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  • Increases in deaths in Tijuana and Mexicali

    Source: https://zetatijuana.com/2020/05/defu...ante-pandemia/

    Deaths increased 72.3% during pandemic
    May 30, 2020

    During the current coronavirus health contingency, the record of deaths recorded in death certificates increased in Tijuana and Mexicali, the two municipalities in Baja California that account for 90.4% of coronavirus deaths. In both demarcations, an increase was observed in deaths due to respiratory causes, an underreporting that the Health Secretary, Alonso P?rez Rico, does not recognize as a COVID-19 test was not performed, an examination that is only reserved for patients treated in hospital and for a minority (10 %) of infected people as outpatients

    During April and May, at the peak of the pandemic of the COVID-19 disease, Tijuana registered 2 983 deaths from different causes, which represented an increase of 72.3% compared to the same period in 2019, according to the minutes of diffusion issued by the Civil Registry offices of this city.

    Not only that. Of the total death certificates issued, in 53.1%, 1,586 documents, some type of respiratory illness was established as the cause of death.

    Of that number, in 483 minutes COVID-19 was determined as the cause of death, while 103 more deaths were documented as "suspicion of COVID".

    The sum of these two causes of death gives a total of 586 people dead with coronavirus or symptoms associated with this condition as of Monday, May 25, more than the 495 deaths reported in Tijuana in the latest statistics presented on Thursday, May 28 by the Baja California Secretary of Health, Alonso P?rez Rico.

    The increase in deaths from respiratory causes is also registered by Mexicali, a municipality that in recent weeks has exponentially increased the number of positive patients and deaths from coronavirus, placing it in third place with active cases nationwide.

    According to official data provided by the Civil Registry, the Baja California Capital added 1,731 deaths during April and May, 597 with respiratory diseases as the cause of death.

    In the Civil Registry statistics, the number of deaths properly determined as COVID-19 or coronavirus was not broken down, but an increase of 124.4% from one month to the other in the number of people who died from some type of respiratory disease was evident. .

    Proof of this is the number of death certificates issued for that cause. While in April they added 184, during May, as of Wednesday the 27th, the registration was 413. Of the 1,052 death certificates recorded in the Civil Registry of Mexicali during May, 39.2% registered respiratory diseases as a cause of death.

    The increase in the number of cases due to death due to respiratory causes registered in Tijuana and Mexicali during April and May, corresponds to the trend of the official epidemic curve of COVID-19 presented by the government of Baja California.

    However, this underreporting is not considered in the statistical analysis presented by the Ministry of Health, much less does it offer a reasonable explanation for such increase and whether or not it has a correlation with the coronavirus pandemic in Baja California, an entity that at the close of of this edition (Thursday, May 28) adds 774 deaths, keeping it in second place at the national level of coronavirus mortality.

    Even so, the head of the Ministry of Health stated that "not all diseases will stop by COVID and we will not hide them either."

    WITHOUT PROOF, DECESSES DO NOT ENTER PANDEMIC STATISTICS

    Of the exponential increase in death certificates in which a respiratory-type illness was established as the cause of death, Alonso P?rez Rico, declared: "I cannot deny or say that these patients died from COVID, if I do not have a PCR -COVID19 test - ”.

    Despite lacking a test, it related the mortality rate from respiratory diseases to viral diseases that are already common, unrelated to the SARS-CoV-2 pandemic.

    "In Baja California we have averaged around 600 to 700 deaths from atypical pneumonia in the last ten years, we are going to continue registering atypical pneumonias, even if we have the COVID pandemic," said the official.

    Although “the viral parasitic agent is COVID, that does not mean that we will not have atypical pneumonia or pneumonia, due to H1N1 or pneumonia from any other cause; We have had deaths of patients in COVID hospitals that have negative PCR, "he added.

