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Covid-19 marks a before and after in the life of the SNS24 line and its health professionals, who in addition to the struggle to win the pandemic also try to overcome the fatigue of nine months of unrelenting calls .

In the ‘call-center’ located in the center of Lisbon, a few dozen professionals distributed throughout an ‘open space’ seek to respond to people’s concerns, while a monitor is charging the numbers of the service in real time. Calls do not stop, but you cannot hear phones ringing incessantly with the demand for an answer; everything is digital, fast and repeated by professionals to the point of seeming mechanized.

At the age of 51 and since 2003 in the contact center of the National Health Service, the nurse José Gouveia, who also works in the general surgery service of Hospital Garcia de Orta, in Almada, admits to Lusa that this was “a very complicated year” and that the first wave of the pandemic confronted the SNS24 with “total despair”.

“We are the first line in serving and meeting people’s doubts, since there were limitations for health centers and emergency rooms. We were almost the only possible help, albeit with difficulties ”, he says, calmly, in contrast to the busy days due to the impossibility of responding to all problems.

And it was not just on the other end of the line that changes took place. José Gouveia responds to calls over the course of the shift with his mask on, in the image of all his colleagues, now a few meters away from security and with many in teleworking situations. When you leave, it will be time to head to the hospital to continue the fight and be replaced by another colleague, who does not sit down before disinfecting the work area.

New procedures were instituted, new guidelines were defined and everything had to be assimilated without wasting time, in a context in which information about the new coronavirus challenged even the most experienced professionals and generalized uncertainty about the future.

“It is necessary to have some experience, which counts here, but sometimes it is difficult with some tricks. It means having the experience of screening and trying to understand what it really is: if they are symptoms related to covid-19, anxiety, etc. It is the experience that gives us this ‘feeling’, this proficiency ”, explains José Gouveia, guaranteeing to have“ the same principles and the same dedication, but with more effort ”.

In the workspace next door, Manuel Mourão, a 52-year-old nurse with almost 30 professional experience, reviews in the days lived with this pandemic its beginning in the SNS24, in 2009, with the flu epidemic A. However, even with the accumulation of work in the emergency department of Hospital de São José, in Lisbon, refuses to let down.

“As I am in an emergency, the burden has been enormous and obviously health professionals are a little exhausted, but that is no excuse for us. As I usually say, every day I take my shower, wear my nurse’s uniform and go to the fight ”, he summarizes, naming knowledge as a weapon to“ calmly clarify and give some very assertive guidelines ”so that the pandemic is under control.

Unlike most days in the past few months, Manuel Mourão is in the building providing service instead of doing it from home. Although he misses living with friends created over 11 years, this nurse specialized in the field of psychiatry assumes the comfort of the option and recognizes the advantages in reducing the risks of contagion.

“The teleworking experience has been very positive. The pandemic has hurt many people, but for us it has also brought some benefits; we were already talking about it: ‘why not be at home with a computer doing this?’ There was never that opportunity, but the pandemic ended up pushing us more quickly towards that ”, he says, before completing another journey and leaving his post.

Catarina Rebelo, a 25-year-old nurse, arrives to fill the position. After disinfecting the table, the computer and the kit, he puts his rubbers on the headphones to start answering calls. This is the routine he embraced about a month ago, after deciding to reply to an email from the Ordem dos Enfermeiros asking for applications for the SNS24.

“I felt that there was a need to want to participate in helping the front line of the pandemic and that I was unable to exercise at my workplace. So, I opted for this place, being a place where we are very in contact and we help people, despite not being directly cared for ”, confesses the young woman, who still lives in her parents’ house and also works in a private clinic.

Without hiding that coming to SNS24 was a purely “personal” choice and driven by the desire for a “new adventure”, Catarina Rebelo already recognizes the tiredness in her colleagues after a “scary” November that she marked in her early days the peak of the second wave of the pandemic in the country.

“In fact, there were a lot of calls on hold when I joined and it was a completely new thing. It was quite scary ”, he recalls, although later on“ loving ”the experience:“ It is very motivating that we are here to help people and they show even during the calls that they are satisfied with our help and our support. And this is gratifying ”.

A few lines ahead, Carla Miguel continues to answer calls beyond the end of the shift. In this case, a father asks on the other end of the line how to deal with the fever of the 12-month-old baby and the nurse, 56, punctuates each question with his left hand, as his right hand clicks on the mouse to enter data on the computer. “If you run your hand over her neck, you feel ganglia,” she asks, while she herself runs a hand over her neck.

Already with two children also involved in the “front line” of the fight against covid-19, Carla Miguel highlights the impact that the pandemic had on people’s feeling of security in relation to their own existence, both individually and collectively.

