17th August 2021
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Wright GC et al. AWIR global: Perspectives on the COVID-19 pandemic (Australia, Brazil, India, Italy, Canada, Caribbean, Puerto Rico). Presented at: National AWIR Conference; 12-15 August 2021; (Hybrid meeting).
Disclosure:
The speakers do not report any relevant financial information.
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In a session here, participants heard global perspectives from their rheumatologists in Australia, Canada, Puerto Rico, the Caribbean, Brazil and India.
From Australia, Andreas ÖNSÖR., MD, MA, MBBS, FRACP, FRCP, FRCP (Edin), of the Cabrini Medical Center in Melbourne, shared the reasons for the country’s “success” during the pandemic.
“It has been an overall success story in Australia and care has continued and I believe patients are still doing as well as they were before COVID, even though in this new world we live in,” Andrew Östör, MD, MA , MBBS, FRACP, FRCP, FRCP (Edin) said. Source: Adobe Stock
“Tests and isolation and now vaccinations have been key to how we treat our patients and also reassure them with data from around the world that they should be vaccinated,” he said.
According to Östör, the quick lockdowns and “excellent” contact tracing in Australia since the beginning of the pandemic have been effective containment strategies, as have politicians’ cooperation and citizen compliance with mask usage.
“It has been an overall success story in Australia and care has continued and I believe patients are still as good as they were before COVID, albeit in this new world we live in,” he said.
Vancouver, British Columbia
Under the direction of their state health officer Bonnie Henry, OBC, MD, MPH, FRCPC, British Columbia has seen similar success, so Mollie Carruthers, MD, Clinical Associate Professor at the University of British Columbia.
“During this time, we Canadians had the feeling that we were protecting one another and that Dr. Listening to Henry and obeying their public health restrictions as they were established. [and that] reflected our trust in the government, the appreciation of education and science and a commitment to help one another under its leadership, ”she told attendees.
The Government of Canada also pays for doctors to see their patients on the phone so that patients are only treated in person if medically necessary. According to Carruthers, this has contributed to “ensuring the safety of patients and our society”.
Puerto Rico
Although the pandemic affected the island of Puerto Rico in a similar way to much of the world, Oscar Soto-Go outIthose, MD, a rheumatologist in San Juan, Puerto Rico, said her community of rheumatology patients had done reasonably well overall.
“In the beginning, our job in the clinic was to provide as much information as possible, acknowledge people’s stress and anxiety, and help them stay compliant with their treatment,” he said.
Soto-Raíces and colleagues kept patients informed of the latest developments and facts about the virus and vaccines through social media and a weekly radio broadcast, also available on YouTube.
“We believe the information provided and the fact that [our patients] who are used to protecting themselves from infection have probably helped them cope with this process better than other patients, ”he said.
The Caribbean
Amanda King-Greenidge, MD, MBBS, FRCP, Head of the Caribbean Chapter for AWIR and Founding President of the Caribbean Association of Rheumatology, is the only rheumatologist in St. Lucia. In the rest of the Caribbean, less than half of the areas have rheumatologists.
In a poll of her colleagues, King-Greenidge reported that her rheumatology patients had little or no cases of COVID-19 in most territories, despite the fact that remdesivir deficiency hospitals were overcrowded in places like Jamaica.
India has donated doses of the AstraZeneca vaccine, but hesitation remains in the Caribbean.
“Rheumatology patients across the Caribbean have expressed fear of disease outbreaks or vaccination-related side effects, especially because they are so vulnerable,” she said. “We are concerned about clots due to the AstraZeneca [vaccine]Then there is misinformation and disinformation from the start and a lack of a coordinated approach from WHO, CDC, global regional leaders and also experts who have fueled the problem with suspicion. “
King-Greenidge added that many rheumatologists in the Caribbean reported receiving numerous questions from patients, but found that rheumatologists were usually one-on-one to convince patients to get vaccinated.
Brazil
When the pandemic spread to China and Europe in February 2020, Brazil hosted 2 million people for its famous carnival, according to rheumatologist and former president of the Sociedade de Reumatologia do Rio De Janeiro Selma Merenlender, MD.
When COVID-19 reached Brazil, Merenlender described the situation as “insane” as the country was closed for 6 months.
“Nobody was prepared to work from home, schools and universities weren’t prepared,” she said. “… families were separated, playgrounds were closed and children were afraid of killing their grandparents.”
People washed everything, including money, and hydroxychloroquine sold out when people took the drug prophylactically to prevent infection, she explained. But in June 2020 when the first tests arrived, the country reopened and cases went back to October. However, in November the number of cases rose and the New Year’s Eve celebrations, which normally attract 4 million people, were canceled and an economic crisis erupted.
According to Merenlender, the situation worsened in January 2021 when hospitals collapsed and oxygen ran out. Vaccines were finally made available to health workers aged 60 and over in January before being introduced to the larger population. However, the lack of government support for the vaccine and the promotion of drugs like chloroquine to prevent the virus led to what Merenlender referred to as the “vaccine war.”
The front page of a Brazilian newspaper reported today that 95% of those hospitalized had not been vaccinated and most of them were due to the Delta variant.
“We’re still trying to survive,” she said. “If we do, it’s basically because our people have come together to fight; We don’t have a lot of government support. “
India
In the city of Chandigarh, Shefali Sharma, MD, Associate professor in the Department of Clinical Immunology and Rheumatology in the Department of Internal Medicine at PGIMER said that care for a designated COVID hospital was carried out after careful planning. There, the virology staff was trained to put on and take off PPE and prepared for the pandemic.
To date, the government is supplying the vaccine and more than 70% of the city’s adult population has been vaccinated.
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