    All deaths associated with respiratory causes that lack a COVID-19 test will be analyzed by the State Center for Epidemiological Surveillance (CEVE), but until the end of the year, as long as the bodies of these patients are sent to the Forensic Medical Service (Semefo), which does not happen in the case of deaths from disease, which is diagnosed as natural death.

    "If they go to Semefo, these cases will be analyzed in the CEVE, at the end of the year all the patients who died from a verbal autopsy, which are the symptoms shared with COVID, the group of experts, epidemiologists and infectologists, will determine If I classified for COVID or not, right now deaths from complicated heart attacks, diabetics, or other respiratory causes have not stopped, "P?rez Rico reiterated.

    SECRETARY OF HEALTH DESTIMATES UNDER-REGISTRY INVESTIGATION

    Questioned both by the increase in deaths outside the hospital and by the increase in the number of deaths from respiratory causes established in death certificates, Dr. Alonso P?rez Rico only managed to dismiss any statistic that does not agree with the official numbers presented in your daily report.

    Such is the case of the study carried out by a group of researchers from the University of California -Los Angeles and Riverside- that, in conjunction with El Colegio de la Frontera Norte (El Colef), the Autonomous University of Baja California (UABC) and staff of the Tijuana Red Cross, in which excess death was established outside hospitals during the pandemic period.

    "It has several methodological flaws incorrectly," said the study's Secretary of Health, noting that in the deaths established in the study sample, there was no PCR test to detect COVID-19.

    In effect, according to the Sentinel method, the Ministry of Health limits the application of tests to all patients in hospital, and only 10% of outpatients.

    This means that in most out-of-hospital deaths, a PCR test was not applied to determine whether or not the deaths derived from coronavirus.

    The collegial analysis suggests that the increase in the number of deaths derives directly or indirectly from the coronavirus health contingency, although in cases of death from respiratory causes, it could not be determined whether it was due to COVID-19, as there was no evidence of through, clarified at the time Dr. Eva Tovar Hirashima, medical director of Prehospital Care of the Mexican Red Cross.

    The study was based on reports from paramedics from the Tijuana Red Cross, who warned of the increase in deaths at home or transfer to a hospital during the pandemic period in this city.

    On this, P?rez Rico explained: "I highly appreciate the paramedics, they are an indispensable part of the medical workforce, but they are not the most qualified to determine, based on epidemiological studies, the cause of death when they have a few minutes caring for the patient, when they don't know how to ask the family about previous symptoms or a history. "

    From the analysis, "I see that it has many methodological flaws, so research studies in search of a pathogen are not done."

    And he added: "It is very simple to say that there are deaths from COVID, however, we have to be very careful with these types of statements because not all those who die, die from COVID or respiratory symptoms, however, we associate them like this" .

    Finally he brandished: "I want to know what authorization they had to say if they are symptoms of COVID."

    INFORMATION ON DEATH RECORDS TEST SUBREGISTER

    From the increase observed in the cases in the number of deaths, many of which are associated with respiratory diseases in the statistics of the death certificates of the Civil Registry, Letza Boj?rquez, from the Department of Population Studies of El Colef, specified that "the deaths in general increase in the end of the year season, in the cold season and a lot of it has to do with respiratory diseases ”.

    Regarding the study in which he participated to analyze excess death outside the hospital, he said that the study carried out by academics from California and Baja California, gives a closer approximation to the true general impact of the pandemic, beyond the deaths have been directly by COVID. For this reason, it could not be reliably affirmed that the excess of deaths registered in the pandemic curve in Tijuana was due to COVID.

    However, "with the information in the minutes it can be stated, although not in everything that is recorded in the minutes is with laboratory examination, it is more with clinical suspicion, but with the information in the minutes it can be stated" , stressed the specialist, noting the possibility of following up on the first study carried out.

    "What happens is that in this work we did, we did not have information from the records, only the information that the paramedics had when providing the information," Boj?rquez admitted.

