world. Hence the importance of implementing incentive programs and salary bonuses for doctors who decide to do their residency in vacant fields, such as pediatrics, neonatology, medical clinics, or intensive care. Even more so if one takes into account that human resources are the main actors in the health system.
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