“The human being has become very weak in this context, all the certainties that we had … There is nothing acquired, we are all very afraid and the instability of insecurity is what concerns me the most. It is a ‘bug’ that nobody sees, a micro-organism with statistical data that leaves us completely defenseless ”, he says.

Before going on to another phone call, he introduces some more information into the system, in a process that he fears to increase again from January, because of the easing of the restrictions on the Christmas season.

“We were able to control and keep a lot of people at home, but this is a time when there are people who think from the outset that with a negative test it is all safe and this will cause hospitalizations to increase in this third phase in January. I’m scared out there ”, she confides, in a 2020 that was“ very hard ”and left her in service“ from eight in the morning to ten at night ”in several days.

“It is a permanent effort”, completes the director of SNS24, Maria Cortes, for whom the expectation of “light at the end of the tunnel” launched by the start of vaccination against covid-19 reinforced the determination.

“We have to consider that the effort was worth it and that we are motivated to continue until there is a time when we will live our lives again in a free and more relaxed way”, notes the official, who has been at SNS24 since 2017. Until When that moment arrives, it highlights the fact that “no outbreak occurred in the ‘call centers’” and that the system resisted the changes introduced throughout the year.

From a capacity for 200 calls simultaneously up to 2,000 in just nine months, the SNS24 has also grown in the number of professionals and in its automation of service processes, with the entry of two ‘bots’ to collect responses and which, according to Maria Cortes , allowed significant efficiency gains in call times, not only in the present, but also for the future: with or without covid-19.

“SNS24 started in 1998 with a line called ‘Dói Dói Trim Trim’, evolved to Saúde 24 and has a whole tradition of telephone screening in the most diverse areas. It has not yet emerged for the covid ”, he stresses, envisioning a positive horizon for the service:“ Due to the role it had in the management of the pandemic, the visibility it gained and the trust it generated in the population, the SNS24 will continue to have a determining role at the level access to health care ”.

Article from Expresso

New Measures for New Year Period

In recent days a consensus has begun to emerge that the rules for the New Year should be tightened. And in the end that is what the government decided. Christmas will continue with the rules that were set but the New Year’s Eve will be much more restricted. The Council of Ministers, meeting this Thursday, decided that movement on public roads would be banned from 23h00 on the 31st – when it was previously allowed until 02h00 – thus limiting the festivities at the end of the year.

The signs that had emerged were in this direction: of a tightening of restrictions after Christmas, in order to contain as many contagions as possible, in part because experts considered the plan “risky”. Thus, in addition to the New Year’s limitation, there will also be a curfew on days 1, 2 and 3 from 13h00. As had been defined, the ban on movement between municipalities is maintained between 00h00 on 31 December and 05h00 on 4 January.

The pressure for something to change in the next 15 days has grown stronger not because of the number of cases, which has been falling, but because of the deaths associated with the disease, a number that is stubbornly not decreasing: for eight days they have remained above 80 and have already reached record numbers of 98 people in one day. This is what Marcelo Rebelo de Sousa noted in the new state of emergency decree: “The number of deaths are still very high, and the experts confirm the clear risks of a further worsening of the pandemic if the measures taken to deal with it are reduced”.

On the political side, the President of the Republic is appealing to the “common sense, civic maturity and just restraint” of the Portuguese at Christmas, asking them for a “contract of trust”, in a message he left after the approval of the new state of emergency – which lasts until January 7.

Decisions in other European countries have also been assessed with a magnifying glass. Germany, France, Italy, the Netherlands and the United Kingdom tightened the rules for this period, going back on what had been decided. All this happens as the Prime Minister is, for the first time in 10 months, in prophylactic isolation after having lunch with the French President, Emmanuel Macron – who tested positive for the virus. Costa’s first test, done this Thursday, was negative. The Prime Minister has no symptoms and has continued work from a distance.

 

Christmas, a poisoned gift

What will happen at Christmas will depend more on all of us and less on what the government says, experts believe, but nevertheless they consider it “risky to keep the restrictions open at Christmas,” says Expresso Manuel Carmo Gomes, professor of Epidemiology at the Faculty of Sciences of the University of Lisbon. According to the expert, it is not possible to anticipate the size of the increase in cases in January, but it should not be “as high as in October or November. Everything depends on the behaviour of the population: “We have never experienced a Christmas season like this and we know that it is a time very much influenced by a social behaviour factor that is difficult to anticipate”.

In order for it to depend on each one, “more information should be given so that people clearly know what to do”, suggests the head of the crisis office for covid-19 of the Order of Physicians (OM), Filipe Froes. “More restrictions should be advised in a pedagogical way, as a civic duty, and this should be a continuum”, he adds.

