Doctors in Limbo

Thousands of private doctors are fighting the coronavirus without medicine, without equipment and without a vaccine.

COVID-19, Morelia.- The patient stopped lying when she was inside the office, she did not have an allergy attack as she had alleged at the entrance of the pharmacy, it was most likely that she had COVID-19.

“Manuel” was scared, he said that he got angry immediately, that woman was contaminating his office and at that time they did not have the necessary tools to fight the novel coronavirus; It was August 2020.

It was not the first case that he witnessed, but it was the first one that he had to face in person, the most disconcerting thing for him was that the woman had lied to enter the small pharmacy office with just a cloth mask covering her face.

Despite his anger, the doctor cared for her the best he could. He prescribed medications for symptoms such as fever, headache, and sore throat, and asked her to stay home on for at least 22 days.

“Manuel” continued to monitor the case through WhatsApp messages until the patient showed improvements. A week after sneaking in among his patients, she had lost her sense of taste and smell, confirming that she had COVID-19.

“At that time we knew very little about the new virus, at the pharmacy they barely gave us a small course, but the truth is that we knew nothing, so suddenly you are, as people will say, on the front lines of the battle.” Recalled “Manuel”.

The real name of the doctor will not be revealed, he fears being reprimanded at the pharmacy chain for which he works in the city of Morelia and asked to remain anonymous in exchange for his testimony.

What is not a revelation is that from one day to the next “Manuel” and thousands of his colleagues were left at the front lines of the SARS-CoV-2 pandemic, they are doctors who work in private practices that are -on many occasions- the first point of contact with an infected patient.

“Many trust us because of our proximity, because they know us already, others come with us because we do not make them wait as long as they do in a clinic and some others do not have enough resources, so they go to budget private practices within pharmacys”, he assured.

Whatever the reason, thousands of doctors have to face the new coronavirus without the necessary tools, without the medicines, without the equipment and without the vaccine, they are caught between the sword and the bureaucratic wall that prevents them from accessing these resources.

No vaccines

Currently, the main problem that private practice doctors face, as well as dentists, paramedics and nurses, is that they have to wait to be vaccinated according to their age range regardless of the level of risk they run.

The system that was adopted in Mexico to immunize the entire population started in December 2020 with a first stage in which only first-line medical personnel would be vaccinated, that is, those who are working in hospitals with COVID-19 patients.

Then on January 20, 2021, they continued with the vaccination of 5,000 doctors from private hospitals where these same patients were also being treated and later they continued with the staff of public hospitals and clinics, so by March it was already a large percentage of immunized doctors of the first line.

However, doctors who work in shopping malls, pharmacy chains and private practices were left out of the vaccination program. These professionals, despite being on “the front line,” do not have any guarantee of receiving any of the 15 million doses that Mexico has received.

Just this Monday, April 5, Hugo López-Gatell, Undersecretary of Health, reported that 15 million 163 thousand 420 doses of 5 different vaccines have arrived in our country: Pfizer-BioNTech, AstraZeneca, SinoVac, Sputnik V and Cansino.

“We always see the reports and we say that it is fine, that they take care of our front-line colleagues, our older adults, but when it is our turn? We can say that we are also at the front but we do not have any help” , assured “Manuel”.

At the beginning of this conflict, the doctor David Berrones launched a national initiative through the twitter account @VacunasMedicosMX to register all the private doctors in the country and present the lists to the Ministry of Health.

As of April 6, 2021, about 28,100 health workers had registered on the google docs platform. They have not yet received a vaccine and are waiting to be immunized before more and more doctors are infected with COVID-19.

However, the figures may be much larger, in 2019, according to the National Institute of Statistics and Geography (Inegi), private hospitals registered 92,169 doctors: 91,182 in direct care of patients and 987 in other tasks.

The risk of not vaccinating all medical personnel is high, Amnesty International warned that Mexico was the country with the most medical personnel killed by coronavirus according to a report issued in September 2020.

At that time, there were 7,000 doctors dead from COVID-19, of which a total of 1,320 had died in Mexico, making it a high-risk country for health personnel along with Brazil and the United States.

Waiting and waiting

At the same time that the undersecretary of health reported on the vaccines received and the progress of the program at the national level, a group of doctors from private hospitals closed the Calzada Tlalpan, amid a protest over a lack of vaccines.

However, the response to the protests has been the same, both the Ministry of Health of Mexico City and the Ministry of Health at the federal level continue to put off requests from doctors across the country.

“It has been complex in the private sector to have clear, refined, updated lists and of course this is a challenge. We continue to ask for collaboration, more than protest, the collaboration of those who can integrate clear, defined lists that allow us to know the equivalence of exposure to COVID risk in the private sector, with the same clarity that we have in the public sector ” López Gattel said at a press conference.

The level of desperation has been such that dozens of organizations now work on the lists requested by the Government of Mexico to collect data such as name, age, professional identification, email, entity and specialty of each of the private doctors.

Associations such as the Mexican Hospital Consortium, the National Association of Private Hospitals, the Mexican Council of General Physicians and the National Academy of Medicine of Mexico also demand a response.

In addition, the VacunasMédicosMx initiative sent a letter addressed to the director of the World Health Organization, Tedros Adhanom Ghebreyesus, to whom they asked for help after accusing the Government of Mexico of leaving its health personnel behind.

“We are reaching out to you for support. The WHO has asked the international authorities that all health workers be vaccinated and in Mexico this right is not being fulfilled ”, they denounced in their letter.

On March 5, Dr. Ruy López Ridaura, general director of the National Center for Preventive Programs and Disease Control, promised that the scheme for doctors to be vaccinated along with older adults would be clear that same week.

But so far neither the letters, nor the protests, nor the records have taken effect and private medical personnel are waiting to be vaccinated before the numbers of deceased doctors increase.

“We are not robots”

More than a year ago, the questions asked to identify a case of COVID-19 had to do with the place where the patient had been infected, things such as if he had traveled, if he had been in contact with someone who was in Italy, China or the United States.

“All this is a thing of the past, now we almost always have to assume that a person who presents the symptoms actually has COVID, in fact, it is rare that a patient sick with something else comes to me, I would say that 90 percent they have COVID, ”said Dr. Rosa Esmeralda Sánchez Castañeda, who runs a private practice in the city of Morelia.

The doctor recalls that her first case was in January 2020 with a woman who arrived in Morelia from Mexico City, where she had been infected from her acquaintances.

“We immediately realized that it was a different type of disease to what we knew, that is, it is not that the patients had different symptoms, we were already familiar with them, but never together, never with the magnitude that we saw at that time ”Said Esmeralda Sánchez.

But that was in 2020, so far in 2021 the doctor assured that she has treated almost 80 cases of patients with COVID-19, all of them with different symptoms and who have evolved differently despite having the same virus.

All these changes have been part of the day-to-day life for the more than 90,000 private doctors who work in Mexico, many times against the tide and under attack from the general population.

“Today we still see it, colleagues who are thrown chlorine in the street, they are insulted, there is a very strong lack of empathy that angers me because we are here to help, to heal, that is our vocation, we are not robots,” he said Emerald.

However, the doctor assured that it is time for doctors to give their “101 percent” to overcome the health crisis, despite poor working conditions, lack of support and not being included in the vaccination lists; that is, despite being in limbo.

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