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Danilo Alves – from Cenarium

BELÉM – “I confess that I came to believe that azithromycin would be effective”. The statement is from the Information Technology manager, Leandro Júnior, 55, that, in the beginning of this year, searched an Emergency Unit (UPA) of Belém with symptoms of Covid19, such as shortness of breath and loss of smell and taste. Azithromycin, one of the drugs with unproven efficacy, but still used as an early treatment for the disease, was prescribed to him, but without the promised result.

Before vaccination started in Pará, in February of this year, the Unified Health System (SUS) attended, on average, 8 thousand patients with Covid-19 symptoms per day, according to the monitoring site of the Pará State Health Department (Sespa). The gateway to the public network was the UPAs and hospitals run by the city halls. In Belém, at the peak of the pandemic, the service became overcrowded, with an average of 3 thousand daily consultations. It was during this same period that Leandro Júnior tried to get assistance.

“Besides AZ [azithromycin], the doctor also prescribed me palliative medication for symptoms, paracetamol and B-complex vitamins. Since there was a lack of taste, he also made my referral for the test”, he said. Leandro was diagnosed with Covid-19. “I confess that I came to believe that azithromycin would be effective, since it is indicated for the treatment of infections caused by sensitive bacteria. However, none of this exempted me from being infected”, said Leandro.

Five months after Leandro’s treatment, CENARIUM’s reporting, in Belém, visited two UPAs to find out if doctors in the public health system still prescribe drugs from the “Kit Covid”. One of them was precisely the UPA where Leandro was treated, in the Terra Firme neighborhood. There, the scenario was different from the last months, when patients waited in lines for the doctor, while the companions waited outside.

There are records of use of drugs from the “Covid Kit” in Belem earlier this year (Ricardo Oliveira/Cenarium)

The service took about an hour and a half. During the triage, the patient is asked about the symptoms he feels and, after 40 minutes, the doctor makes the appointment. For those who do not manifest serious symptoms, the doctor prescribes B vitamins and hydration serum. During the consultation, the reporter asked the professional about the test. He advised that the test should be done in the central polyclinic of Belém, located in the state field hospital, and prescribed a recommendation, since the symptom of loss of sense of smell was mentioned during the consultation.

The other UPA visited is in Icoaraci, a district of Belém. There, besides the patients with Covid-19 symptoms, there were other people who needed urgent/emergency care, so the appointment took longer to happen. During the wait, the CENARIUM reporting talked to Keylleane Santos Dias, 23. She went to the UPA complaining of shortness of breath and was medicated on the spot with bronchodilators. “The doctor said it wasn’t Covid-19, but an anxiety crisis, but, even so, I will pay to have the test done, because I have been feeling this pain for a week”, she talked.

After two hours, the service took place, in the same protocol of the first UPA visited. During the consultation with the doctor, the same one who treated Keylleane, he also stated that despite the symptoms described, he did not believe it was Covid-19. After insisting that one of the symptoms was a lack of smell, the doctor then asked him to describe the symptoms in detail. In the end, the doctor assured her that there was no way it could be Covid-19, given the number of patients he had seen, and how the disease develops, even in an asymptomatic person. There was no prescription and the consultation was over.

I confess that I came to believe that azithromycin would be effective, since it is indicated for the treatment of infections by bacteria. However, nothing exempted me from getting infected”, Leandro Júnior, 55, Information Technology manager.

The procedure may have been different in the two hospital units visited, but there was something in common: the free decision of the health professional to adopt or not the protocols to identify whether the patient is infected or not.

The Municipal Health Department (Sesma) said that the care provided in UPAs and municipal hospitals respects the protocol adopted by the Ministry of Health and the World Health Organization (WHO), since the beginning of the Covid-19 pandemic. Also according to Sesma, the health professionals who perform the care were instructed to respect the safety rules for better treatment of infected patients. The department also informed that there are no records of complaints related to early treatment against Covid-19 in the Metropolitan Region of Belém.