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. In this sense,
decision-making amid a major emergency, such as the one we are currently experiencing due to the COVID-19 pandemic, requires a balanced and calm judgment
that considers both the general context and local specificities, as well as the best
available scientific evidence, that is, evidence that not only supports decisions, but
also prioritizes benefits over risks.
As in other recent catastrophic events, during the COVID-19 pandemic, it has
been necessary to resort to “real-time evidence,” to consult continuously the data
emerging from observation and the results of health surveillance and interventions,
to build statistical and epidemiological models, and to compare scenarios using sensitivity analysis under different assumptions and conditions. All of this has been an
ambitious exercise to respond to this emergency with the best tools available.
In this exercise, there may be risks derived from the “biases” that are inherent
to epidemiological thinking and are viewed as a, visible or concealed, enemy to be
avoided. In our case, the objectives are primarily aimed at controlling or eliminating the transmission of SARS-CoV-2 while avoiding overburdening health systems
to mitigate the impact of the pandemic, minimize its social impact and reduce the
number of preventable deaths.