About the “critical reflections” on the Municipal Epidemiological Resilience Index

Abstract

En junio de 2021, un grupo de distinguidos académicos colombianos sometieron a su revista algunas reflexiones1 sobre el Índice de Resiliencia Epidemiológica Municipal (IREM), el cual fue propuesto por el Ministerio de Salud y Protección Social de Colombia como una herramienta para la toma de decisiones en los territorios del país respecto a la reactivación económica que se plantea en el proceso de superación de la crisis social y económica relacionada con la pandemia por COVID-19. A continuación, deseamos aportar algunos elementos analíticos e interpretativos sobre dichas reflexiones con el ánimo de enriquecer la discusión.

Reply to the letter to the editor entitled “About the ‘critical reflections’ on the Municipal Epidemiological Resilience Index”

“…We greatly appreciate the comments made by Rojas-Botero et al 1 on our paper entitled "Critical reflections on the Municipal Epidemiological Resilience Index used for public policy decision-making regarding the control of the COVID-19 pandemic in Colombia". 2 We acknowledge that public health, understood as the well-being of the community, should be the focus of all our efforts as health professionals.…”

“…2,3 Eslava-Schmalbach J, Restrepo-Henao A, Guarnizo-Herreño C, Castillo JS, Vega-Romero R, Arbeláez Reply to the letter to the editor Therefore, critical reflections should be understood as a contribution of academia to society because it seeks to bring a broader perspective to problems and a dynamic strategy that facilitates the understanding of different situations in their multiple dimensions, with its own resources and with independence, which evidently helps to make the most appropriate decisions. Thus, we appreciate the letter to the editor submitted by Rojas-Botero et al, 1 to your journal since it represents a step forward in the informed, serene and necessary debate on the management of the COVID-19 pandemic in Colombia, as well as a document that healthcare delivery planners will undoubtedly value. Accordingly, we would like to make the following observations about said publication:…”

“…First, we would like to go through the definition of "resilience index." Although Rojas-Botero et al 1 state in their letter to the editor that the definition is clear, the technical documentation of the Municipal Epidemiological Resilience Index (IREM) does not support such a statement, nor does it elaborate on the assumptions used as a basis for such a definition and does not indicate the conflicting theories that support it or the epistemological process that led to such a definition, raising doubts about its validity, as argued below. This is not intended to start a debate on a definition; however, in the face of such an initiative, it would be helpful to know what theoretical contributions are being made, because de novo definitions and theories must be based on concepts that have been established and widely discussed in the existing literature to ensure that they are built on solid foundations.…”

“…As mentioned above, Rojas-Botero et al 1 state that the definition of the construct to be measured by the IREM is clearly explained in its technical document. An excerpt from that document backs up this claim, stating that "this construct has been defined as Epidemiological Resilience, to the extent that it indicates the capacity of the territory-population dyad, as well as the dynamic process of overcoming stressors in an adaptive way while maintaining functioning."…”

“…Thus, a concept's polysemy requires a sound scientific construction that brings together and outperforms the arguments for and against it. Rojas-Botero et al 1 insist that the definition of resilience proposed in the IREM technical document is entirely valid since it does not allude to other meanings of the term, particularly those based on social and behavioral sciences and among which, according to them, there is no consensus because there are no universally accepted referents for this term and because language is dynamic and changing. We have pointed out that there are multiple indicators of resilience specific to the COVID-19 pandemic, which have already been discussed and used, contradicting the authors' claim of a lack of consensus and international references, 1 as well as their unquestionable conclusion that "the meaning proposed in this index is fully valid."…”