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Health & Insurance. 22

Published in Health & Insurance. Written by May 21 2020 0

Medellin-based insurance and health-network provider Seguros Sura announced May 21 that it’s expanding a novel home-care testing-and-recovery program for Covid-19 patients.

“The company is a pioneer in this model that already operates in Antioquia, and from next week in Barranquilla, Cali and Bogotá, and then in other cities in the country,” according to Sura.

The scheme “will operate through the ‘Salud en Casa’ Sura home care program and also with other allied medical services of this type,” according to the company.

“The model has a great educational, self-management and interdisciplinary accompaniment component including [services from] professionals in general medicine, nursing, internal medicine, pediatrics, gynecology, infectology, nutrition, respiratory therapy and psychology.

“It includes periodic measurements of blood oxygen saturation levels, postural correction and respiratory therapy. With this, Sura wants to intervene directly in the reduction of two fundamental indicators for the control of the pandemic: mortality and hospital stays, especially in intensive care units (ICU),” according to the company.

“Educating people will allow us to empower them and make them participate in the management of their health and that of their family group,” added Sura EPS general manager Gabriel Mesa Nicholls. “For this we rely on technological advances to intervene early in populations that are symptomatic and require attention. Germany, for example, with a similar model, has achieved mortality levels 50% below the world average,” Mesa explained.

Home-care implementation of the scheme “begins with the delivery of a kit for positive or suspected patients with risk factors for Covid-19, consisting of a pulse oximeter, thermometer and an education plan with very precise and simple instructions for constant monitoring of [blood oxygen] saturation levels and temperature; as well as a guide to postures that patients with symptoms should adopt,” according to the company.

“Based on the data that users will permanently provide from the measurements,via WhatsApp, face-to-face or virtual accompaniments by general medicine doctors and specialists in internal medicine, [subsequent treatment schedules] will be programmed for pediatrics, gynecology, infectology, nutrition or psychology, according to the particular needs of each patient,” according to the company.

“This model benefits the affiliates and policyholders of EPS Sura, Complementary Plan, ARL Sura and Health Policies, and began in Antioquia on May 18.

“It will gradually be extended to the other cities where Seguros Sura Colombia has a presence, through the ‘Salud en Casa’ home-care model or through agreements with other home health service providers.”

Seguros Sura Colombia also processes 600 samples daily (25,000 tests to date) to detect possible Covid-19 infections -- either from patients driving to Sura locations or else at home. The company also is racking-up 9,000 related home-health services daily through virtual care and telecare services, according to the company.

Published in Health & Insurance. Written by May 21 2020 0

Antioquia Governor Aníbal Gaviria Correa on May 20 hailed leadership by the “LivingLab-Telemedicina” patient-contact-and-testing center here in the continuing struggle to detect, contain and overcome Coronavirus.

“LivingLab-Telemedicine is developing as one of the greatest successes in Antioquia in confronting the Coronavirus contingency,” Governor Gaviria said following a personal visit to the lab.

“This, in a way, is a hospital not only for the present but also for the future. Here we have the functions of promotion and prevention, but also, especially, everything related to telehealth and telemedicine, which has been absolutely key to containment of Covid-19,” he added.

To date, the lab and its 200 health professionals have dealt with more than 200,000 calls from Antioquian citizens worried about suspected or possible cases of contagion, along with related concerns about mental health problems arising from the pandemic. 

“One of the keys to the [relatively low rates of contagion] that Antioquia has obtained has been telemedicine and, in this initiative, the University of Antioquia, the LivingLab, other universities in the city, the EPS [health-insurance networks] and the government of Antioquia are integrated,” the Governor said.

Antioquia Health Secretary Lina María Bustamante Sánchez added that the LivingLab-Telemedicine center not only screens initial calls from concerned citizens, but also refers patients with likely contagion for follow-up testing, diagnosis and treatment services.

Published in Health & Insurance. Written by May 10 2020 0

The Medellin Mayor’s Office announced May 10 that starting tomorrow (Monday, May 11), 201,461 more people will return to work here at 12,210 companies newly meeting Health Ministry Covid-19 prevention protocols as well as registration in the high-tech “Medellin Me Cuida” program.

