It was like starting over. Clemente Zúñiga left the house heading to the General Hospital of Tijuana, like every morning. When he arrived, his companions handed him the guard and he put on his boots, overalls, gloves, N95 mask, goggles, the hat, the mask and the gown. It took almost 10 minutes to put on all the protective gear. “I have to accept that I felt very anxious when I returned to see the patients,” confesses the 53-year-old doctor. It had been a long month since Zúñiga caught coronavirus. He was hospitalized, homebound and completely isolated from his family. He returned to work last Monday, but it was on Tuesday when his nerves really got on edge, when he returned to the zero zone.
“My wife begged me not to,” he laughs, “but I had to be in the trench with my teammates again.” Zúñiga is one of the 1,934 healthcare professionals who have been infected with covid-19 in Mexico until last weekend, about 12% of cases, according to official data. In the first line of combat there are learning and feelings found between fear and a vocation to fight against the pandemic, despite knowing in a health system without sufficient resources to face it.
“I can’t describe itHaving coronavirus is a feeling that I do not wish even my worst enemy, you feel that you are going to die, “admits Zúñiga. Being a doctor and dealing with the virus changes everything: you know all the symptoms and you know when there are reasons to worry, but you have to put yourself in the hands of your colleagues. Your job is no longer saving lives, now you are prostrate as your patients. “I suffered what they suffer in their own flesh, that fear … at night you are sweating, with a fever, you cannot breathe,” says the doctor, “and you become much more empathetic and understanding when you return to care for someone.”
Locked between four walls, after spending a week hospitalized, Zúñiga read everything he could about the disease. “In the hospitals we were not ready to receive patients yet, the management of the protective equipment was not so integrated into our abilities and the physical areas of the hospitals had not been transformed,” reflects the doctor, who directly treats patients with ventilation mechanics.
The precise timing of the contagion is difficult to determine, he says, because while seeing suspicious patients in the hospital and his private practice, he was also doing his life normally. Even so, his diagnosis of the working conditions of hospital personnel is not in doubt. “We are working in a fragile health system and where supplies have always been scarce and suddenly a wave of sick people comes to you, of a new disease, that you do not know, that does not have a specific treatment, that we are learning to manage and that, In addition, it brings you patients who, for the most part, arrive at the hospital very seriously, “explains Zúñiga. “Our system has been sidestepped and beaten for many years, “he says.
In recent weeks, news about covid-19 outbreaks in hospitals They have flooded the press in Mexico, especially given the signs of lack of medical supplies and preparation for the epidemic. As the red light bulbs multiply, the underlying question is whether the country’s cracked healthcare system can bear the brunt of the emergency. At the Tijuana General Hospital, which reports to the state government, there have also been confirmed cases among doctors, nurses, auxiliary workers, and general service personnel. “There have been at least eight to 12 of my colleagues who have been infected,” says Zúñiga, but clarifies that when faced with a systemic problem, it is very difficult to find culprits. “Many were infected in the first weeks of the epidemic and I think we have learned by leaps and bounds,” he adds.
“There are many factors for each hospital, but I believe that no institution in the world can be prepared for such an epidemic,” says Francisco Cisneros, a doctor at Hospital General Regional 20, another medical center in Tijuana that he had two weeks ago. at least 24 infected workers. This sanatorium belongs to the Mexican Institute of Social Security (IMSS), the largest public network of its kind in the country and targeted because it groups the largest number of infections among its employees, of known cases.
Cisneros, with a 24-year history at the IMSS, points out the shortage of personnel and materials, the lack of criteria to distribute them, the gaps in protocols, technological delays and infrastructure lags as determining points for Mexico. Tijuana is also one of the five points in the country with the highest hospital saturation due to the pandemic. “All the pressure falls on very few hospitals in the city and since last week there has been a great saturation, although not at the level of other countries,” says Cisneros, one of the founders of the Por Tijuana Sana campaign, which seeks donations from the citizenship to circumvent the price premium and piracy of supplies.
“It is part of a culture of concealment. There have always been things missing, but in the end nothing happens. A bubble is created in which the middle managers hide information and the high officials say that everything is fine, ”answers Cisneros. “We have not fully understood the need not to hide reality,” agrees Enrique Mendoza, former president of the National Mexican Association of Bioethics. “[Los 1.934 casos] They are only a segment of the doctors and nurses who are infected and it is very likely that these figures are underestimated, as are the total numbers of infections, ”adds Mendoza, despite the fact that the health authorities have defended that the infections of doctors and nurses they are within the parameters of other countries.
However, unlike daily reports on the advance of the virus, incidents among health personnel are practically not reported worldwide or are done sporadically. Until last April 8, more than 22,000 workers were infected in 52 countries, according to the World Health Organization (WHO). The agency warned that “there are no systematic data” and said that it is likely “that this number will underrepresent the actual figure.”
The wake-up call served to get some countries to reveal their data. The US has almost 9,300 cases (as of April 9, 2% of the total); Spain, more than 26,000 (as of April 14, 15% of the total); Italy, about 18,500 positive diagnoses (as of April 22, almost 11% of the total), and Colombia registers 417 infections (as of April 28, 7% of the total).
The lack of information is evident also for other epidemics. The main academic articles and public accounts of H1N1 influenza in 2009 they left out the breakdown of cases between Mexican doctors and nurses. Cisneros and Zúñiga were also infected on that occasion. “It does not compare, it was not as delicate and the epidemic is not compared as such, there were not as many infections as now,” recalls Zúñiga.
The doctor says he entered a different hospital than the one he left a month earlier, better conditioned and with doctors who went through a learning curve. “I will always be grateful to my colleagues,” says Zúñiga. “This is real,” insists the doctor, “you spend time seeing extremely serious patients, one after another, is the challenge we face.”
Information about the coronavirus
– Here you can follow the last hour on the evolution of the pandemic
– If you have symptoms, these are the phones that have been enabled in every country in Latin America.