    Analyzing the set of deaths during a pandemic is something that is done internationally to assess the effects of this type of epidemics, “it was done with influenza -H1N1- and it is being done with COVID, because it is known that when these epidemic situations occur and of a pandemic, deaths are increasing that do not have to be related to the disease, so it is important to record all the others ”.

    An example is the increase in cases of silent hypoxemia, “it is something that has been observed in various parts of the world and there are really still few studies to see how much it is related to COVID, but there does seem to be a trend that, in particular this infection, cause this situation of a drop in blood oxygen that the person does not detect and that is very serious, because it could be one of the reasons why the person does not go to seek care. "

    The El Colef researcher noted that silent hypoxemia could be a characteristic of patients treated by the emergency services, “but we do not know how general, if there are reports from different parts of the world that people who are dying are having these characteristics. With COVID, we are not yet quantifying what percentage this condition has here, we are only saying that it could be, but it is still tentative ”.

    Although the report has not been analyzed in pairs, the decision was made to publish it due to the emergency situation and hoping that it could serve so that, as a whole, strategies and solutions are taken, and a good response is given to the attention of the health contingency.

    Data from the Red Cross paramedics may be another indicator of the state of the pandemic, which, if analyzed systematically through an epidemiological surveillance system, gives a very good indicator of when an indicator of risk or when it has already decreased, so it would be very good to incorporate epidemiological surveillance systems.

    Letza Boj?rquez considered that there is still a lot of research to be done in order to determine how much the health contingency is affecting, “so far everything has focused on the result of suspected and confirmed cases, negatives, positives and deaths, but there are other indicators that can be faster, although they are not so precise ”.

    EXTRAHOSPITAL DECESSES DUE TO LACK OF MONITORING: MEDICAL SCHOOL

    "Patients who have symptoms of COVID-19 should have better orientation and follow-up to prevent their infectious symptoms from complicating until death," said Dr. Abraham S?nchez Frehem, president of the Medical College of Tijuana, commenting

    that there is no true patient orientation, even in public health institutions.

    "Hence, academics from the UABC, the Colegio de la Frontera Norte and the University of San Diego, have found that when the ambulance service goes to the homes, the patient has already died," he said, adding: "I have had attending patients of other pathologies, and when I interrogate them, I find suspicious data and they come out positive, so there must be adequate monitoring, because I understand that people do not want to go to hospitals. "

    He recommended that people who are in their homes be attentive to their symptoms every day, check their blood oxygen level and not ask for help when they can no longer breathe, "because 8 out of 10 intubated people do not survive," S?nchez said. Frehem.

    FALSE HOSPITAL CAPACITY REPORTED

    As of Wednesday, May 27, the head of the Ministry of Health in the State, Alonso P?rez Rico, reported a hospital occupation of 84% in Mexicali and 56% in Tijuana.

    In particular, he stressed that the General Hospital of Mexicali, located in the city that since Saturday, May 23, became the epicenter of the pandemic in BC, by surpassing the number of positive cases in Tijuana - accounting in the last report for one thousand 983 infected people in The Baja California Capital against 1,878 located in this city- was at 91.45% of its capacity, with ten beds available.

    What the official did not report was that the capacity of medical personnel was exceeded since last weekend, when this hospital registered a 100% occupation, a state in which it remains.

    In the particular case of the General Hospital of Tijuana, it reported it with a 59.5% of occupied capacity, when this hospital unit has a capacity of 75% of occupied beds.

    It was also from Saturday 23rd that Mexicali ranked third in the municipalities that nationwide have more active cases of coronavirus; at press time, it added 424 active cases, well above the 128 reported in Tijuana.

    In the last week Mexicali registered 370 new cases and added 36 deaths, for a total of 177 deaths recorded in the pandemic statistics presented by the Ministry of Health.

    In this context, Governor Jaime Bonilla Valdez considered the possibility of moving furniture and medical personnel from other municipalities to Mexicali, or transferring patients from the State Capital to the converted hospitals in Tijuana.

