At Hospital Provincial There were no places left in the Intensive Care Unit and the scenario became even more complicated with the isolation of 20 nurses due to being close contacts of people with a Covid diagnosis. The Modular, in Granadero Baigorria, had 18 of the 21 therapy places occupied last night. Finding a bed is no longer easy. Even at the Clemente Alvarez Emergency Hospital, ambulances arrive asking for “institutional support” for patients with social work who require hospitalization and cannot find a place to stay. In this context, with a 90 percent occupied health network, both in the public and private sectors, the pandemic shows “the bottleneck” that is generated in the system because “More enter than leave”, a vehicular metaphor that allows to clearly visualize the lack of availability for patient care. “It’s like having a parking lot that from one day to the next stops having cars per hour, with a high level of circulation, and suddenly they are all monthly”, explain the health authorities.
The person in charge of the Third Level of the provincial Ministry of Health, Rodrigo Mediavilla, admits that “the scenario is increasingly critical”, and to this he adds the dynamism and volatility of the balances that are achieved within the crisis. “Until a few hours ago in the Provincial there was a stable situation that collapsed with the isolation of 20 nurses, so what was more or less controlled, is at the limit”, details.
In fact, with just 72 hours of operation, the Modular Hospital of Granadero Baigorria has already occupied 18 of the 21 intensive care beds available. However, another scarce asset, which is the trained human resources, means that this space is not working yet at one hundred percent of its capacity, the official himself admitted.
In this fragility, the Covid has peculiarities that further complicate the scenario, and it is the time required for hospitalized patients, either in the general ward or in intensive care, to leave discharge and vacate a square. “The doubling time of the disease is 10 days, but the time of stay of a patient in intensive care is 20”said Mediavilla, to explain that the “bottleneck occurs because more people enter than they leave.”
The vehicular metaphor
For several weeks now, the Municipal Health Secretary, Leonardo Caruana, used the vehicular metaphor to explain why, beyond the fact that 80 percent of those infected with coronavirus They travel the disease in the isolation of their homes and with mild symptoms, the remaining 20 percent that contract the virus and do require medical attention, rapidly causing the collapse of health effectors.
“It’s like having a parking lot that from one day to the next stops having cars per hour, with a high level of circulation, and suddenly they are all monthly,” said the official; an image that was ratified in the last hours by the head of the Sanitary Emergency Operations Center (Coes), Juan Becerra, and broke down the reasons that cause this situation.
“You have to take into account that a patient with Covid who is in the general ward has an average stay of between 10 and 14 days, and if he requires assistance in intensive care where the resource is even more finite, that average is stretched to 21 days, making the process even slower, “said Becerra, explaining the bottleneck that the system has, even despite having suspended all scheduled interventions that lead to hospitalization.
Thus, the doctor explained not only that “the coronavirus patient is a patient who does not stabilize in therapy in three or four days and is then discharged, as in other cases, but quite the opposite,” and even indicated that “in winter respiratory diseases they do not have an average occupancy of beds as high as Covid.”
To the saturation itself, elements are added that are not admitted out loud, which is that the hospitalization of patients with coronavirus positive or suspected of having the virus is not simple due to the procedures themselves and also, there is a high rejection in the private sector which may have to do with the quality of social work to the occupation of the system itself, and the fact that not all sanitariums prioritize them.
Faced with this critical limit in which beds are located, Becerra once again emphasized the “need for restrictive measures that make the city behave differently”, adding: “What is sought is to have less” competition “With other emergency pathologies that must continue to be treated and that require those same beds, such as polytrauma, road accidents, those fallen from a height on a construction site”.
For the doctor, these limitations not only reduce contagions, but above all they “relieve” the system.