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Health & Insurance. 51

Published in Health & Insurance. Written by January 31 2021 0

Medellin-based Healtix Home IPS and Bogota-based WTA Latam IPS jointly announced January 29 the start-up of Covid-19 testing services at Medellin’s José María Córdova (JMC) international airport in Rionegro.

“From today, our airport will have a laboratory to carry out Covid-19 detection tests,” according to a bulletin from JMC. “This service will be provided by WTA Latam IPS and Healtix Home IPS.”

All international passengers arriving to or leaving from Colombia are now required to pass a Covid-19 test within 96 hours of flights to-or-from most destinations including North America, Europe and much of Latin America.

Many nations (including Colombia) currently accept either the relatively rapid-result (but less accurate) antigen test (results in 20 to 40 minutes) or else the more-accurate but lengthier PCR test (24 to 36 hours for results). Passengers unable to get a Covid-19 test before boarding a flight to Colombia must get this test upon arrival and face quarantine as well.

The antigen test here at JMC is priced at COP$80,000 (US$22) while the PCR test costs COP$230,000 (US$64.50), according to the companies involved.

Colombia’s medical-services regulator Invima has certified both of these tests, according to JMC.

Published in Health & Insurance. Written by January 30 2021 0

Colombia Health Minister Fernando Ruiz announced last night (January 29) that the first 337,000 doses of Covid-19 vaccine will be administered starting February 20.

Thanks to recent purchase deals, “Colombia has secured the 35 million vaccines necessary to immunize 70% of its population against Covid-19, with which we will achieve herd immunity,” according to the Ministry.

“We have managed to buy 20 million doses for 10 million Colombians through Covax, and through bilateral [purchase] mechanisms another 41.5 million doses for 25.25 million people. In this way we reached 61.5 million doses for 35.25 million people to be vaccinated,” Minister Ruiz revealed.

Total government spending for vaccine acquisition now totals COP$2 trillion (US$560 million), he aded.

The “National Vaccination Plan” (PNV in Spanish initials) now includes the following vaccines:

Pfizer: 10 million doses purchased for 5 million people (two shots per person), using the “messenger RNA” chemistry. “This vaccine differs from the traditional ones because it does not incorporate live or attenuated virus agents, or fragments of it,” explained Ruiz.

AstraZeneca: 10 million doses for 5 million people, similarly a “non-replicating viral vector vaccine that must be applied in two doses.”

Janssen (Johnson & Johnson): 9 million doses for 9 million people, as a “single-dose vaccine that is easy to take to dispersed areas” since it doesn’t require ultra-cold refrigeration.

Moderna: 10 million doses for 5 million people, “a new technology vaccine also of messenger RNA that requires deep freezing,” he said.

Sinovac: 2.5 million doses for 1.25 million people. “It is an inactivated, two-dose vaccine that can be stored in standard refrigeration at 2°C to 8°C,” according to the Ministry.

All these vaccines “have shown efficacy, all exceed the minimum standard required by the WHO [World Health Organization] for vaccination processes and allow us a diverse portfolio of maneuverability in the event of any eventuality,” Ruiz said.

Updated Vaccination Rollout Schedule

Thanks to the recent acquisitions and updated delivery schedules, the following dose schedule is now foreseen starting February 20, 2021:

February: 337,000 doses
March: 3,333,764
April: 4,663,843
May: 3,939,843
June: 7,553,450
July: 8,294,941
August: 11,258,941
September: 5,642,941
October: 6,260,116
November: 4,934,352
December: 3,166,666

As a result, “Colombia has the possibility of completing 100% of targeted vaccinations in 2021,” rather than an earlier estimate of 2022, he said. “Bear in mind that 35 million people represent almost the entire population over 16 years of age in Colombia,” he added.

“This is the opportunity for the country to unite, regardless of any divergence, towards a safe and effective vaccination process, because that is the basis for our country’s ability to turn the page on Covid-19” -- enabling both public health improvement as well as fuller economic recovery, he concluded.

