Outpatients will be given low to medium doses for a maximum of seven days

by Mexico News Daily

MEXICO, May 23, 2020 –  The federal Health Ministry will use the anti-malaria drug hydroxychloroquine to treat 20,000 Covid-19 outpatients despite doubts about its efficacy and the risk of it causing an irregular heartbeat and even death.

The director of the National Institute of Medical Sciences and Nutrition told the newspaper Milenio that the health regulatory agency Cofepris has authorized the administration of the drug to patients recovering from Covid-19 in their homes.

José Sifuentes acknowledged that clinical trials have shown that high doses of hydroxychloroquine for a prolonged period of time can cause a range of side effects in Covid-19 patients but emphasized that the drug has been shown to reduce generalized inflammation in people with the disease.

In that context, he stressed that outpatients will be given only low to medium doses for a maximum of seven days starting in the early phase of their illness.

Sifuentes said that all patients receiving treatment with the drug will be closely monitored, explaining that the “careful follow-up” will occur at people’s homes and via telephone and video calls.

He said that 130,000 doses of hydroxychloroquine donated by the Swiss healthcare company Novartis will be distributed to national health institutes, regional hospitals and specialty hospitals, among other facilities. The use of the drug among ambulatory Covid-19 patients will commence next week.

The announcement of the plan came just two days after the World Health Organization (WHO) reiterated that the drug should only be used in closely-monitored clinical trials due to the potential side effects.

Michael Ryan, executive director of the WHO health emergencies program, said that hydroxychloroquine and the similar drug chloroquine have “yet to be found effective in the treatment of Covid-19” or to prevent the disease.

The medical journal The Lancet published a study on Friday that said that there were no benefits to treating Covid-19 with either drug and that their use actually increases the risk of dying for coronavirus patients.

In a study of 96,000 coronavirus patients, 18 percent treated with hydroxychloroquine and 16.4 percent of those treated with chloroquine died. For patients in a control group, the death rate was 9 percent.

Deputy Health Minister Hugo López-Gatell, Mexico’s coronavirus point man, is among a large number of medical professionals who have warned against taking hydroxychloroquine as a preventative measure against Covid-19.

But United States President Donald Trump, who has repeatedly promoted the drug as a Covid-19 treatment, was not dissuaded from using it to try to stave off Covid-19, the disease caused by the new coronavirus.

“A lot of good things have come out about the hydroxy,  you’d be surprised about how many people are taking it… before you catch it. …  I happen to be taking it…” he told reporters on Monday.

“Couple of weeks ago, I started taking it because I think it’s good, I’ve heard a lot of good stories. And if it’s not good I’m not going to get hurt by it. It’s been around for 40 years for malaria, for lupus, for other things. I take it, frontline workers take it, a lot of doctors take it …” Trump said.

Source: Milenio (sp) 

In another coronavirus news:

Mexican-made ventilator ready for coronavirus patients

The US $10,000 machines cost significantly less than those on the market

After a month and a half of development, biomedical engineers at the National Institute of Health Sciences and Nutrition Salvador Zubirán are ready to roll out a new ventilator for the treatment of Covid-19 patients.

The engineers developed the VSZ-20 based on an older Mexican model and consulted with doctors to make sure their new version met needs specific to the treatment of coronavirus patients.

“We needed precision equipment that gives the exact pressure and volume of air we need from the ventilator,” said Guillermo Domínguez Cherit, deputy director of critical medicine at the institute, which is operated by the Ministry of Health.

“Having our own resource, developed in this country, offers the advantage of not having to be looking elsewhere,” said Cherit’s colleague David Kershenobich.

Nearly all the ventilator’s parts were made in Mexico to circumvent the possibility of shortages on the global market in the future.

Engineers tested the ventilators on artificial lungs, as well as healthy pigs and pigs with pneumonia. The VSZ-20 has been approved by the Commission for Protection Against Sanitary Risk (Cofepris) and is ready to be used on people. Some 1,500 ventilators will be produced immediately for distribution by the federal government.

Each unit costs US $10,000, which is significantly lower than the typical market price of US $30,000 to $50,000.  The ventilators were manufactured and assembled with the help of a team from the beverage company Femsa, automotive component manufacturer Metalsa and the Monterrey Technological Institute.

“It is a very meticulous process,” said Carlos Guerra, Metalsa’s mechanical engineer, whose team worked long hours and weekends in order to get the prototype ready and will be producing the ventilators at their Nuevo León factory.

Another made-in-Mexico ventilator, scheduled for delivery May 15, has been delayed. The director of the National Council for Science and Technology (Conacyt) announced April 23 that at least 500 would be produced weekly, with the first delivery in mid-May.

The Ministry of Health said on Sunday that the machines had not yet been delivered.

Hospital occupancy in Mexico reached 39 percent yesterday, and 32 percent of all intensive care beds for critically ill patients requiring intubation were full. However, in hot spots those numbers are much higher. In Mexico City only 22 percent of intensive care beds are vacant, and in Guerrero that number is 40 percent, the news agency Infobae reported.

