The Impact of Public Health, Socioeconomic, and Environmental Factors on SARS-CoV-2 Infection and Mortality Rates in Peru: Exploring the Role of Obesity

Introduction: Although several factors contributed to the rates of infection and mortality of the SARS-CoV-2 pandemic, obesity seemed to have played a larger role than most within the first several months of the pandemic. In addition, both preexisting health conditions and poor environmental condi-tions seemed to have added to higher levels of infection and mortality in several regions of the country. This study aimed to explore the impact of public health, socio-economic and environmental factors on the rate of infection and mortality of SARS-CoV-2 on gender and age groups in Peru.Methods: We explored the relationships, using Pearson's correlation and stepwise linear regression, between the in-fection and mortality cases per 100,000 individuals with pub-lic health data (obesity prevalence, total number of health in-frastructure, hypertension prevalence, active smokers, tuberculosis cases freely available from the Ministry of Health of Peru), socio-economic data (health needs not met, child-hood malnutrition, access to potable water, access to chlori-nated water system from National Institute of Statistics and Informatics of Peru) and environmental data (NO2 concen-tration from the Sentinel-2 satellite) in Peru. We used con-firmed cases from the 26 department level jurisdictions from 2020, before known variants were registered within the country and focused on gender and age groups, as well as case-fatality rate.Results: Multiple linear regression models indicate obe-sity, air quality, access to chlorinated water system, and prevalence of smoking are influential factors in the distribu-tion of infection and mortality for middle-age and elderly fe-male and male groups, but prevalence of TB and health needs not met were more important for children and young adults in Peru. Case-fatality rate was weakly associated with NO2 concentration.Conclusions: Obesity, exposure to poor air quality, and so-cio-economic conditions are significant factors in the morality of individuals above the age of 40 for both men and women, while other health factors appear to be more important to those younger than 40. The combination of these factors played a significant role during the first wave of SARS-CoV-2 infection in Peru in 2020.

¡Agile Marketing! Trends in promotion and commercialization in social networks

Given the great technological gap driven by COVID-19, it is intended to analyze and explain the synergy between technology and marketing, through the implementation by the use of social networks. Where the application of fundamental digital tools is necesary in the creation of a content marketing plan and social media structures, as well as in digital positioning processes. Investigating marketing and the rise of technological transformation mainly driven by the use of social media. As defined by Philip Kotler et al. (2020) "the situation in which we are living not only changed the lifestyles of humanity, but also the way in which the marketing of content, data, and the marketing and positioning processes is handled.” © 2022, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.

Socio-emotional competencies and social support in Peruvian university students: post-COVID-19 educational context

Objective: To determine the relationship between social support and socioemotional competencies in Peruvian university students, Hermilio Valdizán National University, Huánuco-Perú, post-COVID-19 context. Methods: The work had a quantitative approach of correlational type with cross-section 353 male and female students randomly selected from different faculties of the Hermilio Valdizán National University, Huánuco-Perú, 2022 participated and responded to two self-report type scales, one of social, family, and friend support and another of socio-emotional competencies. Correlation analysis was performed using Spearman's Rho non-parametric statistical test. Results: 84.1% of the students presented a medium level of socio-emotional skills;in the same way, 52.1% perceived social support as medium level. The positive correlation between perceived social support and socio-emotional competence was moderate, with p≤0.000, and the dimensions of social support, such as family and friend support, also showed a positive and significant correlation, all with p≤0.000. Conclusions: The social support that young university students have is modestly related to the development of the socio-emotional competence under study. © 2023, Editorial Ciencias Medicas. All rights reserved.

A Macroeconomic Model of Healthcare Saturation, Inequality and the Output–Pandemia Trade-off

COVID-19 became a global health emergency because it threatened the collapse of health systems as demand for health goods and services and their relative prices surged. Governments responded with lockdowns and transfers. Empirical evidence shows that lockdowns and healthcare saturation contribute to explain the cross-country variation in GDP drops even after controlling for COVID-19 cases and mortality. We explain this output–pandemia trade-off as resulting from a shock to subsistence health demand that increases with capital utilization and economic activity in a model with entrepreneurs and workers. The health system saturates as the gap between supply and subsistence narrows, which worsens consumption and income inequality. An externality distorts utilization, because firms do not internalize that lower utilization reduces healthcare saturation. Lockdowns and transfers to workers are the optimal policy response. Quantitatively, strict lockdowns and large transfers yield sizable welfare gains because they neutralize the utilization externality and prevent a sharp rise in inequality. Welfare and output costs vary in response to small parameter changes or deviations from optimal policies. Weak lockdowns coupled with weak transfers programs are the worst alternative and yet are in line with what several emerging and least developed countries implemented.