Published in Health & Insurance. Written by January 15 2021 0

Colombia Health Minister Fernando Ruiz announced last night (January 14) that another 71,473 vaccination specialists soon will join the existing 7,000 nationally qualified Covid-19 vaccinators via a new training program that starts today.

The “Management of Vaccination Against Covid-19 in Colombia” course now underway with Colombia's SENA training institute includes more than 42,000 nursing assistants, 13,000 registered nurses, 6,800 doctors, 3,500 dentists, 3,500 public health workers and 2,200 bacteriologists.

Of the 71,473 new trainees, Antioquia accounts for 8,637, according to the Ministry.

Course materials cover basic information on Covid-19 infection, technical and operational guidelines for vaccination, preserving the ultra-cold-temperature-storage chain, an “open bottle policy”on how to handle vials of vaccines, patient monitoring and data-information systems for correct registration of those receiving vaccines.

By end-January, yet another batch of trainees will enter the national program. For that upcoming session, “we will be inviting other professional health workers with a whole contingent that is working with us throughout the year, and with the territorial entities, the EPS [health insurance networks] and IPS [hospitals and clinics], in vaccination programs,” Ruiz added.

Published in Health & Insurance. Written by January 13 2021 0

Colombia Health Minister Fernando Ruiz revealed last night (January 12) that the first 850,000 people here to get Covid-19 vaccinations will get their shots in February.  Assuming compliance with projected delivery and distribution schedules, the tentative vaccination plan includes:

February: 850,000 people vaccinated.
March: 3,862,900.
April: 1,800,000.
May: 7,968,900.
June: 3,360,000.
July: 8,431,567.
August: 6,382,667.
September: 3,779,567.
October: 7,212,900.
November: 3,212,900.
December: 2,097,011.

The COP$1.5 trillion (US$432 million) budgeted on vaccinations so far include Pfizer vaccines -- soon arriving here -- while Janssen and AstraZeneca vaccines are scheduled to arrive between April and May 2021, Ruiz said.

The initial plan would vaccinate the 34 million most-vulnerable Colombians, with contracts for 29 million immunizations “already guaranteed,” Ruiz said.

Under the “Covax” multinational vaccine-purchase program, Colombia already has 20 million doses guaranteed (two per person required), hence this program will cover 10 million inhabitants.

“An agreement has been established with the pharmaceutical company Pfizer for 10 million doses, which will be destined for 5 million people, as well as with the pharmaceutical company Janssen, a single dose, for 9 million people, and with AstraZeneca with 10 million doses for 5 million Colombians,” according to the Ministry.

“Distribution mechanisms are being established with Pfizer. It is projected that vaccinations will begin with the prioritized populations in February,” then more doses through the Covax program will continue in March, Ruiz said.

“Probably May, June and July will be the months where we have the greatest amount of vaccinations. Those from Janssen and AstraZeneca would be arriving in the country from April or May 2020,” he added.

Meanwhile, the national government “has established talks with other pharmaceutical companies, whose vaccine developments are expected to be approved by international authorities for emergency use in the coming weeks. Surely, these would be applied for the second half of this year,” he said.

Colombia today has about 3,000 vaccination points and 7,000 vaccinators, "but we must grow in that capacity, for that reason the training course ‘Management of Vaccination Against Covid-19 in Colombia’ was developed with [Colombia’s national training institute] SENA, with which we seek to support the territories throughout the vaccinator training process," Ruiz said.

Doctors, nurses, dentists, bacteriologists, nursing and public health assistants or technicians will be able to access the training course, he added.

Ultra-Cold Storage Capacity Grows

On a related front, Gerson Bermont, director of prevention at the Ministry of Health, revealed that Colombia now has two special large-capacity warehouses in Bogota for initial receipt of “up to 40 million vaccines at a single moment” while nationwide, "Colombia has 37 collection centers for the storage and conservation of vaccines."

“The first vaccines to arrive in Colombia require deep freezing and from this moment there are eight [ultra-cold freezer] distribution points in Bogotá, Cali, Medellín, Barranquilla, Cartagena and Pereira,” he said.