Prior to May 11, Medellin and its neighbors in Valle de Aburrá already had 52,852 companies registered in “Medellin Me Cuida” -- and also approved as meeting biosafety protocols.

“Our purpose from the Mayor's Office of Medellín is to guarantee that all these companies can operate without neglecting the health and well-being of all our inhabitants,” said Medellin Secretary of Economic Development Paola Vargas González.

Qualifying companies and their employees “must register their data on the Medellín Me Cuida platform. Employers must attach the biosecurity protocol, which will be reviewed to verify that the requirements that guarantee the health and well-being of workers are met,” according to the Mayor’s Office.

The computerized “Medellin Me Cuida” program feature big-data analysis, including a “technical table for economic impact measurement,” which now indicates an “urgent need to encourage staggered [work-hours] scheduling strategies in companies in order to avoid crowds in public transport and common places,” according to the Mayor’s Office.

“We are going to work hand-in-hand with the public sector but also with companies and transporters to ensure that employers have all the necessary requirements to protect the employee, that they can be transported safely, and that they can travel to their office if it is strictly necessary,” Secretary Vargas added.

Medellin Leads All Colombia in ‘Smart’ Covid-19 Response, Controls

While Bogota, Cali and other cities poorly struggle to cope with Covid-19, Medellin once again leads all Colombia in “smart” technology and “smart” public policy – with exceptionally low rates of Coronavirus infections combined with relatively successful, well-organized, gradual economic reopenings -- without political demagoguery.

As of May 9, Colombia’s Health Ministry had recorded 10,495 Coronavirus cases nationally, with 445 deaths and 2,569 recoveries. Bogota has nearly 40% of all cases (4,028) followed by Cali/Valle del Cauca (1,320) and then Medellin/Antioquia (466 cases, including six deaths, 335 recoveries and a 77% recovery rate so far).

In a May 8 report from Bogota daily newspaper El Tiempo, Medellin Mayor Daniel Quintero and other local experts explain why Medellin has had such unusual success in Covid-19 control.

One key to success is sophisticated “big data” analysis of the 2.2 million individuals and 800,000 families registered in the “Medellin Me Cuida” database, which among things enables tracking of people to-and-from the tens of thousands of workplaces included in the computer program.

The report quoted Dr. Carlos Agudelo – infectious disease specialist at the Clínica Universitaria Pontificia Bolivariana here – as saying that Medellin not only moved relatively quickly to enforce quarantine at an early stage, but also aggressively tracks and studies every outbreak of contagion, especially originating at sites of notable crowding.

Thanks to this program, people infected were interviewed promptly to see what other contacts they had recently, which enabled early testing and isolation of more potential spreaders of disease.

Statistically, Medellin’s “smart” response to these early infections was nearly four times greater than in Bogota and more than three times greater than the national average, Agudelo explained.

Mayor Quintero added in the same report that “through epidemiological fencing exercises, we have managed to keep this [infection growth rate] curve low.”

For example: The “Medellin Me Cuida” database enables local health officials to “pick up the phone and call a person who is over 70 and who has hypertension and lives with someone who is working in a department store. With that information, when there is a [Covid-19] case we can test not only a first circle of related people, but up to five circles around, and even a block, to try to find positive cases,” Quintero was quoted as saying.

“From the first infection [detection], we began to practice examinations at home, instead of telling people to go to clinics. Then we start continuous monitoring, with daily calls.

“This helps us not only to know if the person is well, but if, in fact, he is at home. We call him and ask him to pass the phone to his mother, his brother, and [if] they did not pass [the phone to] someone, we immediately made an inspection visit. This includes in some cases putting plainclothes police outside the houses,” he added.

Published in Health & Insurance. Written by April 18 2020 0

The Mayor’s Office of Medellin announced April 17 that 100 of 183 confirmed cases of Coronavirus here have already fully recovered – a 54% recovery rate to date, with more recoveries expected.

In total, 4,154 persons in Medellin suspected of having Coronavirus-like symptoms have undergone laboratory tests. “Of these, 3,669 have shown no infections, 302 are under study and 183 have been positive,” according to the Mayor’s Office.

What’s more, “100 of the 183 confirmed cases have been recovered -- that is, more than half,” according to the Office.  So far, only one person in Medellin -- a 90-year-old woman suffering several other life-threatening illnesses -- has died of Coronavirus complications.