The diagnosis is shared by infectiologist Margarida Tavares at São João Hospital. “I have always been very critical of the restrictive measures imposed because they do not prevent people from doing what they want. What makes a difference are the awareness messages, but in this case what people have retained is ‘alleviating'”. A few days before Christmas, lung specialist Filipe Froes believes that it will be difficult to get families to change their plans. However, there are some cautions that need to be taken: “I advise you to avoid travel, crowds when shopping and more than two households gathered at home”.

António Diniz, also a member of the OM office, warns that the greater freedom during this season is a poisoned gift. “The number of new daily cases is high and there was little appreciation for the fact that they came after two exceptional periods with many people at home and a sharp drop in the volume of tests performed. It will be very difficult that in the following 15 days there will not be a significant resurgence of infections”.

The greater freedom of movement will have consequences: “It will be very costly in January. As nothing has changed, we will return to the number of cases from a few weeks ago, with the aggravating factor that we already have full intensive care units,” warns the former Secretary of State for Health, Raquel Duarte.

“The siege should have been tightened as early as October to bring the numbers down further during the festive period,” adds António Diniz. Now it is necessary to contain damage, “to have tables or places per household when there is more than one household or to keep children away from family members at risk”. And be very careful with false senses of security. “The rapid test is above all to evaluate the infectivity, that is, whether we can transmit the infection. A negative result only ensures that the virus does not spread within 18 to 24 hours at most”. The times are of battle against the virus and the speech must be at the same level. “A broad national mobilisation was lacking, almost as if for war. To tell the Portuguese that we will have to sacrifice a little of our social and affective freedom for a greater value,” he says.

For José Artur Paiva, president of the College of Intensive Care Medicine of OM, “we have a tangible goal and this vision must be given. With one million vaccinated in the first phase and nearly one million who have already had the disease, we can achieve group immunity in six months and that will be all the better if our behaviour is adequate. For that we need social restriction this Christmas and New Year”, he explains. “People are very tired, very lonely, and the emotional argument is far superior to the scientific one. Therefore, the only way is to use a little emotion in science”, he prescribes to the Government.

Source: EXPRESSO

Fátima Ventura, director of the Scientific Evaluation Unit at Infarmed, explains to Expresso how new scientific techniques and new verification procedures came together to produce what for many people seems like a miracle: vaccines obtained in record times. The expert tells how researchers and regulators managed to save time in each phase

Vaccines against covid-19 have already started to be administered in several countries, and are almost arriving in Portugal, less than a year after the start of the pandemic. The relative speed of its appearance, compared to the long periods associated with other vaccines of the past, generate suspicion in many people. In order to get treatment for the disease, aren’t dangerous shortcuts taken? Will the vaccine be effective? Won’t it have dangerous side effects?

To answer these questions, it is important to understand what this vaccine has new, in relation to others that we have been used to since childhood. Expresso spoke with Fátima Ventura, a pharmacist, director of the Scientific Evaluation Unit at Infarmed, and an evaluator herself. Ventura is also an alternate member of Portugal of the Committee for Medicinal Products for Human Use (CHMP), the last EU body that will give an opinion on vaccines in the EU before the European Commission.

Anticipating something said at the end of the conversation, it is not expected that life will return to what it was, or something like that, before the second half of 2021. Fátima Ventura refers to the prospect of a relatively normal winter, if all goes well. For the time being, he notes that, despite what the headlines suggest, the vaccines already approved in certain countries were for emergency use. “They have not yet been authorized for introduction to the market, either in the United Kingdom, the United States or Canada,” he says.

A NEW TECHNIQUE

To understand what makes many of the vaccines now developed different, it is essential to understand what distinguishes them from traditional vaccines. While an attenuated version of the pathogen in question, whether a virus or any other, is used, fragments of a genetic code are now involved. Specifically, that of the protein that appears in the images of the virus with the characteristic spike, or “peak”.

“When we administer this genetic code in a vaccine, our cells will translate that code into the virus protein”, explains Ventura. “As there is no genetic code behind the virus, this protein is not infectious. We are not going to get sick. What happens is something else. We have special cells, called antigen-presenting cells, that present this protein to other cells and will trigger the immune response: the production of antibodies that are expected to be neutralizing. That is, when the virus itself appears, they look at the protein that it brings and say: oh, it’s strange, I’m going to kill it. Basically, that’s it This protein is the way that the virus has to enter our cells. If the antibodies attack it, the virus does not bind to them and does not infect “.

Fátima Ventura refers to the six vaccines acquired by the EU – “or rather, with a proposal for acquisition, as they will only be effectively acquired if they are authorized”; two with messenger RNA, that of Moderna and that of BioNTech / Pfizer; that of the German company CureVac, which uses the same technique; one from SanofiPasteur-GSK; that of AstraZeneca and Johnson and Johnson, which use other viruses, the so-called adenoviruses, modified to not multiply in other cells and which also have the genetic code of the SARS-CoV2 ‘peak’ protein. “None of the vaccines acquired jointly by the European Union is the virus itself”, summarizes Ventura. “All of them lead, in one way or another, to the production of this ‘peak'”.