“At the national level, we have 2,975 vaccination points equipped with cold equipment certified by the World Health Organization (WHO,” Bermont added.

CDC Mandates Covid-19 Tests International Arrivals

Meanwhile, the U.S. Centers for Disease Control (CDC) announced yesterday that starting January 26, all international airline passengers must show proof of having passed a Covid-19 infection test within 96 hours of boarding a flight to the USA from Colombia (or from anywhere else). As a result, the USA joins Colombia and  some100 other nations mandating Covid-19 infection tests and/or quarantines for all international passengers.

“With the U.S. already in surge status, the testing requirement for air passengers will help slow the spread of the virus as we work to vaccinate the [North] American public,” according to CDC.

“Before departure to the United States, a required test, combined with the CDC recommendations to get tested again three-to-five days after arrival and stay home for seven days post-travel, will help slow the spread of Covid-19 within U.S. communities from travel-related infections,” according to CDC.

“Air passengers are required to get a viral test [either PCR or antigen] within the three days before their flight to the U.S. departs, and provide written documentation of their laboratory test result (paper or electronic copy) to the airline or provide documentation of having recovered from Covid-19.

“Airlines must confirm the negative test result for all passengers or documentation of recovery before they board. If a passenger does not provide documentation of a negative test or recovery, or chooses not to take a test, [then] the airline must deny boarding to the passenger,” the agency added.

Published in Health & Insurance. Written by January 05 2021 0

The Medellin Mayor’s Office on January 5 issued a bulletin updating plans to begin Covid-19 vaccinations in February. The first phase of 86,526 doses of the vaccine will be administered to front-line health-care workers and adults 80-and-over, next month.

That will be followed by a second phase covering those 60 to 79 plus second-line health-care workers, then a third phase including those aged 16 to 59 and those with co-morbidities, collectively totaling 384,370 people, according to the Mayor’s Office.

“Thanks to the ‘Medellín Me Cuida’ platform, the municipal administration knows the location of the prioritized population,” according to the bulletin. “Seven [ultra-cold] freezers will arrive in the city and will serve to distribute doses to the entire Antioquia territory and other departments.”

The first phase will tap Pfizer and Aztrazeneca-Oxford vaccines in February, according to the national government’s distribution schedule.

Medellin’s Secretary of Government Esteban Restrepo added that “we are working in an articulated manner to achieve a successful process of scheduling and applying the vaccine. We will have 94 vaccination points in the city” manned by 282 vaccination teams, he added.

‘Mi Vacuna’ Scheduling App to Debut

On a related front, Colombia’s Health Ministry announced January 5 that it will debut a cell-phone application called “Mi Vacuna” later this month so that people will know when and where they can get vaccinated.

According to the Ministry bulletin, “the Ministry of Health will have the databases of the population subject to vaccination in order to carry out the identification, assignment of the vaccination appointment and follow-up to the vaccination in the IPS [hospital or clinic] assigned for each individual, by the [EPS health-insurance networks] and the territorial entities.

“Insurers and territorial entities must monitor and confirm the vaccination appointment to users, in order to guarantee access and compliance with hygienic sanitary measures for the prevention of contagion during the vaccination strategy.”

To register for vaccinations, “an access link is currently under development on the Ministry’s web portal, in which any person can enter and through their [cedula] identification number verify the [schedule] phase and stage in which they are to receive their vaccine against Covid-19. If you are not registered, then you can apply by reporting the criteria for prioritization, which will be verified and confirmed by the insurer.

“The EPS (Benefit Plan Administration Entities) must assign each insured user to the vaccination IPS in the municipality of residence and close to home in order to guarantee timely access to vaccination. In the same way, the territorial entities responsible for the health of the uninsured poor population will assign the vaccination IPS under the same conditions of the insurers.

“During the vaccination [implementation], populations will not be massively summoned in order to avoid crowds. In this sense it is necessary that appointments be established by the institutions that provide the vaccination service. For health professionals, this vaccination will be carried out directly in clinics and hospitals with mobile teams in accordance with the strategy established by the territory.

