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Revista de la Facultad de Medicina Humana

Print version ISSN 1814-5469On-line version ISSN 2308-0531

Rev. Fac. Med. Hum. vol.20 no.3 Lima Jul-Sep 2020 


COVID-19: War protocol to fight the pandemic

Germán Rossani Alatrista1  2  , Plastic, aesthetic and reconstructive surgeon

1Instituto de Investigación en Ciencias Biomédicas, Universidad Ricardo Palma, Lima-Perú.

2Facultad de Medicina de la Universidad Ricardo Palma, Lima-Perú.

Dear Editor

During the medical training years, in one way or another, we have obtained knowledge and have prepared in the best possible way for emergencies and/or natural disasters. In the last 25 years, action protocols have been executed and implemented in a successful manner before endemics, epidemics and pandemics, such as Influenza, Ebola and SARS1.

What we have been observing in the last 3 months makes us reflect on the reactions before this global emergency and the ethical problems that have emerged due to COVID-19. We are moved and it sparks diverse reactions that to look beyond the initial emotions and generosity2.

These circumstances puts health professionals and workers to the test to do their best to save lives, treat harmful symptoms or lessen them, as well as provide measures of least possible suffering to those who have severe damage and irreversible complications3.

On this occasion we refer to COVID-19, which has surpassed all contingency plans as the report generated by the experts from Harvard Global Health Institute and London School of Hygiene & Tropical Medicine4. As has been observed in health institutes in Italy and Spain, where the warning actions to the population were delayed or ignored, causing the hospital overflow (emergency, hospitalization and intensive care units), causing a shortage of personal protective equipment (PPE) for the medical personnel and insufficient mechanical ventilators5

Table 1.  Contingency plan elaborated by Harvard Global Health Institute and London School of Hygiene & Tropical Medicine. 

Subject areas Needs
Prevent severe disease outbreaks. Support of international community to improve the installed capacities.
Prompt response to severe disease outbreaks. World Health Organization (WHO) participation.
Research areas. It is necessary to produce and share data, knowledge and technology. data, knowledge and technology. Multidisciplinary work and clear norms to ensure the access to research benefits.
Organized global health system. For the prevention and response to these outbreaks .

In these times when the main value is the utility, due to the extreme resource limitation (cost-utility), social benefit has prevailed over individual benefit, with the intention of maximizing the number of lives that can be saved6. The efforts and attention have been centralized in patients with mild symptomatology, recoverable patients and in severe recoverable patients.

This current situation makes us see the extreme limitations of logistic resources, human or materials, that is why extreme measures have been adopted in every way. Hospital and clinic beds belong to the community and are made available to the patients that can Benefit most from them, not by severity but by recoverable years of life7.

These are drastic and horrific measures we have observed through reports or protocols as have been applied in Europe8, where the infection curve has been ascending and these measures will only be stopped when the curve starts to flatten and/or descend.

In the face of a rapid global spread of COVID-19, the Inter-American Commission on Human Rights (IACHR) has elaborated a resolution before the unprecedented global health emergency. Looking at the vulnerable groups such as the elderly, those deprived of their liberty, women, indigenous communities, people in human mobility situations, children, adolescents, LGBTQ, afro descendants and the handicapped8.

Our alert gaze is in accord because in our countries, as in most of South America, the health system has certain shortages and limitations. Given these facts we must join forces and we must not dwell on criticisms that deflect our attention. The duty of medicine in treating pandemic diseases is summarized in solidarity and vulnerability.


1. OMS (Organizacioón Mundial de la Salud). ]

2. Beca J.P. Una mirada ética a las epidemias. Academia 2010; 9: 24-27 8. ]

3. Juan Pablo Beca, Sofia P. Salas. Problemas éticos y de salud planteados por la reciente epidemia del Ebola: Que debemos aprender. Rev. Med. Cile 2016;144:371-376. ]

4. Moon S, Sridhar D, Pate MA, Jha AK, Clinton C, Delaunay S, et al. Will Ebola change the game? Ten essential reforms before the next pandemic. The report of the Harvard-LSHTM Independent Panel on the Global Response to Ebola. Lancet 2015; 386: 2204-21. [ Links ]

5. Gianfranco Spileri, james Fielding, Michaela Diercke, Christine Campese, Vincent Enouf, et al. First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020. Euro Surveill. 2020 Mar 5; 25(9): 2000178. [ Links ]

6. MsC. Juan Carlos Pradere Pensado, Dra. Susana Chao González, MsC. Alberto García Gómez y Dra C. Luisa Gutiérrez Gutiérrez. Consideraciones éticas sobre la atención médica en situaciones de desastre. MEDISAN vol.16 no.8 Santiago de Cuba ago. 2012. ]

7. Brody H., Avery E.N. Medicine'e duty to treat Pandemic Illness: Solidarity and vulnerability. Hastings center report 2009; 39: 40-48 9. [ Links ]

8. OEA (Organización de Estados Americanos) ]

Financing: Self-financed.

Received: April 20, 2020; Accepted: May 20, 2020

Correspondence: German Rossani Alatrista. Address: Calle José del Llano Zapata 245, Miraflores, Lima-Perú. Telephone Number: 996 414 005

Author contributions: The author has participated in the genesis of the idea, the collection and interpretation of data, result analysis and manuscript preparation of this research article.

Conflict of interests: The author declares that he has no conflict of interests in the publication of this article.

Creative Commons License Este es un artículo publicado en acceso abierto bajo una licencia Creative Commons