    The transfer of patients from Mexicali to Tijuana, will depend on how the degree of hospitalization behaves, “a transfer from any city or any institution has to fulfill a premise first, and, first of all, that it be safe; We are increasing our hospital capacity so that we do not have to get to that point, if we require it we will have no problem doing so, just as we have no problem transferring them to a Military Unit, "said P?rez Rico.

    None of these strategies has been implemented. To open space, it was decided, for the time being, to discharge the most recovered patients from COVID to receive new patients who require hospital care, reported the medical staff of the General Hospital of Mexicali, nosocomio which records the highest demand for care of people infected with coronavirus.

    "No country in the world is going to have available beds if people continue to mobilize," said P?rez Rico.

    From the behavior in the pandemic statistics, he cited that there is the possibility of a second rebound in the number of people infected by COVID-19, which would be "much more damaging" than the first apex recorded in the pandemic.

    "There is always the possibility of a second wave, the fact that we have a gradual gradual decrease right now in confirmed cases in Tijuana, with visits to hospitals in the emergency department and hospitalizations on the floor, does not mean that the pandemic is over, not at all," he said. the state official.

    Four doctors who consulted in pharmacy die of coronavirus


    Four general practitioners who dispatched in clinics attached to Tijuana pharmacies died from COVID-19, and a similar number is in custody at their homes, testing positive for the pathogen, said Dr. Abraham S?nchez Frehem, president of the Medical College of Tijuana.

    He noted that the deceased doctors lacked adequate protection to prevent the spread of coronavirus, in addition to not having sufficient income, so "the ladies pass the tray so that we could cooperate to cover some expenses." Their relatives had to require help to cover the funeral expenses.

    The condition in which the doctors died "highlights a severe problem that we have been seeing for years", such as the fact that they do not receive adequate protection or fair remuneration for their work, since while a doctor who consults at a pharmacy charges between 30 and 50 pesos for its services, the business charges 2,000 to 3,000 pesos for medicines.

    S?nchez Frehem concluded that as a College they will fight "so that the general practitioners have a dignified life."

    While the state secretary of Health, Alonso P?rez Rico, acknowledges the death of two doctors from the private initiative by COVID-19, but none who have worked in a pharmacy office, for which he qualified the assertion of the president of the Medical College of Tijuana , a declaration "without support".

    He said he did not know "if those doctors whom he (S?nchez) referred to died of COVID, because I have not seen their PCR for me to make a statement like that, because I have to have a living."

    Baja California at “maximum risk”

    On May 30, the Sana Distancia Day comes to an end and the Traffic Light System begins with which it intends to enter the so-called new normality in a phased manner throughout the country.

    Baja California will start at a Red traffic light, considered a "maximum risk" in COVID-19 infections. To exit this phase, the entity must adhere to four criteria: Hospital Occupancy of the IRAG Network (Serious Acute Respiratory Infections), Hospital Occupancy Trend, COVID-19 Syndrome Trend (last 14 days) and COVID Positivity Percentage.

    However, in the last week, instead of going down, the number of COVID-19 infections increased 27%, making Mexicali the epicenter of the disease with 2,226 confirmed cases accumulated and 474 active -detected in the last 14 days-, leaving second place to Tijuana, which since April remained at the head with 2,031 accumulated confirmed cases and 138 assets.

    Thus, Mexicali became the third municipality at the national level with the most active cases, behind Iztapalapa and Gustavo A. Madero, mayors belonging to Mexico City.

    The increases in infected patients caused hospitals in the Baja California Capital to present an increase in occupancy, mainly in General, which from May 24 to 26 was 91% of its occupation - with 10 beds - and between 8 and 14 ventilators available ; while in the Hospital of Zone 30, attached to the Mexican Institute of Social Security, between 73 and 81% of its capacity was working during the week of May 22 to 28, the last two days when it had less than ten beds free for use and less than five fans.

    This situation caused the Secretary of Health, Alonso P?rez Rico, to announce that if necessary, the patients would be transferred to the General Hospital of Tijuana, which has worked around 60%, with an average of 69 beds and 35 fans in the last week.