“The IPS must inform each EPS and territorial entity the appointment assigned so that the platform is updated by the insurers and allows the individual consultation by the population to determine the phase and stage of vaccination, as well as the place, date and time of appointment for the application of the vaccine.

“Once the data has been included in the ‘Mi Vacuna’ Covid-19 platform, the population can make queries through the hotlines, website and access the 'ABC for Covid-19' vaccination site. If you meet the criteria for vaccination, then review and remember your appointment assigned by the IPS, access the informed consent [forms] which you must present at the time of vaccination, and attend the vaccination on time.”

Vaccinations will be voluntary, not mandatory, the Ministry added.

Published in Health & Insurance. Written by December 20 2020 0

Medellin Mayor Daniel Quintero announced December 19 that 338 vaccination teams throughout the city are gearing-up to administer 800,000 Covid-19 vaccinations starting in February.

“Those people who are part of the population that will be vaccinated in the first stage will receive information and instructions through the ‘Medellín Me Cuida’ [application],” according to the Mayor’s Office.

The vaccination plan “appropriately prioritizes people who are in the front line of health care, those over 80 years old, those over 60 years old and those with comorbidities,” according to the Office.

Paired with the 338 vaccination teams, “there will also be vaccination centers in each commune and logistics centers with super freezers for vaccines,” according to the Office.

Thanks to the “Medellín Me Cuida” application, “there is information on more than 3 million citizens and the location of those people over 80 who will be vaccinated in the initial stage is known,” according to the Office.

Highest-priority people “together with their families will receive text messages during the first days of January with relevant instructions related to the place of vaccination in your neighborhood and the corresponding registry,” according to the Office.

Published in Health & Insurance. Written by December 19 2020 0

Colombia President Ivan Duque announced last night (December 18) in a nationally televised address that Colombia now has guaranteed supplies of 40 million Covid-19 vaccine doses in deals with Pfizer, AstraZeneca and the Covax multinational consortium.

As a result, “in the first weeks of 2021 we are advancing the process of mass vaccination,” Duque revealed.

“The agreement with the pharmaceutical company Pfizer for the acquisition of 10 million doses has been closed. The agreement with the pharmaceutical company AstraZeneca for the acquisition of 10 million doses has also been closed. And we have also closed our agreement through the Covax platform, to acquire 20 million doses.

“This initially gives us 40 million doses, to make available in our country a vaccine dispersal process that provides broad coverage in the Colombian population,” he added.

The complete plan includes vaccination prioritization of vulnerable populations including health-care workers and people over 60 years old. It also includes a logistics plan, criteria developed by a technical committee and cold-vaccine chains-of-custody all the way through the supply chain.

Finally, President Duque warned that, even with the vaccinations starting in early 2021, "we must bear in mind that this does not mean that the pandemic is gone."

Health Ministry’s Five-Stage Plan

During the same broadcast, Health Minister Fernando Ruiz Gómez explained the free-vaccination rollout scheme for 20 million people here (two doses per person).

The government signed the contract with AstraZeneca on December 16 for 10 million doses, and on December 17 with Pfizer, likewise for 10 million doses, he said.

In addition, since October 30, the multilateral agreement with the Covax mechanism was signed for 20 million doses, for a total of 40 million that will arrive in Colombia during 2021.

“We will be doing the entire [vaccination] enlistment process during January,” Minister Ruiz explained.

“We will be starting mass vaccination in February and if, as in other countries, we have access to trial vaccines, we will also be starting trial vaccination processes in January,” he added.

The first-phase rollout aims to “reduce mortality and the incidence of severe cases of Covid-19, as well as to protect health workers; while the second phase is to reduce the contagion to generate herd immunity,” he said.

Colombia’s total population in 2021 is projected at 51 million inhabitants. “In order to generate herd immunity, according to scientific evidence, it is necessary to vaccinate 70% of the population, which is equivalent to 35.7 million Colombians,” he said.

Since data gathering started in February, a cumulative total of 1.5 million Colombians have contracted Covid-19, he said.