Multiplatform Mobile Applications for the Promotion of Physical Activity in times of Covid-19: A Case Study at Trujillo City

The lack of a mobile application for the promotion of physical activity of people in the city of Trujillo, has not allowed to improve their physical and mental health, resulting in sedentary lifestyle and diseases caused by overweight and obesity. The objective of this research seeks to promote physical activity of people in Trujillo, through the use of a multiplatform mobile application. For this, a multiplatform mobile application was developed using the Mobile-D methodology, a control group (Gc) and an experimental group (Ge) were used, the hypotheses were validated through Student’s t test. Finally, the results showed significant improvements in Ge with respect to Gc in the indicators of time physical activity/day, physical activity/week, number of exercises practiced and time without exercising/day. © 2021, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.

Development of decree 1072 of 2015, as a regulatory factor of practices in the construction field for the prevention of workplace accidents with MHF Construark SAS, carried out during the year 2020 in Bogota

Introduction: This article "Development of Decree 1072 of 2015, as a regulatory factor of practices in the construction field for the prevention of workplace accidents with MHF Construark SAS" was executed during 2020 in Bogota. Background: There has been recurring practices in the construction sector that generate difficulties in the implementation of the SGSST, which may be the main cause of this insufficient implementation, which can lead to workplace accidents and occupational diseases. Objective: The objective of the investigation is to establish the level of compliance in the implementation of the SGSST, in order to identify determining factors that negatively affect such a process. Methods: This research resulted in the design of a study with a predominantly qualitative approach. Interviews were conducted with company representatives from the administrative area in charge of implementing the SGSST. Results: The MHF Company has achieved an implementation level of 85%;a high level. Conclusion: This project contributes to the research in terms of the study of SGSST in particular, from a perspective that queries factors related to the role of key factors such as senior management and construction personnel. Originality: A small business of the construction field is investigated, setting up human factors in the SGSST implementation processes and the improvement strategy. Limitations: Information gathering on-site was affected due to the circumstances generated by COVID-19 due to the fact that the construction field was forced to suspend work as consequence of the pandemic.

Advanced atrio-ventricular block in patients with active covid-19 infection

Introduction: Cardiac arrhythmia is a frequent complication of COVID-19, However, there are currently only a few case reports of advanced atrioventricular block (AVB). Hypothesis: We sought to describe a case series of AVB as a complication of COVID-19. Methods: We included a series of ten (10) consecutive patients with confirmed COVID-19, who developed advanced AVB in a prospective observational multi-center study. Patients underwent clinical, laboratory evaluation, Holter, telemetry, Echocardiogram, Chest X-Ray, chest CT scan and cardiac MRI. Results: Of the ten (10) patients, 5 were female (50%) with a mean age of 62,7 +-11,5 years. Eight (8) developed complete AVB, one a 3:1 AVB and one 2:1 AVB. None of the patients had a history of cardiac arrhythmia AVB was not related to medication or intubation. Six patients developed AVB during their hospitalization for COVID-19 and 4 after the first month as a late sequela. Four patients were asymptomatic, one presented syncope, two dyspnea and two dizziness. Six patients presented reverse AVB early by a high dose of corticosteroid in six and colchicine in 3 cases, with no recurrent episodes.Four patients required a permanent pacemaker for persistent conduction defect. Conclusions: Advanced AVB could be a complication of COVID-19. The conduction disturbance was reversed by corticosteroids with or without colchicine in six of ten cases The resolution with corticosteroids of the advanced AVB in these patients could reflect the transient nature of the viral infection and the inflammatory response associated with it in some patients. Four patients required a pacemaker. Physicians should be aware of this complication.

