As they brace for large numbers of Covid-19 patients, Cuenca medical officials worry about their capacity to provide care.
“We are limited in our personnel and we are limited in supplies,” says local health ministry coordinator Julio Molina. “We hope that the epidemic cases remain low but this is probably not realistic. We must prepare for an epidemic.”
There are only 35 doctors and nurses specially trained by the health ministry to work with Covid-19 cases in Cuenca, according to Molina. “These are associated with the [Vicente Corral Moscoso] regional hospital, which is the designated center for virus patients,” he says. “They are prepared to work long shifts in groups of three but we are naturally concerned about their health and what happens if they get sick. Of course, we have hundreds of other well-trained medical personnel in the city and they will also be called into duty during the crisis.”
Molina makes clear that he is not complaining. “What we face is the same conditions the health system faces throughout the country. None of us have ever seen anything like this and we are committed to doing the best we can.”
In addition to personnel concerns, health officials say that medical supplies are in short supply. “What we need immediately are test kits so we have a better understanding of the extent of the contagion,” says Luis Villegas, director of the private Santa Inez hospital. “The officials tell us there are less than 100 coronavirus cases in Cuenca but we know there are many more and without testing we don’t know how many.”
The rule of thumb among international health experts is that most local virus counts represent a tenth of total cases. In Ecuador, the difference could be even greater. “The multiplier could be 100 but who knows without more tests,” says health ministry physician Carlos Castro. “With a limited number of test kits, we are unable to test the family and friends of those who have tested positive and we know that many of them are infected too.”
In Cuenca, Castro says, there are at least 100 people in isolation due to their direct exposure to the virus. “We cannot release them to the public because of the fear of further transmission.”
The health ministry says that 6,000 tests should arrive in Cuenca on Monday or Tuesday, and their results should provide a clearer picture of the local infection.
Unfortunately, private health facilities must fend for themselves to obtain test kits, says Villegas. “We have people with symptoms knocking on the door for tests but we have to turn them away.” The problem, he says, is the provider of the tests, Roche Pharmaceutical, delivers most of its products to public health agencies. “There are very few kits left over for private providers and if you are not a Roche client, they refuse to sell to you.”
In addition to test kits, public and private health officials say they are in short supply of personal protection supplies for doctors and nurses, such as gowns, masks and gloves, as well as medical equipment such as respirators. “These supplies are arriving but at a much slower rate than we would like,” says Molina.