María Eugenia Martínez, who acknowledges that it had become almost a vice for her to read how much news came out about the pandemic in order to be well informed, for a few days she has passed by when she sees from her cell phone or in the news any note that talks about an increase in occupation ICU in Antioquia.
“It’s just that I’m not going to digest those scares,” she says, smiling to mock for a while the concern that overwhelms her that at some point the hospital red alert and hepatobiliary surgery will be decreed, which have already been postponed a couple of times due to lack of beds in the last few days, stay in we’ll see who knows for how long.
Since the fourth peak began, the departmental Health Secretariat had been emphatic in denying the possibility of decreeing it due to the impacts that the suspension and postponement of health services brings, from consultations to surgeries, to concentrate personnel and resources in the care of the pandemic.
However, now the manager for the care of the pandemic, Leopoldo Giraldo, assured that it is a possibility that is on the table in the face of sustained pressure from four indicators: outpatient services, outpatient consultation, emergencies and priority care.
According to Giraldo, the occupation of beds by covid patients, both in general hospitalization and in the ICU, has almost tripled during January. The average number of deaths went from 10 daily in the first week to 30 in the last.
And as he recognized that the number of positive cases no longer gives an accurate picture, following the Ministry of Health guidelines to prioritize tests for the vulnerable population, he maintained that monitoring all health services is what should guide the corresponding decisions.
The truth is that the positivity rate in Antioquia until yesterday was 38.4%, above the national rate (37.9%), while mortality was 6.24 cases per 100,000 inhabitants, also above of the national rate (4.5). Most of the deaths in the department are of people over 80 years of age without a reinforced scheme.
María Eugenia prays that the alert not be declared, not only because of her necessary surgery, but because she knows firsthand how they suffer from a borderline situation in which health personnel are, because her sister is an intensivist doctor.
“A peak for many of them means having to take responsibility for five ICU rooms at the same time. My sister and many of her colleagues who have been infected finish the seven days of disability and return with all the commitment, but it is not easy to add to the wear and tear of two almost non-stop years, a post-Covid recovery that sometimes brings extreme exhaustion and so on. “, bill.
And even so – he emphasizes – they must be at the foot of the canyon because each disability leaves a large gap. Intensive care rooms need at least five or more professionals, including specialists who are not abundant.
According to figures from Asmedas, more than 2,430 members of health personnel, including doctors, nurses and assistants, are disabled due to contagion or isolated due to suspicion.
The doctor Jorge Iván Posada, spokesman for Asmedas, says that although the high coverage in third doses for health personnel has avoided dire scenarios such as the number of deaths that left previous peaks, the number of affected personnel, far from decreasing, seems be in tune with the staggered increase in hospital pressure due to the virus, indicators that according to the doctor show that the peak and decline of the current peak are still distant.
However, Asmedas insists that this is not the time to postpone services, but even to open alternative spaces such as field hospitals to guarantee the opportunity in medical care, so that a neglected general consultation does not become a hospitalization, just when the beds are becoming scarce.
“The red alert is capacity control, a blow to the economy; postponement of surgeries, a blow to patients, and it is also stressful for medical personnel,” he says.
In any case, according to Giraldo, even with the latent possibility of a red alert, the Government’s position vis-à-vis providers and insurers is that outpatient procedures and services cannot be neglected.
The East is on the edge
While the department tries to withstand the onslaught, Rionegro, which after Medellin has the largest number of ICU beds, declared a red alert upon reaching 100% occupancy.
The Undersecretary of Health of the municipality, Felipe Puerta, explained that although they increased their capacity by 10 ICU beds so far in January to reach 67, they quickly reached the top with 37 patients with various pathologies and 32 with covid.
The delicate thing is that Rionegro provides a key service. So much so that of the 32 covid patients, only eight are from the municipality, another 17 from various areas of the East, there are three from the Aburrá Valley, one from the Middle Magdalena and another from the North. However, the official pointed out, anyone in the municipality who requires an ICU must be transferred to the Aburrá Valley or another region of the country.
Faced with such a challenging scenario, the formula remains the same: accelerate vaccination, much more so after the four-day hiatus in which vaccines were applied by drops due to the lack of third doses. Sunday’s report left only 6,409 doses applied, a slowdown of almost 90% compared to the daily averages of previous weeks. The application of the reinforcement continues to drag deficit.