BASIC INVESTIGATION WAS ADVANCED

Why was the process so fast compared to normal vaccines? The reasons were several, according to the same expert. Right from the start, the public health emergency situation. “Certain phases took place as usual, but took less time”, he explains. The companies were already developing vaccines of the same type for SARS-CoV1 and MERS. “As the SARS-CoV1 pandemic has since disappeared, there is no longer any possibility of conducting clinical trials. There is no possibility of verifying whether the virus is effective in the environment. All this research was in the drawer.” This is the case with SARS-CoV, because in relation to MERS (still a problem in the Middle East today), the case is different. Pfizer and BioNTech also had a partner for a flu vaccine with this messenger RNA technology. “That is, basic research was already very advanced. This saved some years in advance “, says Ventura.

Another difference has to do with clinical trials. “They have four phases, three before approval and one last after. In phase 1, with lower numbers and a younger population. Phase 2 is dose selection. Then phase 3 begins, which in the case of vaccines should cover tens of thousands of volunteers, to be sure of the vaccine’s effectiveness. Normally, the phases are sequential. In the traditional process, each phase is expected to start before the next one. the next one started.

“When it was already known that it was safe to move to a larger number of individuals or to an older population, it went ahead. The phases have not been shorter, they are overlapping”, he says. “Nowadays, even in relation to Pfizer vaccines, which we are almost ready to have in our market, if all goes well, studies of phase 2 are still going on, at the same time as those of phase 3”.

NORMAL SIDE EFFECTS

Some unknowns remain. It is not known how long the protection lasts, how many times it will be necessary to get the vaccine, or if it only prevents those who take it from contracting the disease or also from spreading it to other people (the first signs of this seem positive, but it is too early for drawing conclusions).

The side effects, too, are still not entirely clear. Fátima Ventura notes that the tests are carried out in a controlled manner. “When we move to the global population, it is natural that side effects will appear. Those effects that only appear when millions are vaccinated. This is normal. It is nothing that does not happen with any medicine. When we read the leaflet that comes in the medicine boxes, we see the frequency of side effects indicated there: if they are common, rare, very rare … “.

“The effects mentioned so far in the studies are the usual ones: the tough guy on the arm, the discomfort on the body … In general, they are very similar to those of the flu”, he says. Even anaphylactic reactions, like those seen in two health professionals in the UK, are far from being unheard of, he says.

THE ROLLING REVIEW AND OTHER NEWS

Another relevant difference is that the industrial production of the vaccine was anticipated. “How can we say that, a few days after the European Commission approves the vaccines, we will already have them to give to people? This is because companies, at risk, started to produce even before being authorized. They achieved this with many support from governments and foundations that support research. There were incentives for companies to go as far as they could “, explains Ventura, giving the example of BioNtech, which will commercialize the Pfizer vaccine in Europe and has everything ready.

Also, the way the authorities are carrying out the assessment was different now. “We usually have more time. The normal process for approving a drug is 210 days in the European Union. For certain diseases that have no therapeutic alternative, that time can be shortened. It is already part of our legislation. It is called accelerated evaluation.” This time, at Europe level, a new mechanism was created. As the evaluation is made, the company submits this data to the agency and they are evaluated. “This is called ‘rolling review’, that is, continuous review”, says Ventura. “We are receiving the book in chapters, so to speak, and we evaluate each chapter. When we have all the chapters evaluated, the company formally submits the marketing authorization request. Usually,

PRECEDENTS IN CANCER TREATMENT

The Portuguese specialist also mentions, as another determining factor, the commitment of many teams, the reinforcement of evaluators that the agencies made. And he notes that the authorization will be conditional, as the clinical trials have not yet ended. “Companies are subject to a series of conditions, with deadlines to meet. The assessment therefore does not stop. If things are not going well, the authorization is withdrawn.”

If the new technique is much faster than the traditional one, there are objective reasons for this. In the traditional technique, “a virus had to be cultivated, cells were needed, etc. It took a long time. In the RNA technique, the first stage is the production of the mold from cells. But from then on, you don’t depend on the cells grow “, he explains.