    Despite the fact that the number of infections increased considerably in Mexicali, in Tijuana the number of people who have tested positive for COVID-19 has not decreased: 257 new cases and 46 deaths have accumulated in the last seven days. Overall, in BC there were 1,226 confirmed cases and 136 deaths, without neglecting the 1,292 positive IMSS tests that continue to be disregarded in the statistics that the Ministry of Health presents every day.

    As of the morning of Thursday, May 28, Baja California accumulated 4,940 confirmed cases and 774 coronavirus deaths. Uriel Saucedo Ram?rez.


    91 police with coronavirus; 13 died

    In Mexicali, Tijuana and Rosarito, 91 cases of uniformed persons infected by COVID-19 have been registered, according to the interviewees. Mexicali has the highest number with 40 cases, followed by Tijuana with 38 and Rosarito with 13.

    Regarding suspicious cases, Mexicali reports 120 uniformed personnel, and Rosarito seven, who are in housekeeping.

    In two municipalities (Mexicali and Tijuana) the death of thirteen police officers was reported, however, not in all cases was it confirmed that it was due to respiratory disease. In Mexicali, the three uniformed men who died had a diagnosis of atypical pneumonia, and in Tijuana, of the ten deaths, only four have been confirmed by COVID-19.

    Ensenada is the only municipality where there were no cases of agents reported until May 28. The request for information in Tecate was not answered. Julieta Arag?n Dom?nguez.

    More than 339 clandestine parties in four BC municipalities in times of confinement

    Up to 339 clandestine parties have been held in four of the five municipalities of Baja California during the period of confinement due to the coronavirus epidemic (Tecate did not provide information).

    The number is an estimate, because not all the municipalities have disaggregated the information of citizen complaints related to excessive noise, explained sources consulted by ZETA.

    In Tijuana, Mexicali, Ensenada and Playas de Rosarito, the number of citizen complaints to 911 for excessive noise exceeded 6,700 in the period of isolation. But the authorities clarified that not all calls correspond to meetings of people, and there were even false calls.

    In the statistics, the number of complaints about excessive noise is led by Tijuana, where the director general of Police and Municipal Traffic, Roberto Esparza Trujillo, reported that 3,263 cases have been reported, although he did not give an exact figure for clandestine parties. He estimated that it could be between 5 and 10% of total calls, which would mean between 163 and 326 meetings. There have been no arrests.

    In Mexicali, the head of the Municipal Public Security Directorate, Juan Carlos Buenrostro Molina, commented that 2 thousand 986 complaints have been registered. Of these, only so far in May, 80 people were fined one thousand 737 pesos (20 Units of Measure and Update, UMA), 23 more with 3 thousand 475 pesos (40 UMA) and seven for a fine of 17 thousand 376 pesos (200 UMA).

    The latter data would correspond to tumultuaries in which there were around 50 people gathered despite the confinement measures to prevent the spread of the SARS CoV2 virus. Some even had live music. While last weekend 46 people were fined for not using mouth covers, but no detainees were reported.

    For his part, Edgar Salgado Mart?nez, spokesman for the Ensenada Municipal Public Directorate, reported that 155 clandestine parties with more than twenty people have been reported, "the meeting that most people had was one where there were 210 people," he assured. They have only detained four.

    For this infraction, fines ranging from 800 to 4 thousand pesos have been imposed in the case of repeat offenders. The way for Revenue Collection to link the fines to the property tax payment is being determined so that citizens do not evade the administrative sanction if they do not appear before the municipal judge and pay it.

    In his opportunity, the secretary of Public Security and Citizen of Playas de Rosarito, Francisco Javier Arellano Ortiz, stressed that 14 clandestine parties have been reported in that municipality, with an influx of between 15 and 20 people.