“Timely decision-making, rigorous monitoring of each case, and other measures implemented by the Medellin city government have been decisive for the containment of the virus one month after the first case of Covid-19 in the city was confirmed,” according to the Mayor's Office.

Beyond the national quarantine that is helping not only Medellin but also all Colombia to stem the spread of Coronavirus infections, Medellin also ordered compulsory use of masks in public transport and all enclosed spaces.

“In addition, the activation of 123 field investigations and isolation [orders] has allowed the epidemiological dynamics to be different compared to the rest of the country,” according to the Office.

“We have had valuable days that have allowed us to prepare for the most important phase of the epidemic: the mitigation phase,” added Medellin Health Secretary Andree Uribe Montoya.

“All the actions we have taken to anticipate the Coronavirus have allowed all cases to be controlled and we have all the measures identified to control the spread of the virus,” Uribe added.

Since January 27, the Health Secretariat of the Mayor's Office of Medellín “began executing an action plan to deal with the Coronavirus, initially focused on preparation and coordination of all the actors that would be key to containing the virus: departmental administration, transport terminals, airports, hospital network, personnel and health professionals,” according to the Mayor's Office.

“From then on, [the city government issued] timely communications about personal hygiene and healthy lifestyle recommendations; the training of more than 4,000 people in topics related to Covid-19 prevention; the allocation of more than COP$3 billion [US$763,000] to strengthen the health system; the activation of the ‘Acute Respiratory Infections’ contingency plan and the start-up of the ‘123’ emergency line for the attention of Covid-19,” according to the Office.

“Thanks to timely diagnoses, it has been possible to identify and treat the 183 local patients, thus avoiding [a greater pandemic]. The good news for the city is that more than half of the cases have already recovered . . . a figure that added to those recovered from the rest of Antioquia reaches 158,” or fully one-quarter of the entire national recoveries, the Office noted.

According to the Colombia Health Ministry, as of April 17 Colombia had 3,439 cases of Coronavirus, led by Bogota (1,396); Cali/Valle del Cauca (605); and Medellin/Antioquia (324). Nationally, 153 persons have died from Coronavirus complications, while 634 have fully recovered as of April 17, according to the Ministry.

Published in Health & Insurance. Written by April 17 2020 0

Medellin Mayor Daniel Quintero announced April 17 via his Twitter account that the Medellin metro area -- Valle de Aburra -- theoretically could have 3 million people infected with Coronavirus.

However, the Mayor didn’t specify how this would happen, when it might happen, nor how many cases would be “severe” or “critical.”

“In Medellín and its metropolitan area, we estimate that between 2 million and 3 million people could be infected by Covid-19. I see people relaxing. We have only bought time. The hardest is yet to come,” Quintero warned.

The alarmist message from the Mayor comes on the heels of the latest Colombia Health Ministry computerized data-modeling forecast, which (in theory) indicates that perhaps 50% of Colombians eventually would be infected with Coronavirus (see Medellin Herald April 16, 2020).

However, the number of Colombians with life-threatening complications is likely to be a small fraction of the total Coronavirus infections, according to Health Ministry forecasts.

Nevertheless, Colombia continues to buy-time against a potentially huge wave of simultaneous infections by imposing quarantines and other restrictive measures -- especially for the most vulnerable populations, according to the Ministry.

“The [Coronavirus] mortality rate in our nation is just three per million inhabitants, while in Brazil it is eight, in Panama 22 and in the United States it is 86 deaths,” according to an April 16 bulletin from the Colombian Health Ministry.

“These figures allow us to recognize that Colombia has been facing the Covid-19 pandemic [with proactive initiatives] such as having the first laboratory for the diagnosis of the virus in Latin America and also being the pioneers in adopting extreme measures against the new Coronavirus on the continent, in order to preserve the public health of Colombians.

“Among the measures are a series of decrees, guidelines and protocols that have guided the current situation and that have allowed a better preparation of the Colombian health system . . .

“The Minister of Health hails the work that the private sector has done in the extension of Intensive Care Units (ICU) in a period of a month-and-a-half,” the Ministry added.

