The lack of scientific and statistical information prevents the development of more precise epidemiological surveillance, experts say.
before a possible reduction of COVID-19 infections, the national COE decided modify traffic lights of the alerts that govern each canton, which generated doubts among experts.
epidemiological traffic lights measure the risk of contagion in the population. In this sense, red represents a high risk; yellow, medium; and green, low. The objective of cantonal traffic lights is to organize activities, promote economic and social reactivation and also prevent hospital saturation and loss of life.
On January 16, when the protection traffic light against COVID-19 was launched, the national COE determined that 193 cantons were in the red, 26 in yellow and 2 in green.
A week later there was a drastic change. Through a statement, the MSP reported on January 22 that, after analyzing the demand in hospital care centers and intensive care units (ICU), it was able to determine that “the infections of COVID-19 are stabilized, observing a reduction (…) in relation to the second week of January (from 9 to 15), which was the highest peak in the entire pandemic.
Thus, the COE resolved that 29 cantons go to a green traffic light; 179, to yellow; and only 13, to red. In accordance with the resolutions of the national COE, the epidemiological risk traffic light classification scheme is based on the incidence rate (number of new cases per day), lethality (death rate), infection rate, hospital occupancy and coverage of vaccines at the cantonal level.
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Ximena Garzón, Minister of Health, reported that in the second epidemiological week (from January 9 to 15) 47,053 confirmed cases of COVID-19 were reported; while in the third week (from January 16 to 22), the cases totaled 37,180, that is, about 10,000 less.
The moving average (average of daily confirmed cases) of the last seven days reflects that in the second epidemiological week an average of 8,247 new daily cases were reported; and in the third week, 8,046. In other words, from one week to the next there has been a slight downward trend.
During epidemiological week 51 of 2021 (December 19 to 25), the figures reflected a 25% positivity of infections.
A month later, in the second epidemiological week of 2022 (January 9 to 15), the positivity of infections reached 55%, that is, out of every 100 people, 55 were infected. The next week (January 16 to 22), when the COE changed the traffic lights, the positivity at the national level reached 60%, surpassing that of the previous week.
For the president of the Pichincha College of Physicians, Víctor Álvarez, the decision of the COE was hasty Regarding the change of colors of the traffic lights of the cantons that went from red to yellow, it indicates that, although “we cannot count on the official data, but according to the casuistry that has been had, the cases are still high” .
Furthermore, he attributes the high positivity of infections due to the lack of PCR and antigen tests, the underreporting of cases, the MSP’s recommendation to save diagnostic tests, and the delay in delivering results.
For the epidemiologist Andrea Gómez, traffic lights leave more questions than answers, because the data used as input to assign colors to the cantons has not been published.
“We do not know what the cutoff points are that they use to signalize. That is to say, what percentage of (hospital) occupancy does red mean, green or yellow; what lethality are they taking into account, if the (variant) delta or omicron; what is the evidence base for having placed those indicators that are important; why those indicators and not others”, questions the specialist.
Infectologist Carola Cedillo agrees with this, adding that, in addition to the data offered by the Health portfolio is not accurate, the current rate of positivity is not fully understood, due to the country’s low diagnostic capacity.
Approximately three COVID-19 tests are taken in the country for each positive case, however, the WHO recommends that at least ten tests be taken for each positive case detected to maintain proper epidemiological surveillance.
“Testing has not always been Ecuador’s strength. We do not test in the amount necessary to have objectivity of this data, “says Cedillo.
More than 1,700 laboratories and health centers offer rapid COVID tests under state authorization in Ecuador, while 14 have been sanctioned for not publishing rates or excessive prices in PCR
For Gómez, the behavior of the omicron variant in countries like South Africa shows that “the drastic increase in cases it begins to generate actions so that the curve does not grow so much and begins to reduce”.
It does not mean that infections stop. “It is likely that we will have more cases for a while, until we have a plateau. In the case of Ecuador, we have not reached the day when we do not have confirmed cases, and that is something that has not been able to be controlled.”
Next Saturday, January 29, the COE A new meeting will be held to assess the country’s epidemiological situation. However, on Wednesday the 26th, the body reversed the decision that the football match between the selections of Ecuador and Brazil It will be held without an audience.
This happened after the intervention of President Guillermo Lasso, which asked the COE to review the measure. The Committee accepted the president’s request and authorized the match to be played with 50% capacity. The sports meeting is scheduled for January 27, in Quito.
Restrictions according to traffic light color
When a canton is at a red light, it has the following restrictions:
- 30% capacity in essential activities, such as attendance at markets, financial entities and public services, and restriction of hours.
- 30% indoors restaurants, cinemas, theaters, gyms and spas; 50% outdoors.
- Entry is not allowed tolerance centers, such as bars, clubs and karaoke.
- The capacity of the outdoor activities (beaches, parks, open spaces) is 30%.
- prohibition to massive activities.
The yellow traffic light contemplates:
- 50% capacity for essential activities, such as attendance at markets, financial institutions and public services.
- Inside restaurants, cinemas, theaters, gyms and spas capacity goes up to 50%; 75% outdoors.
- Inside of tolerance centers a capacity of 30% is allowed; 50% outdoors.
- In outdoor activities (beaches, parks, open spaces) a capacity of 50% is allowed.
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The green traffic light allows:
- Capacity of 75% in essential activities (markets, financial entities and public services).
- 75% capacity inside cinemas, restaurants, theaters, gyms and spas; 100% outdoors.
- 75% capacity in tolerance centers and outdoor activities (beaches, parks, open spaces).
- capacity in the public transport for all three colors suggests that all passengers travel seated. (I)
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