Irene Hartmann
03/31/2021 13:02
Clarín.com
Society
Updated 03/31/2021 1:02 PM
"I worry that it catches us tired."
In long interviews,
Gabriel Battistella -
CABA's Undersecretary of Primary Care - usually gives his most genuine impressions.
He spoke with
Clarín
about how
intensive therapies
are
to stop the second wave of coronavirus: “By vaccinating we will not have fewer cases, but less that require hospitalization and
fewer deaths
.
There is no calculated percentage.
The pandemic taught us that predictions are not always advisable.
We screwed up the estimates
”.
The question was about the half empty glass that again worries:
55.6% of the intensive care beds in the country are filled with Covid patients and not Covid
.
There are 3,639 people.
The distribution on the national map shows which systems could be “stressed” earlier, using a classic euphemism of epidemiologists.
Without going into the detail of the almost 50 localities in more than half of the provinces that these days worsened their epidemiological risk (according to the survey of the Ministry of Health), a couple of examples of "delicate" intensive therapies are Río Negro and Santa Fe, whose UTIs are already close to 70% occupancy.
Or the city of Salta, which exceeds 85%.
Doctors from an intensive care unit at a Buenos Aires hospital put on the protection elements against Covid.
Reuters photo
It is logical that the authorities seek (as in 2020) to avoid a health collapse, but from the talk with different experts for this note it is clear that
other variables
play in the new wave
, which will exert significant pressure on the hospitalization figures.
In the first place, the
fatigue
alluded to by Battistella, which undermines social strength in the face of the virus.
In addition, the
socioeconomic activity
, which today no one would cancel completely even if it multiplies the routes through which the Covid circulates.
Finally, there is the issue of the arrival of vaccines and "how they work against the new variants of coronavirus," Battistella highlighted.
City and Province of Buenos Aires
In the Buenos Aires Health portfolio they recognized that the epidemiological situation is "serious" and that
the occupation of intensive care beds "is already felt"
, but they remarked that the conditions are very different from those of 2020.
"The most important factor since the end of the first wave was having
vaccinated 100% of the health personnel
, which puts the Province in a very different situation from last year," they summarized.
Vaccination against Covid for Health personnel at the Argerich Hospital.
Photo GCBA
At the end of this note, the AMBA registered 60% of occupied critical care beds (with a similar proportion of the "public-private" distribution).
The rest of the province did not touch 40%.
In CABA the situation is
particular
: the private sector has more than 50% occupancy of ICU beds, while the public sector, 28.6% (out of a total of 450 beds).
For Battistella, this situation makes it difficult to rely on the experience of the first wave to estimate the "endurance" of the health system to come.
“In June-July 2020 we had 1,500 cases per day and at the end of August we saw the peak of more than 70% occupancy of ICU beds, and private ones, more than 80%.
Now, after a few days with a moving average of 800 daily cases, we reached 1,000.
But the occupation in the ICUs of the public subsector has less than 30%.
The affected population is another
”, he explained.
In other words, there are differences in the
sociodemographic characteristics of the most affected population
":" In the first wave, infections abounded in popular neighborhoods, but now we do not detect more than 10 or 20 per day.
In this wave,
the private sector may be much more stressed than the public sector
”.
Other provinces
Pablo Carvajal
, Secretary of Health of Córdoba, assured that they did not sit idly by since the peak of the pandemic: they went from 2,389 critical care beds for Covid to 2,903.
Although he considers it "difficult to accurately predict the moment of the new peak", they expect a less opaque scenario: "Clearly,
vaccination will prevent serious disease
, since it strongly interrupts hospitalizations and associated mortality."
Córdoba is one of the provinces where the virus is advancing steadily these days.
From the Health portfolio they reassured with the fact that they only have 18% of their ICU beds occupied with Covid patients.
But, as the system is only one, at the end of this note,
Clarín
awaited details of the percentage of occupation that patients admitted for other pathologies represent.
Swabs for Covid detection in the province of Buenos Aires.
Photo EFE / Juan Ignacio Roncoroni
In the case of
Santa Fe
, the UTIs are at 58%, provincial average.
However, the detail of some cities is not encouraging: in Santa Fe capital, it rises 65%.
In Rosario, 66%.
Río Negro was one of the most complicated provinces last year: they exceeded 90% of their ICU beds, although the Health area insists that "there was never a collapse" and that although, for example, Bariloche exceeded 95% occupancy , "There was always the chance to set up 20 more beds,
something that was not necessary
."
Are they better able to face the new wave?
“Before the peak we tripled our ICU beds at the provincial level.
We got to have 183 ... now we have 172 armed forces, of which 68.6% are occupied with Covid patients and not Covid, ”they explained to this medium.
Another province to highlight is Salta.
Silvia Cardozo
, Undersecretary of Health Management of that province, said that "from the peak
pre-hospital care was expanded and more personnel were trained
."
The official reported an occupancy of critical care beds of
73%
(public sector: 74.19%; private sector, 72%).
However, in the capital of Salta, the number of occupied ICU places exceeds
86%
.
This without counting an aggravating factor: dengue cases that have affected the province since November, when they fell from the peak of Covid infections.
For something, the Detectar operation in Salta is called “
Detectar Plus
”.
Tests of the Detectar program in Salta Capital, in the Güemes neighborhood.
Cardozo was concerned about the behavior of the population: “They have relaxed.
Last year the consultation was timely, fast.
Now, in the testing centers we see more flowery symptoms and
the consultations inside are late
.
Patients arrive with moderate and severe symptoms, which quickly lead to hospitalization ”.
Profile change
In line with the "demographic" differences that marked Battistella, there are doctors like
Diego Pereyra
-Coordinator of Intensive Care Sanatorium Güemes- that agree to
observe a
"change profile" of the inpatient for Covid:
"Before I
was about 70 years now, rather, it oscillates between 50 and 60 years ”.
However, Pereyra ruled out a drop in mortality "by default": "Possibly these patients have
comorbidities such
as obesity, hypertension, diabetes or some immune suppression, which matches them in terms of risk with older adults."
Vaccination against Covid for teachers in the province of Río Negro.
Telam
Such is his concern about this issue that this doctor is a promoter of which "
vaccination is
urgently prioritized
in this segment: those
economically active
, breadwinners with previous illnesses.
They should be vaccinated before anyone else
."
Who also spoke about the "state of health" of the Argentine intensive therapies was
Rosa Reina
, president of the Argentine Society of Intensive Therapy (SATI).
He said that "from the first wave there were no major changes
in the system.
The structure was expanded before the peak
: we had 8,500 beds and they went up to 12,500.
Hospitals were built, conditioned areas were expanded, respirators were added.
But
what is still lacking is personal
”.
Regarding the "first / second wave" counterpoint, Reina agreed on the importance of staff being vaccinated.
However, “being so few,
there was not really a break
.
The staff is exhausted and that works against ”.
Tiredness is not only due to Covid: "Many have two or three jobs because of how poorly paid the activity is. It is urgent to
make the profession more attractive
."
"With technological advances, surgeries are more complex and all patients spend one or two days in intensive therapy for observation.
Without a pandemic, Argentine therapies are at 80%
. The
system
easily
collapses
. It did not occur to us to say it now: lo we have been warning since the influenza A epidemic in 2009 ”.
ACE
Look also
The alerts of Fernán Quirós: "There is a tension between the speed of the wave and vaccination"
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