    The corporation has detained 70 citizens for violating the COVID-19 health contingency provision not to hold meetings, as well as ministers of worship have disobeyed sound-distance protocols by officiating homilies even when they put locks outside religious premises. Julieta Arag?n Dom?nguez.


    They force ICU Medical to reinforce sanitary measures after contagion and suspension

    After the denunciations of workers by the outbreak of COVID-19 among thirteen of their colleagues, the suspension and reactivation of work and a new closure ordered by the health authority, the ICU Medical company announced the reinforcement of preventive measures in all its areas, in addition to guaranteeing the payment of wages to the 1,500 employees of its plant located in Maneadero.

    The general management of the company dedicated to the manufacture of infusion therapy products, oncology and intensive care equipment, announced that of the thirteen positive cases detected, one is about to be discharged, while the other twelve are still isolated. at home, asymptomatic and without significant health problems, as well as 30 other suspected cases.

    “We will remain closed as we work with the health authorities. Meanwhile, they will continue to be paid their wages as every Wednesday. We will inform you as soon as possible when we can resume normal operations, "the company released in a statement.

    In total, ICU Medical has developed 28 preventive measures to guarantee the health of its employees once they resume work.

    Since Tuesday, May 19, employees demonstrated at the plant due to the COVID-19 outbreak; that night, Municipal Civil Protection attended, made an act and notified the Ministry of Labor and Social Security and the Federal Commission for Protection against Health Risks.

    On Friday, May 22, the State Commission for the Protection against Sanitary Risks (Coepris) made a visit and confirmed the positive cases, the company announcing the temporary suspension of work from that date.

    The next day, Saturday, May 23, the Secretary of Health in Baja California, Alonso P?rez Rico, explained that the company had resumed its functions despite an outbreak of infections; Thus, through a citizen complaint, Coepris intervened to verify that there was non-compliance with safety and health protocols.

    ICU Medical will reopen once determined by the Epidemiology Department of the Ministry of Health. Marcos A. Flores Mancilla.


    Custodians of El Hongo denounce medical negligence; 55 have been infected with COVID-19 and five have died


    Relatives of custodians who work in the El Hongo penitentiary reported that they, too, are falling ill with COVID-19, but do not allow them to return to their homes, but rather force them to continue working.

    Ana, wife of a deceased custodian, told ZETA that the deceased began with symptoms since April 27 and the institution doctor gave him a ballot paper that indicated he was suspected of coronavirus.

    “They continued to accept him at work, they gave him no rest, nothing. I learned that they have threatened the custodians that if they are absent or incapacitated, they will be made to work longer hours. Those who are from Ensenada will be sent to Mexicali, provided they do not miss, "said the widow, who added:

    "When his shift ended, he came home with a fever, but he kept going to work until the 6th (May), when we took him to a private (doctor), but the doctor tells us that he cannot see him because he was already very bad and his left lung was not working ”.

    He was immediately admitted to the Ensenada General Hospital, but he did not feel safe and asked to be transferred to the Belmar Hospital, using his medical insurance, where he died on May 13.

    Information obtained by ZETA indicates that until May 22, 106 people had been confirmed with COVID-19 or suspected of having the disease within the prison system: 40 inmates of the different prisons in the State, 51 custodians and 15 administrative officers.

    At press time, Thursday May 28, 45 custodians were disabled, of which 19 are confirmed cases of coronavirus and two with atypical pneumonia; Likewise, five deaths and 30 cases classified as suspects have already been registered.

    Salvador Morales Riub?, undersecretary of the State Penitentiary System, told this Weekly that the first cases occurred when Baja California was already in Phase 3 of the pandemic.

    "What we have done from the beginning was to have observation spaces divided into blocks of days, from one to five days, from 5 to 10, and from 11 to 14 or 15, to find out if they develop any of the symptoms of the disease "He added.

    Another vulnerable point is the staff themselves who work 24-hour shifts for 48 hours, which implies that at the end of a day, they go home in an environment of community infection, thus increasing their vulnerability. Angela Torres Lozano







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