COVID-19 virus behavior simulation model: Case of study Bogota, Colombia

Objetive The purpose of this article is to present a prediction on the epidemiological behavior of the COVID-19 virus for the city of Bogota, Colombia and determine the possible incidence of the different restriction measures. Material and Methods: a dynamic model based on state information was built for all the analysis variables in the framework of a SEIR model. Results and Conclusions: it was determined that the incidence of effective isolation measures significantly affects the behavior of the disease. Results are presented for two different scenarios, with their respective sensitivity analysis using the Monte Carlo method. It is concluded that it is necessary to increase testing and reduce the time needed to get the results. It is also crucial to generate and deploy social policies that make the fulfilment of an effective quarantine possible. Finally, the restrictions of the model for decision-making in terms of public policy are shown.

sars-CoV-2 vaccines efficacy in Mexico and the World

The current phase of the pandemic in different regions of the world is complex, a high community transmission of variants adapted to infect more susceptible people, combined with the increasing availability of different vaccines against covid-19, leads to the need to review basic aspects of the vaccines such as their efficacy, dosage and main side effects, among other aspects of interest. It is also important to contrast the covid-19 vaccines currently in use. In this review, an intentional search was carried out by type of vaccine applied and manufacturing laboratory in Mexico. Clinical trials and different secondary sources in PubMed and academic search engines were selected. The primary search variable was vaccine efficacy and its safety profile;secondary variables were viral platforms, dose and site of application. At the time of searching for this information, there were 287 vaccines against covid-19 in development, five different vaccines had been licensed in our country;one based on mrna technology (Pfizer), four based on viral vectors (AstraZeneca, CanSino, Sputnik V, Jennsen) and one based on inactivated virus (Sinovac). With the exception of CanSino which efficacy data are not available, the performance in the other licensed vaccines offers an excellent safety profile and protection against covid- 19. Efforts to improve vaccination coverage in the Mexican population should be reinforced.

HEPARIN-INDUCED RENAL TUBULAR ACIDOSIS MASQUERADING AS HYPERKALEMIA IN A PATIENT WITH SARS-COV-2

TOPIC: Critical Care TYPE: Medical Student/Resident Case Reports INTRODUCTION: Renal tubular acidosis (RTA) is defined as inadequate excretion of acids via the kidneys to maintain the acid-base balance. In RTA type 4, there is either deficiency or resistance to aldosterone leading to impaired regulation of electrolytes and hydrogen ions. This leads to hyponatremia, hyperkalemia, and acidemia. We present an unsuspecting etiology to RTA type 4 in a critically ill. SARS-CoV-2 patient as noted by heparin use for VTE prophylaxis. [1,2] CASE PRESENTATION: A 72-year-old male with history of chronic kidney disease, leukemia in remission presents with 6-day history of flu-like symptoms including intermittent diarrhea, fevers, decreased appetite, shortness of breath and generalized malaise with exposure to several known sick contacts with SARS-CoV-2. The patient was admitted to the ICU for acute hypoxic respiratory failure and started on Decadron, Remdesivir, Azithromycin, Ceftriaxone, Lovenox, Zinc, and vitamin C and subsequently intubated on day 10. Creatinine up trended and peaked at 3.51 mg/dL on hospital day 14. He developed hyperkalemia initially presumed to be secondary to acute kidney injury. His platelet counts declined by >50%, >10 days after hospitalization. Due to concern for HIT, argatroban was started but stopped due to bleeding. As fondaparinux is contraindicated in renal failure, he was restarted on heparin when HIT ab (-) result was obtained. Serum potassium peaked at 6.7 mmol/L on day 21. He was treated with calcium gluconate, insulin D50, Patiromer 8.4 g with no significant improvement in potassium levels. Due to concerns that use of heparin may be causing hyperkalemia by suppressing aldosterone, heparin was discontinued. Subsequently, serum potassium levels improved to normal range. DISCUSSION: In RTA type 4, either low levels of aldosterone or from kidneys not responding to aldosterone, impaired sodium reabsorption and potassium secretion occurs.[2]. Persistent hyperkalemia in whom there is no apparent cause such as potassium supplements or a potassium-sparing diuretic or renal failure, hypoaldosteronism must be considered [3-5].In COVID-19, there exists a higher propensity for thromboembolic disease and often prevention with heparin can serve as the best treatment. Heparin has a direct toxic impact on the adrenal zona glomerulosa cells, which may be facilitated by a drop in the number and affinity of adrenal angiotensin II receptors [4,6]. This reduction in aldosterone can lead to severe hyperkalemia [6]. CONCLUSIONS: This case is unique because hyperkalemia was noted to be refractory to the typical standard treatment given the etiology was hypoaldosteronism likely secondary to heparin use. Most patients with RTA if treated adequately in the early stages do not develop permanent kidney failure, have better mortality and morbidity outcomes and necessitate a broad etiologic differential. REFERENCE #1: Rodríguez Soriano J. Renal tubular acidosis: the clinical entity. J Am Soc Nephrol 2002;13:2160. REFERENCE #2: Renal Tubular Acidosis. www.kidney.niddk.nih.gov.U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. National Institutes of Health, NIH Publication No. 09–4696, October 2008. REFERENCE #3: DeFronzo RA. Hyperkalemia and hyporeninemic hypoaldosteronism. Kidney Int 1980;17:118. DISCLOSURES: No relevant relationships by Vidya Baleguli, source=Web Response No relevant relationships by Martin Herrera, source=Web Response No relevant relationships by Riaz Mahmood, source=Web Response No relevant relationships by Erine Raybon-Rojas, source=Web Response

