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LETTERS TO THE EDITOR

Comment regarding the article “New Coronavirus infections: new challenges, new legacies”

Jorge Alberto Castañón-González,^a Carlos Polanco-González^b

^aFacultad de Ciencias de la Salud, Universidad Anáhuac, Huixquilucan, Estado de México

^bFacultad de Ciencias, Universidad Nacional Autónoma de México, Distrito Federal, México

Communication with: Jorge Alberto Castañón-González

Telephone: 01 (55) 5407 0813

Email: jorgec@prodigy.net.mx

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We read the review of Cabrera-Gaytan et al. entitled "Infección del nuevo Coronavirus: nuevos retos, nuevos legados"¹ (Infection of the new Coronavirus: new challenges, new legacies”) based on notifications from epidemiological agencies (WHO, ECDC, and Eurosurveillance) about infection by this "new coronavirus," known as MERS-CoV, the acronym for Middle East Respirtory Syndrome Coronavirus, about which we have comments:

In response to constant outbreaks of serious infections starting in the airways such as with MERS-CoV, Influenza A H5N1, A H1N1, SARS, etc.,¹ and other communicable diseases with pandemic potential involving high mortality, such as the Ebola epidemic, we consider it important to emphasize that while no information is available about the epidemiology and genome of these pathogens to develop specific vaccines and treatments, it is necessary to take into account the computational and bioinformatics resources available, to be able to create drugs for these diseases that devastate society,² but, above all, to adopt a national surveillance system for serious diseases in "real time" to issue early warnings to hospitals to retrofit them so we can confront and contain the outbreak. In this sense and taking into account that the first "acute organ failure" presented by a gravely ill patient in critical state- regardless of etiology- is respiratory; we designed a computer system that issues alerts for serious infections starting in the airway according to the level of risk and based on a minimum census of Emergency Medical Services of hospitals subscribed to the network.³ This system weighs its figures relative to those occurring in the other participating hospitals according to their location based on zip codes, and aggregates the spatial-temporal distribution of cases as "cumulative sums", so that it can discriminate between a catastrophic event that has local or regional impact (flood, fire, etc.) and an outbreak of a severe respiratory infection. The system was successfully tested against the figures related to the outbreak of influenza A-H1N1 compiled by the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán for the 2008-2010 period for which a computer scenario was recreated that simulated a network of thirteen hospitals, for seven years.⁴

Experience with the recent pandemic of Influenza A H1N1 and the current Ebola epidemic in West Africa supports the need for an efficient and easy alert system in "real time" to function to address outbreaks of infectious diseases with epidemic potential; and that timely action is crucial to reduce the rate of associated consequences.⁵

References

1. Cabrera-Gaytán DA, Vargas-Valerio A, Grajales Muñiz C. Infección del nuevo Coronavirus: nuevos retos, nuevos legados. Rev Med Inst Mex Seguro Soc. 2014:52(4):438-441.
2. Polanco C, Castañón-González JA, Samaniego JL. (Letter) Clinical Course and Outcomes of Critically Ill Patients With Middle East Respiratory Syndrome Coronavirus Infection.Arabi YM, Arifi AA, Balkhy HH, Najm H, Aldawood AS, Ghabashi A, Hawa H, Alothman A, Khaldi A, Raiy B. Ann Intern Med. 2014 Jan 28. DOI: 10.7326/M13-2486.
3. Polanco C, Castañón-González JA (Letter) Drug and Vaccine Access in the Ebola Epidemic: Advising Caution in Compassionate Use. Hantel A, Olopade CO. Ann Intern Med 2014. DOI: 10.7326/M14-2002.
4. Polanco C, Castañón-González JA., Macías AE, Samaniego J L, Buhse T, Villanueva-Martínez S. Detection of Severe Respiratory Disease Epidemic Outbreaks by CUSUM-Based Overcrowd-Severe-Respiratory-Disease-Index Model. Comput Math Methods Med 2013, 213206.
5. Serna-Ojeda JC, Castañón-González JA, Macías AE, Mansilla-Olivares A, Domínguez- Cherit G, Polanco-González C. Encuesta sobre la capacidad de respuesta de los hospitales de alta especialidad ante un desastre médico: después de la Influenza pandémica en México. Gac Med Mex 2012;148:227-35.

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