PERSPECTIVES

Drs. Leal and Bhandari discussed trends of the COVID-19 pandemic in Columbia. Our discussion uncovered 4 core themes. These themes and their supporting insights are highlighted below.

1. Rising COVID-19 cases; Shifting patient age from old to young

In May, Columbia only had under 10,000 COVID-19 cases and ranked twenty-eighth in the world. However, in the last 2 or 3 weeks, Columbia has been experiencing a quick surge in cases. By the end of July when this interview took place, Columbia ranked eighth in the world, with nearly 300,000 infected individuals. The situation is most serious in the capital city Bogota and the metropolitan area of Barranquilla (in northern Columbia, near the Caribbean Sea) which, collectively, account for 40% to 50% of the total number of cases.

 

This is not the second wave, rather, it is the first, big wave in Columbia. In the two months’ period between March 6 and May 6, 10,000 new cases were reported; now, the same amount of cases have been detected in just 30 hours.

Compared to earlier on in the pandemic, there are now much more younger people than older people who are infected by the COVID virus. This shift is attributed to a general sense of invincibility - younger people feel that they are immune to this virus. On the contrary, older people take this more seriously. They understand that they are more vulnerable and are therefore much more aware of the consequences of hospitalization should they get sick.

2. Relaxing of health policies led to the rapid spread of infections worldwide

In Dr. Leal’s opinion, there are three scenarios/modes of the COVID virus infection in the world. (1) People did not expect the pandemic, e.g., China, Italy and Spain. (2) People were prepared by learning from other countries’ experiences, where the curve of cases was just flattened a little bit. (3) People have learned about the potential, upcoming pandemic but they don’t really believe it; and by the time they realize it, it's already out of control, e.g., the United States and Brazil.

 

Dr. Leal believes that Columbia is in the second scenario. The main reason for the sharp rise in cases is the loosening of health measures. The national “lockdown” (Obligatory Preventive Isolation) started in late March. In an effort to kickstart the economy, stringent policies were loosened gradually. They began by allowing people to go out, and then to go to work; each step leading to the removal of more and more restrictions.

Furthermore, people get relaxed after a period of “safety” and are not willing to believe it important to take preventive actions. Drs. Bhandari and Leal believe that the pandemic has not passed, or even reached the peak in some countries, and that people should not be less concerned about disease transmission.

3. Health resources face challenge; Selective surgeries are closed

The government is in charge of all the intensive care units.

 

All elective surgeries, including orthopaedic elective surgeries, have had to close due to the increased need for healthcare and human resources for COVID treatment. It is uncertain when to resume these elective surgeries.

4. Ongoing health policies and strategies

Currently, to tackle the pandemic, there are different strategies in different cities. “Lockdowns” are regionally done (e.g., in Bogota, some areas in the city are locked down) or done based on risk factors (e.g., people who are obese, with hypertension or diabetes). Suspected cases, people who have tested positive, and their family members have to take a 15-day quarantine at home. Everybody must wear a mask in public places.

 

Educating people about the importance of the containment measures is the key, especially in cities like Bogota where there is a dense population.

SENSE-MAKING

Dr. Leal shared his firsthand experience with the rapid rise in COVID-19 cases in Columbia. Younger individuals who maybe feel less vulnerable are now accounting for the majority of new infections.