While hospitals, clinics and Colombia’s “EPS” health-care insurance networks are by law required to invest in measures to protect hospital and health workers from infections, “the [Colombian] state has taken measures in this regard and on April 8 began to deliver supplies to the institutions” including “750,000 items of personal protection throughout the country” and “in the next month-and-a-half, 19 million [more] protection elements can be delivered” to hospitals and clinics, according to Health Minister Fernando Ruiz Gomez.

National Government Helping Poor People, Hospitals, Clinics

On a related front, Colombia’s national government is speeding deliveries of crucial food and medical supplies -- especially aiming to help the poorest people, Colombia President Ivan Duque announced on April 16.

“We are talking about more than COP$6 trillion [US$1.5 billion] to deal with this emergency, and that implies the resources that have to do with equipping and acquiring equipment, but also to strengthen the protection and expansion capacity of the health system,” Duque said.

Under the president’s "Social and Economic Emergency" powers, “resources have been allocated to serve the most vulnerable, particularly 2.6 million families from the Families in Action program, 276,000 Youth in Action students and 1.7 million older adults,” he said.

“This has allowed us to implement ‘solidarity income’ that reaches nearly 3 million families who were not in any government social program, and who are receiving this attention from the state for the first time.”

In total, the national government has already implemented 72 decrees that have boosted funding to address the emergency, the President added.

“Progress has also been made in the distribution of 1.7 million nutritional aids or reinforcements through the Colombian Institute of Family Welfare (ICBF), to serve children,” according to Duque.

What’s more, “we have put into operation the 'PAE at Home' [normally a public-school feeding program, but schools are closed during the crisis]  so that 6.2 million children can receive food at home -- and I want to highlight that we are already above 3.2 million” children receiving home-feeding support, he added.

Published in Health & Insurance. Written by April 16 2020 0

Colombia’s Health Minister Fernando Ruiz Gómez announced April 16 that the current national quarantine against Coronavirus infections will continue past the presumptive April 27 deadline expiration.

However, many current restrictions gradually will be relaxed -- but only when accompanied by strict health protocols, he revealed.

As of April 16, Colombia had reported 3,233 Coronavirus cases nationally, of which 1,333 were in Bogota, 559 in Cali/Valle del Cauca and 308 in Medellin/Antioquia. So far, 144 deaths are reported from Coronavirus complications nationally, with 550 persons fully recovered to date, according to the Health Ministry.

Unlike the U.S., Europe, parts of Asia and elsewhere, Colombia has to date generally avoided a disastrous spread of Covid-19 -- thanks to a general quarantine that started March 20, the Minister noted.

“Colombia opted for a quarantine model in which we have part of the economy functioning: public services, agriculture, food, transportation, medical services and home deliveries, the parts of the economy that support the basics,” he said. “But a society cannot be kept permanently closed,” he added.

In contrast to the current situation in Colombia, countries such as the U.S., Italy and Spain unwisely maintained relatively “open economies” even as Coronavirus cases multiplied. But soon afterward, most of these previously uncautious governments “had to abruptly close down due to the impact of the epidemic curve,” he noted.

In contrast, Colombia took quarantine measures broadly and more promptly, while still maintaining essential services -- avoiding catastrophe, yet still maintaining crucial food, medicine, banking, transport, agriculture and public service sectors, he noted.

Now, “we are looking for strategies to open the economy together with [partial quarantine] isolation -- and how to establish this gradualness, because a closed economy throughout the year will generate severe problems with unemployment, poverty, hunger and all the implications for people’s health,” Ruiz added.

“What we are proposing from the Ministry is not the termination of the quarantine on April 27. That is not the strategy.

“The strategy is to maintain mandatory preventive isolation for specific groups and mandatory preventive quarantine of the entire population with the option of a very systematic, gradual and controlled global opening of some sectors of the economy -- but with the clarity that any eventuality or risk that could be generated will trigger a return to [a stricter] closure, as foreseen in the models that the INS [National Institute of Health] has developed,” he explained.

To enable gradual reopenings of more economic sectors, “new guidelines will have to be created, which, according to Decree 539, are made in a unified way by the Ministry of Health, because what we are looking for is that there be comprehensive protocols for all Colombians,” he concluded.

However, “we have areas in the country that are ahead [of the statistical infection-rate curve], others that are behind in number of cases and curve, but also rural areas where it is much less -- and that is because they live at a much greater distance [from cities], which makes the probability of contagion less,” he added.