From the moment the SARS-CoV2 genetic code was published, “it was very easy”, he adds. “The information was removed from the genetic code, the mold was made, and based on that, it was possible to produce a lot of messenger RNA. Otherwise, very small amounts are needed. A thousand times smaller than usual. With very little product , many people can be vaccinated. A quick technique, easy to industrialize, but of course, as it is new, it is more expensive than the others. ”

Covid-19 is not the first disease whose treatment uses these techniques. “Against the protein of a tumor, the approach is the same,” says Fátima Ventura. “Cancer drugs nowadays often have antibodies – so-called monoclonal antibodies. Immuno-oncology is one of the most effective ways to treat cancer. It is using our immune system to treat what is strange. viruses, whether they are cancer cells. ” The Moderna company, he recalls, was already developing this type of approach for a cancer vaccine.

THERE WERE NO SHORTCUTS

With the much greater openness of the scientific community that took place this year, including the appearance of pre-print platforms (ie, where study results can be shared almost instantly, without the months of waiting that the publication process in reputable scientific journals entails ), it could be nothing less than a real scientific revolution.

Even so, it was a terrible year. When we read that, two days after the publication of the genetic code of covid-19, Moderna’s vaccine was already invented, that all mortality happened after that, some raise ethical questions. The truth is that it could not have been otherwise. In science, there are indispensable safety criteria, and not having met them to the letter, in addition to other effects, could compromise the public’s confidence in approved treatments.

If the dramas of 2020, by giving enormous incentive to a new technique to fight diseases, lead to advances against scourges that have long afflicted humanity, the covid-19 may end up, at a certain level, a blessing for humanity . In any case, for now, there are reasons to be confident.
“Yes, we walked faster but we had conditions for that and there were no shortcuts”, sums up Ventura.

The coordinator of the ‘task-force’ created by the Government to manage the vaccination plan against covid-19, Francisco Ramos, replied today in parliament that it would be “a huge mistake” to make the vaccine mandatory for the Portuguese population.

“This vaccination is voluntary and I think it would be a huge mistake to make it mandatory. We have 40 years of experience in the vaccination plan, which is a crown jewel of the National Health Service, ”he said, relativizing the estimates of people who do not want to be vaccinated:“ Whoever refuses to receive the vaccine must be respected. The reports say that less than 10% of the population refuses to take the vaccine and these numbers are encouraging ”.

Heard at a joint hearing by the Health Commission and the Eventual Committee to monitor the implementation of measures to respond to the pandemic, the head of the task force stressed that “trust is essential” in this process and that there must be “clarity and ease of communication ”.

“We have to win people’s confidence to adhere to the vaccination process. If we don’t win it, vaccines will serve little purpose. We must be able to manage the uncertainty, ensuring that the vaccine is safe, that the Portuguese should adhere to it and that the plan is being prepared with great caution ”, he noted, devaluing the concern that may exist with allergic reactions for that being“ a common issue ”in vaccine administration.

As such, Francisco Ramos anticipated a communication campaign in which, in addition to local contacts, the creation of “a completely dedicated ‘website’ where people can find all the information” and “two telephone contact lines, in which the infrastructure will be supported by the SNS24 ”, with professionals able to answer questions, and the possibility of scheduling vaccines is still open.

Despite recognizing a “reduction of about 20% in vaccines” by Pfizer in the first quarter of 2021 for “a failure by the company in this matter” at European level, the coordinator of the task force, guaranteed the readiness of the NHS.

“Even if this distribution occurs on Christmas Day, we will have people qualified to receive vaccines on the spot. We are available to start vaccinating as soon as the vaccines arrive, it would be intolerable to have vaccines in Portugal and not use them right away. The worst that could happen would be to set fixed dates for a person to be vaccinated in a day at X hours and then not vaccinate ”, he noted.

Faced with the capacity for an eventual anticipation of the vaccine administration until the end of December and not only in January, Francisco Ramos was not concerned, preferring to highlight the “very high hope” that this step means in combating the pandemic caused by the new coronavirus.

“The less time we have to prepare this process, the better, because it means that vaccines will arrive earlier,” he said.

For the first phase of the vaccination plan, scheduled between January and March 2021, vaccination points were defined taking into account the priority groups in accessing the vaccine: people over 50 with associated pathologies, residents and workers in homes , and essential health and service professionals.

For this reason, the vaccine will be administered in the approximately 1,200 vaccination points usual in health centers, in homes and long-term care units and within the scope of occupational medicine for professionals in essential services.

Portugal accounts for at least 5,733 deaths associated with covid-19 in 353,576 confirmed cases of infection, according to the latest bulletin from the Directorate-General for Health (DGS).

Respect restrictions

Rui Portugal, Deputy Director-General for Health, said that it was crucial for people to comply with restrictions in each municipality, especially travel and gatherings.

Care if you are sick

If you are infected or have symptoms of covid-19, you must comply with the health issued by the health authorities. During Christmas, families must support the sick. “Physical leave does not mean family leave”,

Contact reduction

Before and during the festive season, contacts should be reduced, for example, if you usually celebrated Christmas with ten or more people, you should consider reducing the number of family members or friends, in order to decrease the potential spread of the new coronavirus.

