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Why it matters to take measures to avoid contagion even if there is no hospital saturation


In Madrid, primary care has multiplied by ten the attention to coronavirus patients in the last month and the waiting lists for operations and tests grows by thousands of people

Madrid is reluctant to take action. It is one of the most lax communities in its protocols against covid. With the fifth wave, other autonomies again imposed restrictions, some with higher figures - such as Catalonia, with 2,080 cases per 100,000 inhabitants in the last 14 days in the 12 to 19 age group, for example, or Navarra, with a accumulated incidence of 3,276 among those aged 20 to 29—; others tried, such as the Basque Country, and the courts overthrew them. The Community chaired by Isabel Díaz Ayuso has neither done so nor, until now, has raised this possibility.

Young, asymptomatic or with mild symptoms, who do not need to be admitted to a hospital, who do not end up in a bed in intensive care units, who do not die. This is the majority profile of those infected with covid in this fifth wave. In Madrid, since July 1, 68,380 cases have been reported, of which most have occurred among people in their teens and twenties, according to the Community Public Health epidemiological bulletins. This Tuesday has a cumulative incidence among twentysomethings above the Spanish average (1,859), with 2,010 cases per 100,000 inhabitants in the last 14 days.

Part of the argument to continue with the restrictions as up to now is that new pattern in covid patients, which does not mean hospital pressure at the moment, or at least not as much as in previous waves. However, measuring the seriousness of the situation in occupied hospital beds, experts say, is to ignore a multitude of edges as important as the saturation of acute care or ICU places.

Saúl Ares, a systems biologist and researcher at the CSIC, says that it must also be borne in mind that "you never" know exactly how long each wave will last, so prevention is essential "always."

Although he insists that it is unknown, he adds, with the figures in front of him, that “between July 8 and 19, the rate of growth of the virus doubled the incidence every week and in the last week it has already begun to decrease that rate.

It seems that we are peaking and this is going to start to go down, but the relevant question is how fast it is going to do it ”.

If you look at other countries or regions with a similar situation, such as the United Kingdom or Catalonia, this decline "could also be rapid."

Meanwhile, the virus continues to circulate to the extent that the behavior of the population and current protocols allow.

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  • More pressure on Madrid health centers: care for covid patients has tripled in 15 days

In Madrid, these restrictions are minimal and, says Manuel Franco, spokesman for the Spanish Society of Public Health and Health Administration (Sespas), this "sets aside the responsibility of the institutions to protect the health of their population." He explains that "the long-term consequences" of the virus are unknown: "This thing that young people are asymptomatic and have the flu ... We have no clear diagnosis of what persistent covid is, we have no idea of ​​the neurological, cardiological consequences or pulmonary infection. Playing at that, for the sake of nightlife or tourism, when we can avoid it, is not what we should do as people who protect the health of our population ”.

The obstacles at the first level of the health system, primary care, also represent a lack of protection. On July 1, Family Medicine professionals were monitoring 1,386 patients for covid, this Tuesday, 10,475. In several health centers in the south of the capital, their professionals estimate 50% of the positivity of the tests they carry out and ensure that in the central area the situation is worse depending on which outpatient clinics, their agendas are again 60, 70, 80 daily patients, the staff are in the middle of vacations and assure that the situation makes their work “very difficult”.

"The care that we would want and we should give to our patients," says a specialist from an office within the central almond.

And he adds: “We have been thinking about the coronavirus for a year and a half and we still do not realize that it is throwing a veil over all the other patients with all other pathologies.

Covid circuit that we open, fewer hands and less time to recover what we have lost with chronic diseases or with people who could be caught in time for certain diseases and sometimes it is too late.

And it seems that people and politicians forget ”.

More possibilities for mutations

Joan Carles March, researcher at the Carlos III Health Institute, professor at the Andalusian School of Public Health and former director of that institution, also refers to this when he talks about the deaths. Madrid accumulates 24,361 and has gone from notifying one or two a day, even registering zero, to nine this Monday or six this Tuesday: “They are much less than previous waves, but people continue to die. We thought that vaccines would fix everything and no. They are very effective, but they are not sterilizing [that is, in addition to protecting against an acute evolution of the disease, they prevent its transmission] and they cannot be the only question to get out of the pandemic because there is always the possibility of variants and there is to be extremely careful ”.

This expert assures that one of the problems of not taking measures at a certain moment is that it opens the way to a mutation, SARS-CoV-2, like all viruses, evolve over time: "The British variant was already more contagious and the delta even more so.

We do not know if there will be one more and how it will be or if we will not be able to act on it.

No scaremongering, but the possibility is there.

And with a view to September and October, with the arrival of autumn, this should make us rethink what to do ”.

More information

  • One in four admitted for covid in Madrid hospitals is less than 24 years old

Withdrawing measures "hastily", as he believes happened in June, with the fall of the state of alarm, generated this "brutal change in trend." Now he thinks that "there is still time" not to worsen the situation: "There is no other option but to prevent, and the only way is by giving vaccines and putting restrictions, both. Because we don't know what will happen and we have to avoid any risk ”.

It points to decisions that, he says, "are already well known": those of reduction of social interaction, above all, and adequate control of that interaction, such as in the bottles or indoors, also that surveillance in ports and airports .

And, March argues, something that “seems to have been forgotten”, listening to and getting to know the young population: “To think that they want to march, period is a mistake.

If we don't talk to them and we value what things can help, we are making mistakes again ”.

That, "and stop putting an eye on health and another on the economy."

“With an eye in each place nothing is solved”, he says, “either we change the perspective or we have it very difficult, if we do not change the way we do things we are not going to change the story.

The rest?

It is making lines in the water ”.

The not so good situation of the hospitals

In hospitals, the pandemic arrived in February 2020 and has never disappeared. Without that tsunami of March 2020 or the sudden saturation of last summer, the figures are not optimal either. Since July began, the number of patients admitted to the ward has gone from 263 to 1,180 this Tuesday. In the ICUs, which began to be emptied of critically ill patients during the first days of July - they reached 106 on the 10th and 11th - they have once again seen that curve rise again and this Tuesday they have 183. Of these hospitalized, the average age is 37 years, according to Enrique Ruiz Escudero, Minister of Health, last Friday at a press conference: "5% have the complete schedule, 15% have a first dose administered and 80% are people unvaccinated ”.

Added to the numbers is the burnout of professionals after a year and five months of health crisis, the summer period with the corresponding staff vacations and the delays that already accumulate in diagnostic tests and surgeries, among other issues.

Between July 2020 and June of this year, the last month for which there is data, these waiting lists have grown by 19,102 people for those awaiting an operation and by 23,894 for those awaiting a test.

And those are the official numbers, because after these months, many patients, it is not known how many, have left those waiting lists because in order to perform the subsequent test or surgery they have to be evaluated again by their specialists.

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Source: elparis

All news articles on 2021-07-28

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