Is The Health System Prepared? | The USA Print – THE USA PRINT


The climate crisis is “the greatest threat” to health facing the humanity, according to World Health Organization (WHO). One of the challenges facing healthcare systems around the world is the detection of emerging diseases such as the dengue, among many others. This infection, once confined to the tropical countries, is already present in North Hemisphere.

He covid-19, the closest and most recent example we have, evidence the speed with which you can spread a virus due to globalization. In this context, is the Spanish health system prepared for new diseases climate change and future epidemics?

“The covid showed that the health system of advanced countries [que no sus profesionales] it was not efficient”

Joan Cayla

Spanish Society of Epidemiology

“I do not think so. If not, look at what happened with covid-19. People may not be aware, but the pandemic put the whole system to the test. And it was a matter of hours, not days, that it did not fall,” says the infectologist and internist at the Hospital de la Santa Creu i Sant Pau (Barcelona). Peter Sunday, who also points out that a large part of the emerging diseases that reach the northern hemisphere are “unknown” by the doctors.

Spain is one of the few countries that does not have a medical specialty in infectious diseases in the MIR

After the pandemic, the Government decided to create a State Public Health Agency, which Spain lacked, to better deal with future public health risks. But at the same time Spain is one of the few countries that still does not have the medical specialty of infectious diseases in the mir.

Domingo focuses on the fact that the emerging diseases (dengue, but not only, also chikungunya or zika, which can be transmitted through mosquito bites) They could also represent a “major overload” for a system “already in itself overloaded”. “In addition,” says this infectologist, pessimistically, “in Catalonia between 9,000 and 10,000 doctors will retire in the next 10 years. We’ll see how they will be replaced.”

Lack of staff is the main challenge facing healthcare systems across Europe, and it has to do with demographic crisis, although in countries like Spain there are toilets that they go abroad in search of better working conditions.

“First Line of Defense”

Plays a key role, in this context, the primary care, the gateway to the system, capable of solving up to 80% of medical problems. “The first line of defense” precise Sunday. Thus, more and more family doctors are being trained in Tropical diseases. “We have to face what will come. What we see in the consultation [diferentes realidades culturales, migraciones, viajeros] has consequence in terms of disease. Climate change and drought force people to move,” says Muntsa Royo, doctor of the CAP Camps Blancs (Sant Boi de Llobregat) and member of the planetary health group of the Catalan Society of Family and Community Medicine (Camfic). To this is added that disease vectors, Like the mosquitoes waves ticks, They reproduce best in warm areas, so the temperature rise it benefits them.

This reality, continues Royo, forces doctors to have a “Training in Tropical Diseases”. “Many primary care physicians they are not formed. And we must prepare ourselves because the patient may have malaria and we think that it is a flu”, says. This doctor also points out that the primary care it also plays an important role in prevention. The tropical consultation medicine and traveler care, to which she dedicates herself, consists of following the immigrant community that returns to their country of origin to visit and also travelers.

“Many primary care doctors are not trained. And we must prepare ourselves because the patient may have malaria and we think it is the flu”

Muntsa Royo

CAP Camps Blancs doctor

Training in “exotic infections”

primary care works in network with hospitals. Health centers like clinic of Barcelona have international Health Units, where they see infections from exotic countries. “We see patients with infections out of our scope. Above all infections that worry us because they are transmitted here, like dengue, since it spreads through tiger mosquitoes,” says Natalia Rodriguez, Associate physician of the Clinic’s International Health Service. Rodríguez points out that Clínic studies on ticks they show how, with the climate crisis, they are increasing a lot. “And they are vectors of many diseases. It has been seen that they stay longer and at more latitudes,” he adds.

Rodríguez believes that governments should invest more in prevention, in the ‘one health’ committees, in innovation and development. “The problem with many of these diseases is that, being from the tropics, they have not been invested in. There are no vaccines or treatment, so we should bet more on this”, says this doctor.

the epidemiologist Joan Cayla, member of the Spanish Society of Epidemiology (SEE), doubts that the sanitary system be prepared to deal with diseases of the climate change, when “he’s not even ready for the notifiable diseases (covid-19, HIV or tuberculosis, among many others). “The covid showed that the health system of the advanced countries [que no sus profesionales] it was not efficient,” says this epidemiologist.

No specialty in Infectious

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In addition, points out Caylà, Spain lacks a medical specialty of infectious diseases. They develop this specialty doctors internists that have formed into infectious, but “There is a lack of a title that pushes people to educate themselves more on this topic.”

For his part, the head of Infectious Diseases of the Germans Trias i Pujol Hospital (Can Ruti, in Badalona), Roger Paredes, calls for strengthening the systems of epidemiological surveillance to face a reality that is already here. “But climate change is not only faced from the health system, but also from society. The public must be aware of what fuels does it use or of what transport you choose to travel, for example”, ditch.


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