50% Infection Rate Statistically Possible, Triggering Greater ICU Capacity Building

Meanwhile, the Health Ministry continues to run computerized statistical-probability scenarios tied to contingency plans for treating a potentially broader Covid-19 epidemic, the Minister explained.

“In order to establish the parameters for the needs at the territorial level, we took a [theoretical] indicator that showed that slightly more than 50% of the Colombian population is susceptible,” he said.

“The population that becomes infected in the first wave [under this statistical model] is lower because the proportion of our population that is younger is greater than in countries like China, Italy and France. Another factor that is analyzed is that we have a smoking rate – just 14% -- lower than other countries,” he said.

“The updated projection in our country is that 12% of those affected will be asymptomatic and 88% symptomatic. From the latter group, it is necessary to determine whether we’re dealing with [relatively greater numbers of] patients with mild symptoms -- requiring outpatient treatment -- or severe or critical patients – requiring hospitalization -- and thus determine the beds required in intermediate and intensive care.”

Because Coronavirus patients in “critical” state would require intensive care unit (ICU) segregation, the Ministry calculated potential expansion of ICU capacity in Colombia.

“Due to the structure of our health system, where the payment of services is made by event, the majority of providers in our country have had a very great incentive to take patients to intensive care. This led us to have more units of intensive care per capita than many countries,” Ruiz explained.

To address a broader epidemic, “we are not inventing new hospitals [but rather] an expansion of the [existing] network with provision of logistics, medical histories, systems and everything else necessary,” he concluded.

Notably, major cities including Medellin, Bogota, Cali and elsewhere are already moving quickly to increase ICU capacity for an expected increase in future “critical” Coronavirus cases. Medellin leads all Colombia in commercial production of specialized Coronavirus ventilator machines, due for start-up April 20.

Published in Health & Insurance. Written by April 15 2020 0

Medellin Mayor Daniel Quintero announced April 15 that local home-appliance manufacturing giant Haceb and local motorcycle assembler Auteco will launch manufacture and assembly of novel Coronavirus ventilator machines -- starting Monday, April 20.

Three prototypes have been developed in Medellin via a research and technology consortium organized by tech incubator Ruta N and Colombia’s national industrial-commercial trade association ANDI.

Coronavirus ventilators on the global market have been quoted as costing more than COP$150 million (US$38,000), the Mayor noted. But the locally produced ventilators are expected to cost a small fraction of that -- perhaps in the range of US$1,000 to US$2,000.

“The three prototypes, which are part of the '#InnspiraMED' project, were independently developed by Sampedro Medical Industries, the University of Antioquia and the EIA University, meeting all Invima [Colombia medical products regulator] quality and safety standards,” according to the Mayor’s office.

“This is going to allow us to save lives -- not just for Medellín and Antioquia, but for all of Colombia,” Quintero added.

In his April 15 announcement, the Mayor didn't specify exactly how many ventilators will be produced initially, the total expected forecast production, retail prices and commercial availability dates.  

Published in Health & Insurance. Written by April 11 2020 0

Three prototypes of mechanical ventilators being developed for Coronavirus victims by metro-Medellin-based Sampedro Medical Industries, the University of Antioquia and the EIA University are now set to move to human trials following successful tests at CES University School of Veterinary Medicine and Animal Husbandry here.

The development teams are now preparing for tests on human beings and, subsequently, the start of production at two Medellin-metro manufacturing giants: multinational home-appliance manufacturing giant Haceb and motorcycle assembling giant Auteco.

“Advances like the one taking place today are possible thanks to [Medellin-born multinational bottled drinks maker] Postobón’s donation in the project,” according to an April 10 announcement from Medellin-based tech incubator Ruta N, organizer of the “#InnspiraMED” ventilator consortium.

“The three mechanical ventilators for intensive care units (ICUs) [for #InnspiraMED] successfully carried out preclinical tests in the operating rooms of the Faculty of Veterinary Medicine and Zootechnics of CES University,” according to Ruta N.

