Panel SA: President of Einstein sees the risk of lacking unique leadership to tackle monkeypox in the country

Brazil should take advantage of the lessons of the pandemic to deal with the arrival of smallpox from monkeys and also with other diseases that may arise in the future, according to Sidney Klajner, president of Einstein.

He sees the risk of lacking, again, centralized leadership to pass correct information to the population. “This communication has to start before the disease arrives. When we hear about the cases [no exterior]you already need to outline a protocol”, he says.

At Einstein, in São Paulo, at the Morumbi units, advanced units and Einstein clinics, the positivity rate is 35%, with 30 positive tests out of 85 performed. In the Goiânia unit, it is 63% with 19 positives.

How do you rate the situation with monkeypox?Those organizations that are able to provide the appropriate test, the quickest diagnosis, have already started to prepare for it. We learned a lot from Covid. Learning from faster diagnosis and information for the population is essential.

Correct information based on scientific evidence is the best strategy at this time. Even to know how to contaminate, how to protect yourself, to know the confusion that skin lesions can have with other dermatological diseases and not have stigmatization.

We see several countries in which all these norms are dictated by those who actually lead health actions. And, again, what we are seeing is decentralized decision-making and attitudes. I’m not talking about who’s good, who’s not. For example, there is a mobilization in the state of São Paulo that is different from another state, which is different from the Ministry of Health.

And, again, we can make the mistake of not having a single leadership to provide the correct information.
Imagine what we went through with Covid, for lack of correct information. There, people believe in whom the eyes turn, ideologies. Today, I also don’t see a single language of what science recommends.

We reviewed all this in the last month for the release of the documentary “Portraits of a Pandemic: On the Front Line of Combating Covid-19”, [com gravações que acompanharam hospitais públicos e privados administrados pelo Einstein]which premiered on Globoplay.

As much as we are calm today with Covid, because the vaccine brought the tranquility of not killing so many people, when you see everything that happened, you have to learn from this a good lesson to deal, not only with smallpox, but with future pandemics that can happen.

How is the deadline for the exam result? Is that another problem?Einstein’s result has taken three days. How it happened: he needed to collect, have the result and send the positives to the Adolfo Lutz Institute to have the seal. His routine must also be overloaded to return, to do retest.

Thanks to the quality demonstrated in carrying out this exam, we no longer need a retest by Adolfo Lutz. Thus, the exam takes three days for the result.

This should happen in leading institutions. But what should be the degree of concern in the corners?Even to give the correct treatment, you need to have a diagnosis. Monkeypox has a mode of presentation that can raise suspicion quickly, but it has several differential diagnoses for a cutaneous appearance. So, the corners also need referral logistics for those cases that are suspected.

There are a number of cases that would allow, in the case of suspicion, to have the reference to where the exam goes to get the result. This allows not only the treatment of the patient, but the correct epidemiological control so that transmission is not stimulated. It is something that was impossible at Covid, because the degree of contamination was extremely high. Here it is not so high anymore.

This also falls under the paragraph that we have to learn from the last two years.

Is the government perhaps taking too long to provide the population with adequate information?I’ll tell you how I see it as a health professional: everything that has already contaminated almost a thousand people is already late. In fact, this communication has to start before the illness arrives.

When we hear about the cases happening [ no exterior]we already need to outline a type of protocol.

And since this knowledge already exists with other smallpox, it is very different from SARS CoV-2, in which we had no knowledge at all. But for this one it already exists, and this booklet should be ready and being made available to the population, funded by whoever should lead this type of prevention. I see that this should already be preventing.

How are statistics and information on Einstein?It’s not a huge number, but when the news of monkeypox started, the hospital infection control service that already exists here assembles a prevention group and leaves it on the website.

This is open to the public, it is the correct information, but we have a degree of penetration restricted to those who access the site, to our employees. And training for these employees also started before the disease arrived, just as it was with Covid.

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Surgeon of the digestive system and president of the Sociedade Beneficente Israelita Brasileira Albert Einstein, he has a degree, residency and master’s degree from the Faculty of Medicine of USP. He is also coordinator of the postgraduate course in coloproctology and professor of the MBA in health management at the Instituto de Ensino e Pesquisa do Einstein.