Those previously infected people “will not be included in the initial phase of the vaccination program. In other words, the total number of people to be vaccinated to promote herd immunity is 34.2 million, a figure that may change according to the evolution of the pandemic,” according to the Ministry.

“At this moment, with the vaccines already acquired, which represent [vaccinations for] 20 million people, we can say that we have already acquired 58.4% of the vaccines for phase 1 and the beginning of phase 2,” Ruiz said.

As a result, the Colombian government “is already in negotiations to complete the number needed to vaccinate the more than 34 million people,” according to the Ministry.

Minors 16 years and younger “will not be subject to immunization in the first instance until there is scientific evidence that guarantees safety in that population,” according to the Ministry.

Those with pre-existing health problems (11 million Colombians) including hypertensive diseases, diabetes, kidney failure, chronic obstructive pulmonary disease, asthma, HIV, cancer , tuberculosis, hepatitis-C and obesity will be in the first-priority vaccination group .

In addition, 7.6 million people aged 60 and over, plus 1.2 million health workers, are also in the first-priority group for vaccination.

Here is the full five-phase vaccination schedule:

Phase 1:

—Stage 1 (1.69 million people): First-line health and support workers, as well as those over 80, who represent the greatest risk.

—Stage 2 (7. million people): populations from 60 to 79 years old and second- and third-line health workers.

—Stage 3 (2.9 million people): populations aged 16 to 59 with comorbidities, as well as elementary and high school teachers.

Phase 2

—Stage 4 (4.9 million people): institutional caregivers, populations in occupations with higher-risk situations.

—Stage 5 (17.5 million people): populations between 16 and 59 years and free of comorbidities.

The vaccinations requiring special cold-storage will be shipped to Colombia via air to a special Ministry warehouse. From there, the vaccines will be shipped to 30 regional and district warehouses and then to hospitals, clinics and other vaccination points, Ruiz said.

“In the case of vaccines that require deep freezing, this is a new challenge for the world; however, Colombia has already been working on the requirements for two months with the company Pfizer,” according to the Ministry.

“We are in continuous contact with the laboratories to establish how we can set up the process. At first it seemed very complex, but we already have the design from the engineering and medical part as well,” Ruiz revealed.

Colombia will have Pfizer vaccines made via direct purchase, as well as Moderna vaccines through the Covax mechanism, according to the Ministry.

For the ultra-cold requirements of the Pfizer vaccine, “we are in the process of acquiring 44 freezers that will be available in January” Ruiz said.

“We will have databases that will include the identification of people according to their health conditions, and we will have a mechanism so that they can register if necessary if they meet the criteria of over 60 years or with comorbidity,” Ruiz said.

Each person will be given a specific time and date for vaccination at clinics and hospitals “where the vaccination procedure will be explained, an informed consent will be issued since vaccination is voluntary, and a card will be delivered with date for the second dose,” according to the Ministry.

Colombia already has installed capacity of 7,920 vaccinators, capable of applying 277,200 vaccines per day.

“This allows us to have the peace of mind that there is sufficient capacity to carry out vaccination at the national level,” the Minister added.

Published in Health & Insurance. Written by November 27 2020 0

Colombia’s National Health Institute (INS in Spanish initials) director Martha Ospina announced November 26 that a seroprevalence study of a statistically representative sample of Medellin residents indicates that 27% of people here likely have already been infected with Covid-19 -- and hence show antibodies in their bloodstreams.

While that 27% figure suggests that more than 800,000 people here likely have acquired some level of resistance to Covid-19, the preliminary results shouldn’t be interpreted as indicating that metro Medellin has achieved anything close to “herd immunity,” the INS director warned.

Instead, Medellin metro area residents must continue to wear masks, socially distance and respect all strict health protocols for workplaces, public spaces, transport and home life – with special precautions required for the most vulnerable: people over 60 years old and those with pre-existing health problems, she said.

In comparison to Medellin’s presumed 27% infection level, some 60% of the residents in Leticia (Amazonas department) and 55% of those in Barranquilla have already been infected with Covid-19, the preliminary results indicate, she said.

