Before COVID-19 reached Colombia and the World Health Organization (WHO) declared the pandemic, in Antioquia we were already strengthening our capacity to face it. Seeing the experiences in other countries, we took this threat seriously from the onset. Our departmental government declared a health emergency and public disaster to provide better tools to tackle the situation and we created a first-level management structure (pioneer in Colombia), led by a professional with proven experience over a long career and the necessary social sensitivity and organizational ability to coordinate staff, with a clear mandate to protect life.
We made difficult political decisions. In Colombia, the first lockdowns were ordered and protocols such as the use of face masks were implemented before WHO recommended them. The pandemic showed us that we needed to be united, so we invited citizens to do physical distancing and change their habits, but to stay united. Our premise was that together we are more powerful than the disease. By caring for ourselves, we care for others.
We quickly understood that the priority was to ensure health system capacities and increase the number of intensive care units. With the support of the national government and the private business sector, we managed to go from 480 intensive care beds to 1 474. This 308% increase required an investment of US$ 26 million from the public sector and US$ 10 million from the private sector.
There were many expressions of solidarity and we advanced in processes of unity, but this has not been enough. We still have social debts, such as imbalances in vaccination: while 60% of the world's population has received at least one dose of vaccine, only 10% of people in low-income countries have received a dose. The pandemic has clearly been a wake-up call: the world has many gaps to close.
On the positive side, science has played a key role. We were aware of its importance in everyday life, and the dedication of scientists to developing a vaccine and producing scientific data helped us in the most complex periods. More global resources will need to be devoted to scientific research and to the development of technologies that allow us to inhabit the planet in more intelligent and balanced ways. Technological tools were fundamental in offsetting physical distance: web platforms, public radio, and television, among other media, were helpful vehicles for information, education, and companionship, offering meeting places and social movement.
But while science and technology made important contributions, they also revealed risks in terms of how information is handled, threats to privacy, and opportunities for social control and manipulation. The ethical challenge today is to ensure connectivity without invading private spheres, while managing information in a transparent manner.
There are many challenges, and technology has gradually allowed a certain balance between development in urban areas and outside cities. For more than five thousand years, since social agglomerations in cities began, great advances have been made on all fronts, but development has concentrated on urbanization that has transformed villages inhabited by dozens of people into metropolitan areas that are home to millions. The pandemic and the challenges of climate change are two major forces that will help balance development in urban and non-urban areas, moderating the frenzy of crowding.
It is too early to talk about a trend towards deurbanization, but the speed of urbanization has slowed for the first time, and it will continue to do so. The pandemic has given us a warning. It is an alarm we need to heed if we are to correct our course and steer toward the equitable protection of life.
All articles from this supplement are available free of charge and in full text in English in the American Journal of Public Health and Spanish in the Revista Panamericana de Salud Pública.