“The three devices, which are a success thanks to the donation of Postobón and hundreds of people who have joined this initiative through the #InnovaPorLaVida and # UnidosSomosPaís platforms, have been developed in compliance with Invima [Colombia’s national medical-standards regulator] quality and safety standards. The articulation work between all the actors has been led by Ruta N and ANDI [Colombia’s national industrial-commercial trade association].

“One of the prerequisites for achieving success in preclinical trials was the development of in-vitro [laboratory-scale] tests by the group of anesthesia and critical care specialists at the San Vicente Fundación University Hospital, the Las Américas Clinic and the Pablo Tobón Uribe Hospital. These tests consisted of subjecting the ventilators to different clinical conditions with highly specialized simulators that evaluate their operation and, thus, be able to determine how safe they are for patients.

“With the results of the preclinical tests, preparations will be made to proceed with tests on humans, which will allow the devices to be definitively validated and go to the production phase that will be headed by Haceb and Auteco,” Ruta N added.

The three prototypes were designed for rapid scale-up for production, according to the consortium.

FLA Delivering Antiseptic Alcohol to Stores

Meanwhile, the Antioquia departmental government announced April 8 that starting today (April 11) its government-owned Fabrica de Licores de Antioquia (FLA) will start delivering bottles of antiseptic alcohol (70% pure alcohol) to local supermarkets.

“The product’s profit margins will be minimal for each of the actors in the distribution chain,” according to the FLA.

The FLA earlier produced 250,000 bottles of the alcohol to disaster-response agency DAPARD and subsequently to hospitals, clinics and public-safety agencies, according to the company.

“The main objective is to ensure that the greatest number of people access a product that becomes vital when taking aseptic measures and that contributes, to a large extent, to [Coronavirus] contingency control,” according to the FLA.

Published in Health & Insurance. Written by March 30 2020 0

Colombia’s Health Ministry announced March 30 that it’s accelerating national payments totaling COP$2.1 trillion (US$517 million) to hospitals and clinics this year in order to respond to an expected surge of Coronavirus patients.

The accelerated payments total a little less than half of the COP$4.5 trillion (US$1.1 billion) in subsidies budgeted for the entire year of 2020, according to the Ministry.

Meanwhile, as of March 30, the Health Ministry had reported 798 Coronavirus cases nationally, led by Bogota (350) and Cali/Valle del Cauca (104). Antioquia ranks third with 96 cases, of which 60 are reported within the city of Medellin.

Among the Antioquia cases, most involve people that had traveled to Spain, the USA, Jamaica, Turkey, Brazil, Italy, Panama, the UK, Ecuador and Germany, according to the Antioquia Departmental government. The remaining cases involved people who were cross-infected by foreign travelers.

So far, 12 people have died nationally from Coronavirus complications – none in Antioquia -- while 15 patients have fully recovered, according to the Ministry. The vast majority of victims are recuperating at homes rather than in hospitals.

“In order to guarantee financial liquidity in the nation’s hospitals and clinics in the face of the Coronavirus health emergency, the national government made the decision to anticipate the transfer of COP$2.1 trillion (US$517 million) corresponding to budgeted resources for the sector for the entire year, which will be disbursed to the institutions that provide health services [that is, Institutos Prestadores de Servicios de Salud, ‘IPS’] during the month of April and the beginning of May,” according to the Ministry.

Colombia’s Administrator of Resources of the General Social Security System in Health (ADRES) has already ordered advance payment of COP$782 billion (US$192 million) to health provider and insurance networks to help pay for certain other high-cost procedures and drugs that fall outside mandatory covered services in the “EPS” (empresas promotores de salud) insurance network schemes, the Ministry added.

Now, an additional COP$540 billion (US$133 million) will be released to health networks between April and May for mandatory covered services (including Coronavirus cases).

Yet another COP$700 billion (US$172 million) will be paid in May “so that hospitals, clinics and other medical centers can access the hospital portfolio purchase mechanism” in anticipation of future ADRES payments, according to the Ministry.

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About Medellin Herald

Medellin Herald is a locally produced, English-language news and advisory service uniquely focused upon a more-mature audience of visitors, investors, conference and trade-show attendees, property buyers, expats, retirees, volunteers and nature lovers.

U.S. native Roberto Peckham, who founded Medellin Herald in 2015, has been residing in metro Medellin since 2005 and has traveled regularly and extensively throughout Colombia since 1981.

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