Exposure time

The same goes for the hours spending with family or friends on Christmas days: instead of spending five hours with several people, DGS advises to cut down on time and spend only an hour or two in a group.

Family nucleus

Although Christmas is, for many, spending the festive season with the extended family, in times of pandemic it is recommended to party only within the household.

Visits to other relatives safely

If you do visit other family members, you should consider doing it outside area and for a short time.

Avoid spaces such as kitchens

The kitchens are, as a rule, a place where several people gather in the same house. Such gatherings increase risk of spread of the disease and should be avoided. Traditional greetings (hugs, kisses and handshakes) must be avoided. The physical distance of one meter to two meters must also be maintained.

Airing houses

Whenever possible, houses should be ventilated and interior surfaces disinfected regularly.

Objects

Avoid as far as possible sharing objects and cutlery with other people. If unavoidable clean your hands afterwards.

The Deputy Director-General of Health also said that care should be taken with the consumption of alcohol which may reduce the sense of the need of safety among family members and friends.

 

 

This year, different police stations in the country assisted 12 elderly people lost on public roads. A simple bracelet made it possible to take them back home or to family members, through the I’m Here Adults program, which results from a partnership between PSP and Santa Casa da Misericórdia.

In the right hand or in the left? More or less tight? At the door of an odd number on Rua Diário de Notícias, in Lisbon, the PSP agent Lopes da Silva delicately puts a bracelet on the thin and wrinkled skin wrist of Maria Fernanda, 87 years old and resident in Bairro Alto for 60. ” great “, she guarantees. And the agent continues. “Look, you know what this is for, don’t you?” “I’ve heard of it.” It is better to repeat. “This has a little number here, in which your [family members] contacts will stay, in case you get lost, if you have a problem on the public road, and don’t bring anything with you.” Then, Maria Fernanda shoots her conclusion: “I mean, from now on, I am a protected woman. Good!”. He skips his feet lightly on the building’s doorstep and claps his hands.

Age does not forgive, the popular sayings already warn. Over the years, the number of pathologies and the limitation of autonomy tend to increase. These are not nice accounts for those who have become accustomed to making their living in the city and, one day, find themselves on the verge of not being able to leave the house alone without getting lost along the way. Can a bracelet and a number change the safety of the elderly? That’s the purpose of the national program I’m Here Adults, a partnership between the Public Security Police (PSP) and Santa Casa da Misericórdia.

The initiative proposes to distribute a bracelet, which is assigned an identification number, to a more vulnerable population such as the elderly, who will help passers-by or police officers to help them and identify them if these people are lost on the public road. After the success of the I’m Here Children program, created in 2012, in 2015 PSP launched a pilot project for the older version. “We are talking about all the elderly, but it is more aimed at people who, due to a pathology or old age, may momentarily become unbalanced and lose track of time and space on the public road, without any contact or identification .

Artur Serafim explains that if a citizen or agent reports that a person is lost, he can call the national emergency number, 112, indicate that he has a bracelet under this program and dictate the number inscribed on it, so that the National Directorate of PSP can access this user’s profile and contact people nearby. Therefore, the bracelet does not have an integrated GPS tracking system. It works only as a “tool” of work, a means to cut a path.

About a thousand active bracelets

Elderly people lost in the streets of the city “does not happen daily and thankfully, but it is happening”, warns the PSP spokesman in Lisbon. As an example, he recalls that, this year, there were 12 cases at national level in which it was necessary to “make the connection between people and people’s families”. Reducing the geographical scale for the Lisbon Metropolitan Area, there have been four cases since January. Figures that, in his perspective, justify the extension of the program to more and more people. “What we want is for there to be more adherence and we can thus safeguard the lives of many people.”

At the national level, the distribution of bracelets in the scope of I’m Here Adults has reached thousands since 2016. In all, 1388 bracelets were delivered, of which only 961 are active in the system. And Lisbon represents a large share of this total: there are currently 441 active. According to the PSP, the Campo Grande and Odivelas police stations are the ones that aggregate the largest number of deliveries to date.

The distribution process, explains representative Artur Serafim, “is very simple”. It can be requested by the carrier himself, if he is aware of his condition and feels that he wants to be safer every time he leaves his home. Or even by a caregiver, family member or friend, as well as by an institution that the elderly person is in charge of. To apply, simply fill out a form on the internet or go to a police station, so that PSP agents can help with the process. After an identification number is generated, the bracelet is activated and will be given to the elderly.

