CAMAGÜEY.- They enter the X-ray room where everything is ready for them to examine those who have just arrived from the Red Zone. A messenger brings them. After going through a strong decontamination process, the imaging specialist, also with all the protection measures, brings them to the consideration of the group of experts.

- Whose is that? Asks Dr. Yamina, one of the pediatricians in the group.

- From the child traveler from Russia. They respond

- I see an inflammation in the right lung.

Dr. Emilio Guevara, an old wolf in intensive care and a specialist in Internal Medicine, nods.

Then, they discuss the case and agree on the treatment to be followed according to the variants established in the protocol. They had previously reviewed the results of the complementary analyzes carried out in the Red Zone, the results of which are duplicated for this team to analyze. They do the same with medical records. This is the case with each of those admitted, even those who are under surveillance or are suspects.

Initially, the idea of ​​bringing together so much talent in a group of experts was to discuss critical and serious cases, however, it was the Octavio de la Concepción de la Pedraja military hospital, the first to analyze 100% of the patients in this composition .

As explained in a previous meeting by Colonel Taurino Cruz Padilla, director of the "Military", one of the keys to the results exhibited by the institution today lies in the cohesion that the group of specialists has achieved. This allows quick and correct decision making and also serves as a link between the different groups that work in the Red Zone.

“Any detail that those inside could lose sight of, those outside correct it. For this reason, in a moment of the first outbreak we decided that we were in a position for them to evaluate all those admitted, and this has been the case until now ”.

It is not as easy as it might seem. Sometimes they stay there until nine at night, debating on a case-by-case basis, especially when the hospital is at full capacity. In addition, the mechanism is created so if there were any complications at night or early in the morning, everyone could get in touch and decide what to do. It is doubly complex to monitor the evolution of the patient without seeing or touching him, in order to achieve this, the constant communication of those who treat the sick and the mediators plays an essential role, a group of doctors who telephone in hand collect all the information and put it at the disposal of the expert nucleus.

THE HEROES OUTSIDE

There are no Sundays, holidays and much less rest for over a year for this troop. This is assured by Captain Yordanis Salinas Caballero, intensive care physician, head of the emergency service who in times of confrontation with COVID-19 is at the head of the group of experts.

“Even the follow-up of the recovered goes through our hands, in addition to promptly addressing any problem that exists in the red area; and also accommodation for the rest of the workers, insurance, food, changing rooms.

“We pay special attention to the mothers of the children who are admitted, more than 80% have fallen ill, on the fifth day they come out positive and that is why from the moment they enter we put the treatments that are in the protocol such as the nasalferon. We dedicate a lot of time to the little ones, we have pediatricians within the group who communicate directly with their counterparts in the Red Zone to guide behaviors to follow.

“We process epidemiological surveys, and we rectify them, because generally when the person enters they collaborate more and provide data that does not appear in the first one; thus we also help to control the outbreaks in the community ”.

Through the wise minds of these doctors have passed pregnant women, children, elderly, positive with underlying diseases, nephropathies with hemodialysis, cancer patients, transplants, among other complications.

“We have had stories of entire families that we have had to support psychologically. Even doctors require this type of help, because when you have been in the Red Zone for 10 days, your capacities decrease. I tell you that I have entered twice and I have experienced the importance of having colleagues out here ”, assured the group's chief captain.

Each time a rotation comes in, the experts take responsibility for training and updating them on protocol changes and on the status of each one of them entered.

A TEAM OF HEROES

Modern medicine involves teamwork, especially if it is a new disease, which is now becoming known. That is why the team groups together several specialties, there are clinicians, intensivists, epidemiologists, pediatricians, pulmonologists, geriatricians, and others are added according to the needs or in the event of any eventuality.

Empathy is such that they understand each other just by looking at each other. Because of the trust they have cultivated, it does not matter, for example, that the case they are discussing is a child, everyone has an opinion, although the opinion of the related specialist always weighs more in the decision. The same happens when moving a patient to intensive care, or deciding who goes to the intensive surveillance room due to the comorbidities they present.

For more complex cases, every day at four in the afternoon there is a meeting by videoconference with the national group where experiences from the provinces are discussed; a Camagüey's case can be analyzed by experts from all over Cuba. From there, according to the protagonists, there have been changes in the protocols or in the treatment of a person.

The alerts have also been timely. “We suggested to Santiago that they prepare an artificial kidney, because of what had happened to us with nephropaths, we had to create these conditions in less than 24 hours. And a week later the first case that required hemodialysis fell there, ”added Captain Salinas.

“Some time ago - recalls the pediatrician Yamina Rivero Fernández - an autistic girl arrived, who due to her characteristics we decided that a nurse would only attend to her, but we discussed that among all and reached a consensus, they are human decisions that go beyond putting or not putting a medicine.

“We have had two tremendous experiences, an infant and a child with Infantile Cerebral Palsy, two cases in which we had to work in constant communication between the insiders and us here. The work of the intensivists and pediatricians in the Red Zone was commendable, but to achieve it you have to be very focused. That is why when I talk to them in the morning I always ask about the family and ask if there is any situation that could bring them distraction; this has to work like a gear, otherwise things don't go well.

“We insist so much that children should not get sick, especially those under one year of age, because they have a very immature immune system. Among the experiences that we have, we have rescued breastfeeding.

“We must recognize the group of this hospital. I am a pediatrician, I come from a civil institution, and I always marvel at the discipline and order with which they assume the task here, ”emphasized Dr. Rivero Fernández.

Responsibility exceeds hospital limits. After they leave the institution, because they already have a negative PCR, if they have any sequelae, the group of experts sends them to another hospital or indicates a specific follow-up by the health area.

Undoubtedly, these extremely talented professionals of Camagüey's medicine have had a lot to do with the fact that fewer people get complicated or die. That is the merit of those who are outside, whether by phone or by note: from a distance, they save lives.

Translated by Linet Acuña Quilez