‘Portugal has to make an effort in the definition of search’
Portugal was this week the first European country to pass the Universal Health and Preparedness Review test, a new mechanism by the World Health Organization to assess preparedness for health emergencies. The results will be taken to the World Health Assembly at the end of the month. At the end of the work, Stella Chungong, director for Health Security at the WHO, highlighted positive lessons, but warned that covid-19 showed the country’s human resources. Rui Portugal, Deputy Director-General for Health, at the DGS since the summer of 2020, led the work at the national level.
How did Portugal fare?
There were questions that were much appreciated, others that are much needed. On the one hand, there was a set of exercises in which we brought together partners and were tested for a situation, in this case dengue outbreaks. We saw that there are partners to articulate, coordinate communication and sometimes identify those who can provide the best response, something we can work on. There were then regional visits and the WHO team also had the opportunity to have an interview with the Minister of Health and to pay a visit to the parliamentary health committee – and therefore to see the level of political commitment that exists in Portugal in this area and I think that best. For now, two or three lessons learned from this experience, on the one hand, things are being: A very strong digital leap was recognized, both in public health and in the management of hospital beds and especially in the solutions created in the service of the SNS24. On the other hand, the WHO team reinforced the advantage of having public health organized in terms of health authority for over 100 years. We have a proximity network, which is where problems are solved.
On the public health side we often hear complaints about staff shortages.
The human resources problem was clearly identified and at different levels. On the one hand, professional for its solution, on the other hand, because of the difficulty of hiring in areas that may be relevant in the response, in addition to doctors and nurses. Another area in which there is an effort to be made is in the information systems, so that it can always be the relevant information for epidemiological surveillance, whether to work.
Can you give an example?
We have national and regional data but we do not have data by social condition.
Don’t you realize how much poorer the population was by the pandemic?
It is not because of the pandemic, for pandemics, etc. Another area that was recognized in Portugal is the definition of an investment situation, but not only when there is an emergency with a health investment situation. Does it make sense to have so many priority health programs? Knowing that we have no resources available, each of them will have more resources. The need to have more delineated and focused budgets for each type of response, by area of intervention and not diluted budgets was also addressed – and to have these budgets reinforced, namely in the area of public health. By the way, they realize that the training and capacity of our resources are very good – for good measure I always said yes, but that one of the conditions of this visit was that they didn’t come here to recruit them (laughs).
During the pandemic, the DGS itself lost staff abroad. Can’t keep them?
Not specifically focused but it is true the direct that was direct on the part of the State, whose independence is not equivalent to public companies and company. It does not have, in many aspects, competition from other organizations and this will certainly be improved because it has to be, not only in the DGS but in other public health departments. It should be noted that one of the WHO perspectives that was discussed is the need for articulation of all ministries and to solve the challenges with partnerships. Having the first country evaluated will now give us exposure and it will be important to imagine a European level or what will be done to contribute to these reinforcements that are also pointed out as. It’s not just about learning for Portugal, it’s something bidirectional.
Do you believe that this work will have consequences, that the country is better prepared?
It is important that the memory stays and for sure there is still a lot of evaluation to be done. This is one of many. What is interesting about this one is that it was made by an international entity. Now we have to be cautious: we are in a pilot project, so not all instruments are consolidated yet. And being the first in Europe, there aren’t many comparative elements. But it was a good start and the truth is that we were available. We will be able to share this experience and even others in this type of review.
Is that the responsibility of what doesn’t give also fall into rot bags?
Also. And at the same time, as we are collaborators from other countries, we will learn more.
Covid-19 cases are on the rise again. Were you waiting?
After the game everyone knows the result. How little known is the epidemic, and now, of course, what is known as protection in a public health upsurge. The question can be put in another way: why did we hang out with so many times when we stayed the same? I think what we should withdraw is that we know that we still have a level of transmission and that measures are taken. Portuguese society must be able to adapt to risk at each stage.
Was it too early to end free trials?
At the moment we have a very targeted test for those who have symptoms, who can call the SNS24. that people are not a test, there are many asymptomatic people and they are recognized in such a large phase of transmission. What matters to each individual perceived is that if you are going to be with someone who is vulnerable, you can always do it, so that it is not a risk.
Finishing the free tests won’t pass the message?
I don’t believe it, what is believed to be the greatest responsibility and a major is to say that you know that in spring / the transmissibility of the year is lower than at other times. It’s a matter of choosing resources from more or less countries at each stage, how others made them like their cultures, and looking at each other. There is a decision of these decisions that is scientifically based and others that are based on all these factors. Political power always has its say, in Portugal and in any other country in Europe.
It was discussed whether the DGS would have been disallowed with the end of masks.
I don’t see it that way, there’s a set of places where masks remain recommended. The measures are taken according to the evaluation that is made at each moment. And we can forget that there is fatigue in relation to the pandemic and how measures have to take this into account.
In Australia there are already calls for the return of the mask this winter. Really event?
It cannot be thought that in very risky epidemiological situations we will not wear a mask again. We will have to learn, possibly with other countries that have been doing it for many years, and decide.
Recognized for the jams. What memories do you have these December 020 days?
Ask people who were infected this Christmas for higher risk behavior. And to the people who spared themselves for greater care. That’s all for people, it’s every one who counts, it’s not the method of communication.