With the covid-19 pandemic, the challenges have changed. “We note that there is greater adherence and we welcome this behavior, because it is ideal for us,” says the spokesman. In response to the increased interest on the part of family members and the elderly to join the program, PSP now offers a wider range of police stations where the bracelets can be distributed. So far, this service is not available in all police stations, “because we do not have this capacity in terms of the number of bracelets”, explains Artur Serafim. However, the medium term objective “is that a large slice of the squares in the Metropolitan Area of ​​Lisbon have the bracelets”.

 

 

 

 

 

 

 

 

 

 

Many Portuguese are scheduling tests with Covid-19 for the days before Christmas to be able to reunite with the family, according to Unilabs Portugal, which only on December 22 has 1,500 appointments.

“Since the communication [on December 5th] of the Prime Minister regarding how Christmas will be, namely from Monday and Tuesday, we have had a very large increase in testing requests, namely PCR tests and also antigen tests, for the 21st, 22nd and 23rd of December, ”the president of the clinical diagnosis network told Lusa.

For Luís Menezes, this situation demonstrates that “people see testing as a way to create an additional safeguard”, in addition to the measures indicated by the Government.

The director-general of Health, Graça Freitas, called, in a recent press conference on covid-19, that the population does not take tests on their own initiative, and should wait for a request or for medical advice.

A position supported by Luís Menezes, affirming that the diagnostic centers “are available to support public authorities and individuals individually in this request, but it is necessary to remember that everything that is being said by public health authorities must be taken into account. in count”.

“Testing can be seen as another safeguard”, but the Christmas dinner should be held with a small number of people, with physical distance and with the use of masks whenever possible.

Luís Menezes said that this situation was not surprising because there were already some questions in this regard, but he said that it was “nothing normal” for people to schedule tests two weeks in advance and ask if they have the results until December 22 or 24.

Detection tests for covid-19 (PCR) are the most sought after, do not require a medical prescription, unlike rapid tests, which are “clearly contraindicated” because they have very low sensitivity for asymptomatic individuals, he said, stressing that “it is It is important for people to be aware that the test is not an absolute certainty that they are negative ”.

The president of the National Association of Public Health Doctors, Ricardo Mexia, told Lusa that “it is important that people realize that the various measures and precautions they can take in order to prevent the spread of the disease are complementary” and considered “a interesting strategy ”the use of tests to identify people who may be infected but are asymptomatic.

“It is a measure that seems interesting to me and that can also help to reduce the risk of an exposure that is expected to happen during the festivities”, said Ricardo Mexia, noting that the test “is not to allow to reduce the other measures” that contribute to the reduction of risk, but to complement them.

He pointed out the cost of carrying out tests as a condition and said that eventually there may be a supply problem, questioning “to what extent will there be capacity for so many people to be able to take the test in a very short period of time”.

For Ricardo Mexia, this is “one more example” that people are concerned and want to protect themselves and those they like.

The SYNLAB laboratory network has also been recording many RT-PCR test schedules for this period, but associated with travel.

“Customers started contacting very early (since the beginning of December) to make appointments also for December 24th, in order to be able to make their trips on December 26th”, he advanced, without specifying the number of appointments have been made.

The Germano de Sousa laboratories have been contacted by some people asking if they are open around Christmas, but as they are working until the 24th and there is no need to make an appointment, they have not yet seen an increase.

“Probably people who are interested in taking the test will arrive on the 22nd, which is what matters in order to be able to rest,” said pathologist Germano de Sousa, predicting an increase in demand at that time.

 

 

The coordinator of the National Vaccination Plan foresaw today that, in principle, the first vaccines against covid-19 will begin to be administered to the population at risk in early January, a day or two after arriving in Portugal.

Speaking on RTP’s “Big Interview” program, Francisco Ramos was convinced that on December 29 the European Union will give a positive opinion for the distribution of vaccines to member countries, admitting that the “big doubt is the quantity” of vaccines that will arrive in Portugal, with the national access of 1.5 million vaccines from Pfizer pharmacy in the first quarter of 2021.

As he explained, it is predicted that one batch will arrive in January and another batch in February (all from Pzifer), and it is estimated that only in mid-January should a decision be made by the health authorities on the final evaluation and acceptance of Moderna’s vaccine. .

If all goes well, Francisco Ramos admitted that in January it will also be possible to have access to vaccines from these pharmaceutical companies, warning however that there is some “uncertainty” citing that, for example, there is still no date for appreciation of the AstraZeneca vaccine, although there is still “hope” that there will be a decision in January or February.

“It is the best scenario, but there is still uncertainty, namely regarding the quantity” of vaccines available “, he said, reiterating his confidence that in February it is expected to have the Oxford / AstraZeneca vaccine.