The full study covers residents of Leticia, Barranquilla, Medellín, Bucaramanga, Bogotá, Villavicencio, Cúcuta, Cali and Ipiales, she added.

Commenting on the preliminary findings, Colombia Health Minister Fernando Ruiz added that “many people in Colombia could have had Covid and been asymptomatic, while other people could have suffered [and might have recovered] from the disease but had not consulted [a doctor or health department], so they were never registered as people who had Covid.”

While those already infected (and now recovered) presumably now have some level of immunity and presumably wouldn’t transmit Coronavirus to others -- at least, right now -- this situation might only be “temporary,” Minister Ruiz cautioned.

The INS study incorporated “a special technique called chemiluminescence, which has an 86% probability of finding a positive result, and the support of the National Administrative Department of Statistics (DANE) for the definition of a representative sample of people in each one of the cities,” Minister Ruiz explained.

For the study, workers from the national and local health secretariats and the INS have been deployed in the nine target cities to take representative samples based upon demographic factors and risk factors.

By December 20, field sample collections in the remaining cities will be completed, with final results due in January 2021, he added.

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

Medellin Mayor Daniel Quintero on October 17 issued a startling analysis indicating that the Medellin metro area likely has already surpassed 1 million Covid-19 cases with 96% of those likely recovered.

According to the Mayor’s analysis (see: https://medellin.gov.co/irj/portal/medellin?NavigationTarget=navurl://96fe4145738006ecf074a9e8fc82bccc), “in some countries it has been shown that for every person infected [as indicated by a positive Covid-19 test] there are 10 more infected than never were tested. If so, [then] Medellín would already have around 800,000 infected and the Medellin metropolitan area more than 1 million, with most already cured.

“With the [Colombian] National Institute of Health, we will carry out a ‘seroprevalence’ study in Medellín to determine what percentage of the population has already been infected and did not realize it. This will help us refine our ability to manage the infection and the ICU [intensive care unit occupation] curve [see chart, above].

“Regarding the number of cases, we remain in a plateau state without geometric growth and with 96.3% of people who have already overcome the contagion. Self-care has meant that only 10% of cases are among people older than 70 years [the most vulnerable population]. With them we must take the greatest care.

“The ICU occupancy rate has grown driven not by Covid but by delayed surgeries and other diseases. Among Covid cases, we have 249 stable cases, 63 with other respiratory Infections and 358 others in ICU now because of delayed surgeries and other diseases, which is increasing.

The [Antioquia] government has the autonomy to restrict delayed surgeries by raising the hospital [ICU occupancy rate] alert level to ‘red.’ However, this would not require quarantine implications for the city or its metropolitan area due to the reasons that I will explain.

“Medellín has 1,000 ICU beds, not counting the ones we [could] have available from ‘InspiraMed’ [project], which would add more than 300. Of these 1,000, 220 will be activated whenever the Covid [ICU case rate] requires it. To support the current conjuncture of overdue surgeries we will activate 26 this week.

“Many ask, ‘why not activate all of the [spare ICU beds] immediately?’ The first reason is budgetary. Hospitals burdened with debt cannot activate an ICU bed to keep it empty [in stand-by status]. An ICU requires a group of professionals available 24/7.

“Therefore, the activation of the [ICU] beds has been agreed in a phased scheme with the hospital managers and health personnel to take care of the [hospital] finances, avoid the arrival of foreign doctors and guarantee care with the highest standards of quality.

“Medellín has managed to manage the contagion curve thanks to the use of technology, giving us time to manufacture ventilators and comply with the ‘ICU 1,000’ plan.

“The number of ICU patients due to Covid in our health system has remained stable [see chart above, gray line] and below what we expected for this date. This has made it unnecessary to activate new ICU beds that have costs for hospitals.

“However, it is essential to recognize that this is an unprecedented and unpredictable crisis. There are questions still to be resolved: Will new [Covid-19] strains come? Will there be a vaccine? The only way is to keep investigating,” according to the Mayor.

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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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