A macroeconomic model of healthcare saturation, inequality and the output-pandemia tradeoff

COVID-19 became a global health emergency when it threatened the catastrophic collapse of health systems as demand for health goods and services and their relative prices surged. Governments responded with lockdowns and increases in transfers. Empirical evidence shows that lockdowns and healthcare saturation contribute to explain the cross-country variation in GDP drops even after controlling for COVID-19 cases and mortality. We explain this output-pandemia tradeoff as resulting from a shock to subsistence health demand that is larger at higher capital utilization in a model with entrepreneurs and workers. The health system moves closer to saturation as the gap between supply and subsistence narrows, which worsens consumption and income inequality. An externality distorts utilization, because firms do not internalize that lower utilization relaxes healthcare saturation. The optimal policy response includes lockdowns and transfers to workers. Quantitatively, strict lockdowns and large transfer hikes can be optimal and yield sizable welfare gains because they prevent a sharp rise in inequality. Welfare and output costs vary in response to small parameter changes or deviations from optimal policies. Weak lockdowns coupled with weak transfers programs are the worst alternative and yet are in line with what several emerging and least developed countries have implemented.

DEVELOPMENT AND VALIDATION OF SCALE RESILIENT COVERAGE AND FUTURE EXPECTATIONS IN UNIVERSITY OF HUANUCO IN TIMES OF COVID-19

The objective of the study was to build and validate a scale of resilient coping and another of expectations for the future in times of COVID-19. The research was cross-sectional and instrumental. By means of an intentional non-probabilistic sampling, a sample of 200 students from the National University Hermilio Valdizan de Huanuco-Peru, period 2020 was made. The results show that through the content validation carried out by six experts and nine expert judges, preliminary scales of both resilient coping with 43 items and future expectations with 28 items were obtained. On the other hand, through quantitative validation, regarding the confirmatory factor analysis, it showed that the model had acceptable goodness and fit indices for the resilient coping scale and regular for the scale of future expectations. The total internal consistency using cronbach's alpha for the resilient coping scale was 0.94 and for the future expectations scale, 0.83. It is concluded that the resilient coping scales and future expectations for university students, adapted to the context of the COVID-19 crisis, is valid and reliable.

A case of meningococcal purpura fulminans presenting as acute hypoxic respiratory failure during the COVID-19 pandemic: A case report

Purpura fulminans is a rare condition characterized by disseminated intravascular coagulation (DIC) with tissue thrombosis and skin necrosis occurring in approximately 10-20% of patients with meningococcemia. Diagnosis and management can be challenging given the infrequency of this clinical presentation. We present a case of Neisseria meningitides associated purpura fulminans that initially presented as acute hypoxic respiratory failure suspected to be secondary to Coronavirus Disease 2019 (COVID-19). A 55-year-old male with past medical history of hypertension presented to the emergency room after being tested for COVID-19 with fever, cough, and generalized weakness. At time of initial presentation, the patient was tachycardic and mildly febrile. Initial laboratory studies noted white blood cell count 2.5, platelets 127, lactate 2.3, potassium 3.3, and total bilirubin 1.7. Initial electrocardiogram and chest x-ray were unremarkable. Given suspicion for COVID-19, he was started on intravenous fluids, antibiotics, and admitted for further monitoring. Four hours later, he became persistently febrile, tachypneic, and hypoxic. Upon transfer to the Intensive Care Unit, a CTA pulmonary was obtained which showed dependent lung densities consistent with atelectasis. Repeat laboratory studies noted lactate 8.7, fibrinogen 131, ferritin 936, d-dimer > 4, procalcitonin > 40, and an upward trend in PT/INR. Ultimately, the patient was intubated for respiratory muscle fatigue. Post-intubation, he remained hypotensive and vasopressors were initiated. Later that afternoon, his COVID-19 test resulted as negative. During evening rounds, the patient developed significant bleeding from his oropharynx. Repeat investigation revealed platelet count 20, fibrinogen < 94, PT 26.8, and INR 2.37. He was transfused with fresh frozen plasma and cryoprecipitate. Admission blood cultures then grew gram-negative rods which speciated Neisseria meningitidis bacteria. Over the next few days, he developed significant skin necrosis. Plastic surgery was consulted and recommended transfer to a burn center. At the outside facility, given the extent of necrosis, the decision was made to pursue amputation. Subsequently, the patient underwent bilateral guillotine disarticulation of the wrists and bilateral below the knee amputations. In patients with DIC, sepsis, and an evolving skin rash, clinicians should have a high index of suspicion for purpura fulminans. Although initial presentations begin with small areas of petechiae or purpura, the onset of skin necrosis is swift. Delays in initiation of broad-spectrum antibiotic therapy place patients at an increased risk of mortality and limb loss. In this case, early diagnosis proved challenging given the patient's non-specific presenting symptoms in the absence of clinical evidence of meningitis.