In view of the anxiety associated with the arrival of vaccines, Francisco Ramos stressed that it is important to first obtain “safety guarantees” in all vaccines and reiterated that “it is not yet known what quantities (of vaccine) will arrive in the first batches”, pointing out how priorities to prevent mortality, namely of elderly people in homes, health and risk professionals and those who suffer from “severe disease”, associated with pathologies such as chronic kidney disease.

The coordinator for the National Vaccination Plan against covid-19 mentioned that 50% of deaths affect people “over 50 years of age”, mainly those with associated pathologies.

According to Francisco Ramos, if everything goes as planned, 950 thousand people will be vaccinated in this first priority until February and indicated that the elderly in the homes “will not be vaccinated on the same day”, that is, simultaneously, but as the vaccines are distributed to homes and hospitals, where people at risk will be marked “with location, date and time”.

It will also be the Health Centers that call for the vaccination of people with a medical declaration attesting to the clinical condition that allows vaccination in the first phase of the plan.

“What is the routine capacity is 50 thousand inoculations a day without jeopardizing the other normal activities of the Health Centers”, guaranteed Francisco Ramos, admitting that in the most populous cities other spaces could be defined to vaccinate people with right to inoculation against the coronavirus.

“In large cities it will be possible to find other spaces where the teams of the Health Centers operate” the vaccination, he said.

As for the Pfizer vaccine, he said that there will be only one delivery point on the continent, with distribution to the rest of the national territory, with the exception of the Azores and Madeira where the delivery logistics will be specific because they are islands.

Francisco Ramos was confident in the plan and pointed out that “in the best scenario” the experts admit that 50 to 70% of the population may be vaccinated by the end of spring, noting however that vaccination is not mandatory.

However, he warned that “we have to wait a few more months to see if vaccines do what they promise”, in an allusion to effectiveness.

The former Secretary of State for Health welcomed the support and articulation of the Directorate-General for Health (DGS), INFARMED, Shared Services of the Ministry of Health and the Armed Forces (FA), saying that the latter’s support gives him ” an enormous tranquility “taking into account the joint work that he had in the past with the FA when he was at the Portuguese Institute of Oncology (IPO)

Unemployment and death of elderly people by covid justify the growth of this crime. PSP and GNR investigated 667 complaints between January and August this year.

Abandonment of pets has skyrocketed in major cities across the country. The growth of cases investigated by the PSP and the GNR is mainly due to the death of the elderly by covid-19 and the increase in unemployment caused by the pandemic. Most of the crimes occurred in Lisbon, Porto, Setúbal and Leiria.

Maria Quaresma dos Reis points out those two justifications for the growth of crimes of abandonment in recent months, namely in the capital. “Many elderly people who died by covid lived alone with cats. The family members, due to financial incapacity, did not welcome the cats, who end up going to the street”, declares the animal provider in Lisbon. In some cases, covid victims no longer had a family and animals eased loneliness.

SOS Animal recognizes the phenomenon of abandonment fuelled by the pandemic, but does not risk saying that the increase was due to deaths by covid-19. Sandra Duarte Cardoso, president of that association, points to the absence of studies on this issue, but admits that the death of the owners of dogs and cats has a meaning in their abandonment.

“There are cases in which the keepers die of various health complications and the families do not welcome the animals, leaving them to be abandoned. As the crime is attributed only to the keepers of the animals, the families are not responsible”, he laments. Loss of income also precipitates the practice of this crime.

SOS Animal and the Lisbon Animal Ombudsman point out that the financial inability to pay rent on houses in large cities causes residents to move and leave animals behind. The destination of dogs and cats becomes the streets.

The data, provided by GNR and PSP to JN, point to 667 cases of abandonment of pets, since the beginning of the year and until the end of August, throughout the national territory. Most of the situations occurred in urban centres, under the jurisdiction of the PSP. In the same period last year, the cases did not reach 500.

Animal mistreatment, on the other hand, follows the reverse trend across the country, with a special focus on the area under the protection of the PSP. In 2019, there were 538 crimes under investigation in urban centres. Currently, agents are investigating 377 cases.

Maria Quaresma dos Reis believes that this reduction in crimes of mistreatment can be explained by the thickening of affective bonds between people and animals during the quarantine period. There may also be cases where crimes are not reported. For example, “in situations of domestic violence, the victim watches cruelty, but does not report it to the authorities for fear of the aggressor”, identifies the provider.

“In many homes, quarantine and teleworking have strengthened the effective ties between animals and their keepers, avoiding many situations of abuse, such as violence or the lack of food and drink,” he says. Already

Sandra Duarte Cardoso understands that the number of cases under investigation does not reflect the real dimension of the problem. “Despite the fact that the authorities are increasingly aware of these situations, they face problems in the investigation, such as the lack of space to accommodate animals in overcrowded kennels or the unavailability of veterinarians to monitor the operations”.

Original article JN