Yesterday the news came out that all flights in and out of Panama will be stopped on March 22nd. Currently only citizens and residents can come in, but after the 22nd nobody will be able to come in or out of the country. There will be non residents trapped here wondering how this will affect their legality in the country, and I’m sure Panama residents will also be trapped outside of the country. The rumors I’ve heard say it’s almost impossible to go anywhere as more countries close their borders, and as more airlines cancel more and more flights. Wherever you are, chances are that’s where you will be for the foreseeable future.

Within Panama, there are roadblocks to keep people from leaving Panama City and spreading the virus to the rest of the country. You can’t get through unless you can document that you have business in the interior. There is also a curfew from 9pm-5am, and all liquor sales have been banned. Opinion is this will discourage people from behaving irresponsibly, having parties, and spending money on alcohol when people are losing work and will need all their money for basic necessities. Beaches are also closed, as are parks, bars, and anyplace people can gather. Word is that restaurants can serve limited customers, at least at the moment, but take out and delivery are encouraged. There are many rumors going around about everything, of course, and things are changing daily but the changes always seem to be towards less mobility and less opportunity for people to infect each other.

It’s a crazy time not just here, but all over the world. Someone suggested that this is a great time to keep a journal to record this unique experience. I suppose this is one of many activities that have been suggested to keep busy during quarantine. People have been busy on facebook, and our neighborhood WhatsApp group has been going crazy with messages! I’ll have to share some of the jokes and inspiring stories when I get more time.

I saw a great article on the United Nations News website praising Panama for it’s response to the virus. I’ve run it through Google translate for you all and copied it below. I am very very thankful to the authorities here in Panama for doing everything they can to take care of everyone. I know it’s a pain and inconvenient at best, and it will be financially terrible for many, but if we can avoid widespread infection, high numbers of deaths, and an overwhelmed health care system this seems the much better alternative. I only wish a response this strong and effective was the case in every country!

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https://news.un.org/es/story/2020/03/1471462

Panama responded quickly to the epidemic of COVID19, has allocated economic resources, has managed to sequence the virus genome to quickly diagnose cases that appear in the country, has strengthened its health system and has taken measures to isolate citizens. The heads of the UN agencies in the country believe that there are lessons that can be exported to other countries in Latin America.

China and South Korea have been praised by global health authorities and the international press for having responded aggressively and effectively to the coronavirus and successfully curbing the epidemic. But in Latin America there is an example of how the closest response should be: Panama.

The small Central American country has surpassed a hundred cases, but at the moment there is only one deceased.

Panama “has always been one step ahead,” says Gerardo Alfaro, the representative of the Pan American Health Organization in the country in an interview with UN News.

One of the keys has been to start diagnostic tests quickly. “It has allowed us very early to confirm and rule out cases,” says the PAHO representative.

In addition, they have taken them throughout the national territory. “Investments made in real-time PCR kits (test kits) for HIV and tuberculosis are being used. Those same teams are used to run coronavirus tests that give results in half an hour, ”he explains.

In Panama there are 25 teams distributed throughout the country, including in remote areas, such as indigenous regions. The Ministry of Health is acquiring the necessary reagents to have tests in remote places quickly.

Also, tests aren’t just done in hospitals. “The doctors go to the home, with their protective equipment, take the sample and process it,” says Alfaro, who explains that there are 20 technical teams with doctors and nurses. The epidemiological surveillance system receives the results and they notify the patients.

The five lessons of Panama

1. Get ahead of the event and don’t underestimate the risk.
2. Think of possible scenarios and build a support team
3. Quickly mobilize resources
4. Share experiences with countries and work as a subregion in Central America
5. Put the issue on the United Nations agenda and share information between different agencies

Hospital Preparation

Panama took measures to prevent the collapse of hospitals. Each hospital can do “reconversion of beds”, giving early discharges, can suspend non-urgent surgeries and rotate medical and nursing personnel. “The staff has to know the protocols and have the equipment. It is key not to have infected medical personnel, “says Alfaro.

The representative of the Organization believes that another good decision was to appoint an intensive care team coordinator. “This makes it possible to quickly update an inventory of the resources of each institution in the public and private sector and to articulate it as a single network.”

At this time, nine patients, 8% of those infected, are in critical condition, admitted to an intensive care unit and may require assisted breathing.

“They quickly made purchases and we already received 50 additional ventilation equipment. We have already seen COVID-19 modular patient hospital design only. They have made 20 containers available to have mobile offices. The entire inventory of tents was acquired, a total of 25 for respiratory triage “, explains Alfaro.

“Imagine that there is a critical patient in the private sector and their coverage is exhausted and they have to be transferred to the public sector. This means contaminating an additional room. These coordination mechanisms have allowed us to make regulations more flexible and there is a commitment from the insurers’ association to be able to share resources, optimize those resources and be more efficient in the response, ”he adds.

Panama has a public and private health system. In the public sector, Social Security has coverage of 80% of affiliated people (not necessarily with effective access). The Ministry of Health has responsibility for the other 20% of the uninsured population, but owns 80% of clinics and hospitals.

“In the day to day we see a lot of cross subsidy. Many people with insurance are treated at Ministry facilities. At this time, there are no strict verification mechanisms and we are all articulated in a single network at the functional level. The director of social security sits every day with the team working with the minister, who has command as the national authority, “explains Alfaro.

The resident coordinator of the United Nations in the country, César Núñez, provides another key to the answer: the large presence of scientists in the country. “The Gorgas Commemorative Institute reported on Tuesday that it managed to carry out the first sequencing of the SARSCoV2 virus (coronavirus) in an imported case in Panama. “This will allow, knowing the strain that circulates in Panama, to adapt the vaccines when they are available,” he explains.

Social isolation

Panama is applying various measures to isolate citizens, such as teleworking, the suspension of classes in schools and universities, and the “stay at home” campaigns.

These strategies give “a breather” to the health systems and avoid the over demand of services that could not be managed.

“The citizen response is a little slower and hence there are increasingly stricter measures. But we have seen, for example, how several supermarket chains have organized to avoid riots. That is being done well, ”they point out.

In addition, a curfew has been established throughout the national territory, from 9:00 at night to 5:00 in the morning.

Government coordination

The heads of the UN assure that coordination between the different areas of the Government has also been key.

“The president himself exercises command and is activating the devices and ministries to make decisions. It is a pleasure to see with the seriousness that the country has assumed this issue and the agility with which it makes decisions. It is comfortable to work like this. We do not have to go and convince the authorities, because they are already fully convinced, “says Alfaro.

“It gives us peace of mind, because there is installed capacity, committed human resources and economic capacity. The speed with which the Government is making decisions to close the gaps is impressive, ”he points out.

“It is a combination of political involvement and commitment that has resulted in budgets, and an implementation with a clear structure is what has allowed the country to advance,” adds Nuñez.