Environmental Nanoparticles, SARS-CoV-2 Brain Involvement, and Potential Acceleration of Alzheimer's and Parkinson's Diseases in Young Urbanites Exposed to Air Pollution

Alzheimer's and Parkinson's diseases (AD, PD) have a pediatric and young adult onset in Metropolitan Mexico City (MMC). The SARS-CoV-2 neurotropic RNA virus is triggering neurological complications and deep concern regarding acceleration of neuroinflammatory and neurodegenerative processes already in progress. This review, based on our MMC experience, will discuss two major issues: 1) why residents chronically exposed to air pollution are likely to be more susceptible to SARS-CoV-2 systemic and brain effects and 2) why young people with AD and PD already in progress will accelerate neurodegenerative processes. Secondary mental consequences of social distancing and isolation, fear, financial insecurity, violence, poor health support, and lack of understanding of the complex crisis are expected in MMC residents infected or free of SARS-CoV-2. MMC residents with pre-SARS-CoV-2 accumulation of misfolded proteins diagnostic of AD and PD and metal-rich, magnetic nanoparticles damaging key neural organelles are an ideal host for neurotropic SARS-CoV-2 RNA virus invading the body through the same portals damaged by nanoparticles: nasal olfactory epithelium, the gastrointestinal tract, and the alveolar-capillary portal. We urgently need MMC multicenter retrospective-prospective neurological and psychiatric population follow-up and intervention strategies in place in case of acceleration of neurodegenerative processes, increased risk of suicide, and mental disease worsening. Identification of vulnerable populations and continuous effort to lower air pollution ought to be critical steps. © 2021 The authors and IOS Press. All rights reserved.

Adapting a picu to the first COVID-19 pandemic wave

AIMS & OBJECTIVES: the COVID-19 pandemic has posed an unprecedented challenge for adult ICUs. With children relatively spared from the disease, pediatric intensive care resources have provided invaluable support. We describe the interventions carried out in a PICU and hypothesize they will be useful in the next pandemic wave. METHODS: description of interventions in a tertiary center PICU with 3036 COVID-19 patients admitted (283 to ICU) and 648 deaths until May 30th. RESULTS: interventions during the pandemic focused on: 1) protecting patients and healthcare workers within the PICU: open windows, rational PPE use and SARSCoV-2 testing, safety simulation-training (donning-doffing, video-assisted orotracheal intubation, bronchoalveolar lavage, communication in protected code blue), service rearrangement and teleworking to reduce exposure, differentiation of COVID-19 and COVID-19-free areas and limitation of aerosol-generating practices;2) allocation of the PICU medical team (18 attendings, 9 residents) in three different areas working in collaboration with adult intensivists and anesthesiologists: 6 attendings deployed to the adult ICU full time, 12 attendings worked in fixed teams and covered a 16-bed COVID-19 PICU (12 adult, 4 pediatric beds) and a 9-bed reanimation unit with non-COVID-19 critically ill children. Elective surgeries were canceled but emergency surgeries and transplants were performed. One full-time visitor per children was allowed. Table 1 shows relevant characteristics of patients admitted in this period. No-one from the medical team and 6/78 nurses resulted infected, all asymptomatic. CONCLUSIONS: although the first pandemic wave has impacted PICUs worldwide, an anticipated and multicomponent adaptive strategy may help optimize patient care and reduce healthcare worker infection rates.

