La oficina de los Centros para el Control y la Prevención de Enfermedades (CDC, por sus siglas en inglés) en la Embajada de los Estados Unidos en Santo Domingo ha cooperado con varias agencias del Gobierno dominicano desde el inicio de la pandemia del COVID-19 para apoyar el sistema de salud pública y la respuesta ante la crisis sanitaria. Desde abril del 2020, la doctora Carmen Figueroa, epidemióloga de los CDC asignada a la Embajada de los Estados Unidos, apoyó de manera presencial la respuesta del Gobierno dominicano desde el Centro de Operaciones de Emergencias (COE).

Desde el inicio de la pandemia, el COE fue responsable de coordinar la preparación y respuesta desarrollando varios planes de contingencia y acción, en los cuales la doctora Figueroa participó como representante de la Embajada de los Estados Unidos. 

Estos planes y protocolos se enfocaron en acciones preventivas,coordinación del manejo de recursos y traslados de pacientes de COVID-19. Cuando aumentaron los casos en provincias como Duarte, Puerto Plata y Santiago, la respuesta a emergencias liderada por el COE sirvió para mejorar la coordinación entre distintas entidades y optimizar la respuesta a la crisis. 

Por ejemplo, cuando la Policía Nacional, las alcaldías, el Instituto Nacional de Aguas Potables y Alcantarillados (INAPA) y otras instituciones colaboraron en la limpieza y desinfección de áreas extensas, el COE los ayudó a planificar y dirigir todas las acciones de coordinación entre las distintas instituciones hacia el Sistema Nacional de Prevención, Mitigación y Respuesta Ante Desastres.  “Esta coordinación permitió evitar muchas duplicidades, sobre todo al principio, porque en muchas entidades había una preocupación por la saturación de los sistemas de salud, entonces el rol de cada entidad era importante”, aseguró Figueroa. En este proceso de coordinación también participaron el sector privado, sociedades científicas y entidades comunitarias. 

Uno de los roles principales del COE fue la coordinación de traslado de pacientes. A inicios de la pandemia, el COE se destacó por su nivel de preparación y tuvo un liderazgo muy importante en el traslado de los  primeros pacientes  y en el entrenamiento del personal para que tomaran las medidas de protección correctas. “Al principio, entre ellos y los trabajadores de la salud que entrenaron para el traslado de pacientes, no hubo prácticamente casos, y si hubo fueron muy pocos, por la calidad de los entrenamientos y la protección”, aseguró Figueroa. La Embajada de los Estados Unidos también apoyó estos esfuerzos con la donación de trajes y equipos de protección avanzada. 

Estandarizar y centralizar la coordinación de los traslados fue clave para la respuesta inicial y el manejo de pacientes de COVID-19”, indicó Figueroa. “Era necesario transferir a los pacientes a centros autorizados en la menor cantidad de tiempo posible, considerando la distancia, la gravedad de la enfermedad y la capacidad del centro, lo cual requería un alto nivel de coordinación con los servicios privados y los centros que estaban recibiendo casos de COVID-19 a nivel nacional. Los CDC proveyeron asistencia técnica para mejorar y fortalecer los sistemas de monitoreo y una base de datos segura para el seguimiento, la clasificación y la ubicación de los pacientes. Trabajar en estrecha colaboración con conductores, paramédicos, médicos y enfermeras fue clave para obtener una mejor comprensión del proceso y contextualizar nuestro apoyo de acuerdo a sus necesidades”.

La rápida y cercana colaboración que ocurrió entre los expertos de los Estados Unidos y la República Dominicana en los primeros meses de la pandemia fue posible gracias a los lazos que ya existían, fortalecidos por el trabajo conjunto a lo largo de muchos años en temas como la lucha contra el VIH, el dengue y la chikungunya.

Historia de cooperación entre los Estados Unidos y el COE

Diversas agencias del Gobierno de los Estados Unidos, como los CDC, el Departamento de Defensa (DOD) y la Agencia de los EE. UU. para el Desarrollo Internacional (USAID) han apoyado al COE en diversas áreas por muchos años. 

Durante la pandemia, el DOD ha contribuido con equipos de protección personal (EPP) valorados en más de  US$225 mil, que han apoyado el trabajo del centro  en diversas provincias, como San Cristóbal, La Altagracia, La Vega, Monte Plata, Santiago, Santo Domingo, entre otras. El apoyo a la respuesta contra el COVID-19 también ha incluidola donación de dos hospitales móviles con cuatro ventiladores cada uno en el 2020, valorados en más de un millón de dólares, así como tres adicionales que fueron anunciados en la reciente visita del comandante del Comando Sur, el almirante Craig Faller, el pasado mes de abril, valorados en US$2.8 millones. 

La cooperación a nivel general en los últimos diez años también incluye cuatro centros de operaciones móviles valorados en un millón de dólares, de los cuales se anunciaron dos en la reciente visita del almirante Faller, equipos para la generación y provisión de electricidad y equipos para respuestas a emergencias. Además, la cooperación ha incluido entrenamientos y ejercicios conjuntos, con el fin de asegurar un alto nivel de preparación ante distintos tipos de desastres. El valor de los proyectos realizados por el Departamento de Defensa en apoyo al COE desde el 2012 supera los US$2 millones, mientras que  próximas donaciones sobrepasan los US$5 millones. 

Otra institución clave en el apoyo del Gobierno de los Estados Unidos al Centro de Operaciones de Emergencias ha sido la Agencia de los EE. UU. para el Desarrollo Internacional (USAID). Dos ejemplos importantes de sus aportes en los últimos diez años son la donación de RD$1.6 millones, mediante un memorando de entendimiento, para la formación de un equipo de rescate y búsqueda en estructuras colapsadas; y el auspicio de la aplicación móvil AlertaCOE, que permite que las alertas emitidas por el COE sean recibidas por los usuarios de teléfonos inteligentes. Hasta la fecha, la aplicación cuenta con más de 10,000 descargas. 

Durante la pandemia del COVID-19 el apoyo de la USAID incluye  la donación de materiales de bioseguridad valorados en US$30,000 a los Comités Provinciales de Prevención, Mitigación y Respuesta, compuestos por la Defensa Civil, las Gobernaciones, la Cruz Roja y diversas instituciones públicas. 

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