Source: Infobae (sp)

Doctor says under-equipped clinic has been overwhelmed

by Mexico News Daily

The governor of Baja California has warned that doctors are “falling like flies” in Tijuana due to a lack of personal protective equipment (PPE) amid the worsening coronavirus pandemic.

Jaime Bonilla made the remark in a video live streamed to social media on Monday, stating he was particularly concerned because doctors at the Institute of Social Security (IMSS) public clinic No. 20 in Tijuana who have become ill with Covid-19 also work at the city’s IMSS General Hospital.

“What concerns me … is that the General Hospital has the same doctors as [the] Social Security [facility]. We’re seeing now that they’re falling like flies because they weren’t given protection,” he said.

According to the newspaper El Universal, 21 health workers at the IMSS No. 20 facility have tested positive for Covid-19 and 15 others are suspected of having the disease. There is one confirmed case among workers at the IMSS General Hospital and six others are suspected of being infected.

One health worker who asked not to be identified out of fear that he would lose his job told El Universal that when patients with respiratory problems first started arriving at the No. 20 clinic, employees were not told that they were suspected of having Covid-19.

Julio (not his real name) also said that that staff don’t have sufficient PPE to protect themselves while treating coronavirus patients, explaining that hospital authorities expect workers to wear the same mask for as long as 20 days.

“My colleagues have had to buy their own [protective] equipment, … there are long lines to buy gowns and masks because they’re not giving us enough,” he said.

Health workers at the No. 20 clinic have also taken to social media to complain about the lack of PPE. One was Dr. Faustino Ruvalcaba, who posted a letter to Facebook in which he outlined the situation.

Eugenio Derbez, a famous actor and comedian and friend of Ruvalcaba, read the letter in a video posted to Twitter on Sunday.

According to Derbez, the letter said that the hospital was overwhelmed with both confirmed coronavirus patients and people who have been diagnosed with atypical pneumonia.

“The public has no idea what is happening in the hospital. The third floor was prepared for the exclusive use of patients with coronavirus, but it is already full,” he said, reading from Ruvalcaba’s letter.

“We don’t have the equipment and material to be able to protect ourselves. … What we are using is equipment bought [with money] out of our own pockets. We’re spending more than a quarter of our salaries … to buy equipment,” the letter said.

Derbez begged for help for the public hospitals on Mexico’s northern border, calling on citizens to donate items such as masks, gowns and goggles.

In response, the IMSS chief in Baja California accused the actor of spreading fake news. Dr. Desirée Sagarnaga Durante said in a video posted to Twitter that there was no doctor by the name of Faustino Ruvalcaba at the IMSS No. 20 clinic, charging that the letter was made up.

Her video, which had been viewed 1.5 million times as of Tuesday morning, triggered a social media backlash against Derbez, The San Diego Union-Tribune reported.

Derbez countered with another Twitter video posted beneath a message that read: “No … it’s not fake news. It’s sad that more time is being spent trying to hide the truth than saving lives.”

“There have been a number of attacks against me and the doctors saying that this is all a lie,” he said in the video. “I just hung up with doctors at the clinic and I want to tell everyone that what I say is true. … I don’t like to get involved in politics. I’m not attacking anyone,” Derbez said.

A reporter for the news website Noticias Ya subsequently tracked down Ruvalcaba, interviewed him and shared the video on Facebook. He confirmed that the situation at the IMSS No. 20 clinic is indeed dire.

“The epidemic has completely exceeded our weapons [to control it]. That’s clear,” Ruvalcaba said.

Governor Bonilla also came to Derbez’s defense, saying in his video address on Monday that while he may not have the complete and exact information about the situation at the IMSS clinic, many health workers there have become ill with Covid-19. He said that he has been worried about the IMSS health system since the beginning of the coronavirus pandemic.

“I felt that our Achilles’ heel was going to be the social security [system], because I saw a lot of detachment. There was no concern. I did not honestly see the social security delegation concerned about the issues,” Bonilla said.

For its part, IMSS said in a statement on Sunday that it “promptly attended and controlled an external contagion in several workers” at the No. 20 clinic in Tijuana.

The outbreak “was not attributable to [a lack of] personal protection equipment, nor to the care of suspected or confirmed [Covid-19] patients,” it said.

President López Obrador, meanwhile, blamed his adversaries. He told Tuesday’s press conference that “the conservatives” have launched a disinformation campaign that co-opts well known personalities to relay their message and “stop the transformation of Mexico.”

He cited an athlete, a recording artist and a comedian as being among those who have been recruited in order to “maintain the system of corruption.” Soccer star Javier “El Chicharito” Hernández, singer Thalía and now Derbez have all been critical recently of the López Obrador administration.

There were 368 confirmed cases of Covid-19 in Baja California as of Monday but state Health Minister Alonso Pérez Rico has acknowledged that the real number of cases is probably much higher.

Alheli Calderón, a medical researcher at the College of the Northern Border, said earlier this month that it is not plausible that Mexico’s northern border states have so few cases of Covid-19 compared to the states they adjoin in the United States.

California had more than 24,000 confirmed cases of Covid-19 as of Tuesday morning, according to a New York Times database, almost 2,000 of which are in San Diego, located just across the border from Tijuana.

Source: El Universal (sp), The San Diego Union-Tribune (en).