Collateral damages of #stayhome

AIMS & OBJECTIVES: During the COVID-19 pandemic lots of campaigns on social media have been designed to encourage people to stay at home in order to reduce the incidence of new infections. The aim of this study is to describe a case of diagnostic delay of a severe illness due to fear of viral transmission when visiting a healthcare facility during the COVID-19 pandemic. METHODS: SETTING: A pediatric intensive care unit in a tertiary hospital in Madrid, Spain. DESIGN: a descriptive case report. RESULTS: We describe a case of an 8-year-old child who visited his healthcare primary clinic with headache, fever, cough and trouble breathing during the COVID-19 pandemic. He tested negative for SARS-CoV-2 and was discharged with symptomatic treatment. In spite of the medical recommendation to visit the hospital for progressive worsening of his breathing difficulty and weight loss, he remained home in fear of coronavirus transmission. After 5 weeks he was finally taken to the hospital for significant shortness of breath. Upon admission he presented thoracic asymmetry, dyspnea, tripod position, hypoventilation, and decreased oxygen saturation with cyanosis in supine position, requiring non-invasive ventilation. Both the chest X-ray and CT scan showed a large mediastinal mass with trachea and bronchial compression (Fig 1 and 2). The anatomopathological definitive diagnosis was a T-cell lymphoblastic lymphoma. CONCLUSIONS: The importance of encouraging home confinement during the COVID-19 pandemic is without doubt. However, it is equally vital to recommend seeking for medical advice in case of warning symptoms, since delayed diagnosis may result in life-threating situations.

Low rate of SARS-CoV-2 infection in picu workers caring for COVID-19 adults and children

AIMS & OBJECTIVES: To evaluate the risk of SARSCoV-2 infection in health care workers (HCW) in a Pediatric Intensive Care Unit (PICU) forced to attend adult patients during COVID-19 pandemic. METHODS: A retrospective observational study was conducted in a Spanish tertiary care hospital from March to May 2020. SARS-CoV-2 serology tests were performed to all HCW. The PICU attended COVID-19 adult patients between March 19th and April 24th of 2020. Safety preventive measures taken in the PICU and characteristics of the infected HCW were analyzed. RESULTS: A total of 105 HCW worked in the PICU during COVID-19 pandemic: 78 nurses or nurse assistants and 27 physicians. Serology tests resulted positive in 6 out of 105 (5.7%) PICU HCW versus 1224 out of 8384 (14.6%) hospital HCW (χ2 6.7;p=0.009). The characteristics of the 6 infected PICU HCW were the following: 5 females;median age: 36.5 years (ÎQR: 29.5-41);position: 1 nurse assistant and 5 nurses;4 were symptomatic and 4 had a positive/symptomatic co-habitant. Safety preventive measures, such as ventilation of shared spaces, compulsory surgical mask wearing, restriction of visits, and training on the use of personal protective equipment (PPE), were taken earlier in the PICU than in the rest of the hospital (from February 26th, 1 week earlier). Likewise lack of PPE, documented in other hospital units, was not a problem in the PICU. CONCLUSIONS: HCW were less frequently infected in the PICU than in the rest of the hospital, likely resulting from implementing early safety preventive measures and adequate availability of PPE.

COVID-19 pandemic: A paradigm shift in the West?

In this article, we develop evidence-based recommendations to efficiently administer the limited resources of the healthcare facilities in medium and low income countries in the context of a pandemic. We searched MedLine database using the MeSH terms “Pneumonia, viral/prevention and control”, “Pneumonia, viral/transmission”, “Coronavirus Infections/prevention and control”, “Coronavirus Infections/transmission”, “COVID-19”, “Masks/classification”, “Masks/microbiology”, “Respiratory Protective Devices”, among others. We recommend that the general population wears a face mask. On the institutional level, ventilation and appropriate bed distancing proved to be effective preventive measures. The most important factor in the containment of an outbreak is the timely identification of infected patients. Negative pressure and ventilation systems are also highly recommended. Using a full face mask together with a surgical mask might be an option to deal with N95 respirators shortage. We present an integral strategy with coping measures for healthcare institutions and the society in general. © 2020 Sociedad de Anestesiologia de Chile. All rights reserved.