Adriana santagati
09/19/2021 2:39 PM
Clarín.com
Society
Updated 9/19/2021 2:39 PM
The curve at Oxford University's Our World in Data site marks
a steep decline
.
Taking this month, Argentina went from an average of 5,124 daily cases of Covid to 2,265.
The news is more than positive.
And it translates into another curve that is not reflected in an international statistic, but it is reflected in clinics and sanatoriums: for the first time in months, the demand for non-Covid care widely exceeds that of SARS-CoV-2.
Any given day, at any given time.
Waiting room for the guard of a renowned private clinic in Barrio Norte.
This chronicler found that there was
almost no place to wait for the turn in the common guard
.
The Covid guard, on the other hand, looked almost empty.
The delays were directly proportional to the number of people waiting.
"We didn't stop for a minute today," says the cardiologist on duty before literally running off to attend to a patient in the adjoining box who
was having a heart attack
.
The same expression is repeated by a nurse, and adds: “Now all those who were
previously afraid to go to the guard are coming
.
And also the people who during the past year did not do anything ”.
Admission to the guard of a private medical center.
Demand for Covid fell, but it rose for other diseases.
Photo Luciano Thieberger
Different sources from the private medicine sector consulted by
Clarín
coincide.
The forecast that the close of 2020 was going to hit in 2021 is already being fulfilled.
And the fear is how it will continue to impact in 2022 and in the following years due to the controls that should have been done last year and were not done.
Reallocation of resources
Several clinics acknowledge that they
are reallocating Covid resources to non-Covid care
.
The same happens, in the public sphere, in the city of Buenos Aires.
Since mid-August, the Buenos Aires government began to re-functionalize
the services of 80% of its hospitals
and also extended the shifts of all other pathologies not related to the coronavirus.
“Today we have only one hospitalized for Covid-19, who is in the ICU.
In general hospitalization there are none.
We observed a recovery in the demand for outpatient services because many of the patients returned without fear of contagion and were vaccinated, ”they say at the Austral Hospital.
In this medical center in Pilar they made readjustments of beds and personnel, but not of structure or physical plant. “
We are not certain that this epidemiological situation continues as it is now.
We remain prepared to face a new wave of cases, if any. Ultimately, they are changes to once again meet the contained demand for health services caused by the pandemic ”, they point out.
In Medicus they use the same expression:
“Large volume of contained demand”
.
"We have to emphasize the control of chronic diseases that have been neglected and telemedicine services, compatible with the care of most specialties, must be incorporated into the usual care processes, both at the shift level and at the clinical history" , remarks Rafael Zamora, manager of Medical Strategy, who clarifies that the emergency services will be divided into two for a time:
Covid suspicion and general guard
.
The guards divided between Covid and general care will be in place for quite some time.
Photo Luciano Thieberger
Zamora draws a line on
how ambulatory demand evolved
in this year and a half of the pandemic, which he describes as "extremely unstable": marked decline in the first months, progressive growth, interruption with the first wave of Covid, exponential increase after the holidays , a new interruption by the second wave, and now a new and growing increase, in which those who had difficulties to attend to themselves in the pandemic and the numerous post-Covid controls converge.
Different medical entities have been insisting on the impact that the 2020 restrictions had on the diagnosis and care of cancer, diabetes and cardiovascular problems, among other preventable diseases, and emphasizing the importance of
not delaying the controls any longer
.
Some numbers already reflect this picture.
In Argentina, there was a 50% decrease in cases of breast cancer (the one with the highest mortality among women) last year, an alarming figure because early detection is directly linked to prognosis.
And another figure that has just been released in Spain: the survival of lung cancer (the one that takes the most lives among men) will fall by 2% in 2020/2021.
Although there are no official data on the demand in clinics and sanatoriums, industry sources estimated that today they must have
an extra demand over the usual of 50%
, considering a retraction of consultations and diagnoses in 2020 that ranged between 35% and 70%, and that this is already being felt in the extension of waiting times to get shifts.
And, on the horizon, a question mark: what is going to happen in the coming months, with
Delta circulating as a community
?
Exponential growth
According to the latest official reports, the incidence of this variant is
still low
, less than 5%, but in the last nine days it grew six times: as of September 4, it represented 0.71% of sequenced cases with no antecedent traveling or bonding with travelers.
Delta's transmissibility is much higher than the previous variants and the experience in the world is of
an exponential growth in community circulation
: in the United States it became the only circulating strain in just three months, going from 14.21% of 99.1% sequenced samples.
Faced with this scenario, what has already been said repeatedly: the need to complete the vaccination schedules for adults first and to advance with minors later.
Regarding the first item,
the chronic lack of Sputnik V and AstraZeneca
delayed the application of the second dose: according to the latest data from the Vaccination Monitor, almost 9.3 million people have applied only the first.
Admission to the guard of a private medical center.
Photo Luciano Thieberger
Regarding the second point, although there are jurisdictions that have already announced the start of adolescent vaccination (such as a Province, which will assign shifts to 17-year-olds from next week), the fate of this stage of the campaign is
inexorably linked to makes up for the missing for adults
. Or to accelerate the pediatric approval of Sinopharm, not yet approved in the country, for which a recent publication in The Lancet brought encouraging news.
With all these variables at stake, there is uncertainty about when and how strong the third wave will break and how it will affect a health system where care for other diseases is recovering. The famous syndemic defined by various experts,
the overlap of the Covid pandemic and the non-communicable disease pandemic, the
main cause of death in the country.
But from private medicine they add another critical element and, they assure,
structural and not conjunctural
: the crisis in the sector, which reached a point of non-sustainability.
They say that in the last year and a half the costs of medicines and supplies soared "mercilessly", that beyond the increases granted by the Government they are out of date between 20 and 25 points and that
there is no more room to continue increasing the quotas to affiliates
.
In this sense, they demand a restructuring and point out that the Private Medicine Law approved in 2011 established an
analysis of the cost structures
of each prepaid to individually determine the increases that were never made, and that it is already unsustainable to continue applying general increases.
A source in the sector returns to the Delta and says that it is "unknown."
But he
does have a certainty
: that if there is a rise in cases that forces to establish isolation for a couple of weeks, after a year and a half of pandemic and the longest quarantine in the world seasoned with
the VIP vaccination and Olivosgate
, its compliance it will be very difficult to achieve.
ACE
Look also
The encouraging data from the WHO that marks the sustained decline in coronavirus cases
Vaccination: sharp drop in the week before PASO and why you have to play 63