Spanish hospitals are breathing again after the intense scourge of the fifth wave of coronavirus. There are just under 3,000 people hospitalized with covid and, specifically, in the intensive care units (ICU), the patients admitted this week were below a thousand: as of this Friday, there are still 837 infected by coronavirus in the state critical, but the numbers are already acceptable for health centers to resume ordinary activity. With the cumulative incidence at 14 days still decreasing —69 cases per 100,000 inhabitants— and the downward healthcare pressure, hospitals take their breath and set their sights on the coming months, when they will foreseeably converge the classic respiratory viruses, such as influenza or syncytial, with the coronavirus.
At the Vall d’Hebron hospital in Barcelona, the largest in Catalonia, there are only 11 patients admitted to the ICU, explains Ricard Ferrer, head of Intensive Medicine at the health center. “We have had a very bad summer because Vall d’Hebron is a reference for extracorporeal oxygenation treatments [ECMO, por sus siglas en inglés] and to attend pregnant women with covid. We have had 51 pregnant women infected
days and yesterday [por el jueves] we discharged the last one ”, explains the intensivist.
Non-covid patients are gaining ground again, also in the ICU, although some are collateral damage from the last wave: “The same thing happens in each wave: they stop coming to the hospital and, when we are down, they arrive late and with aggravated pathologies , such as heart attacks in advanced stages. We also have large burns or traumatic patients ”, adds Ferrer. In Vall d’Hebron, healthcare pressure has been reduced and the risk of virus transmission has also been reduced, so since last September 17, the hospital has once again allowed visitors and companions in consultations or interventions of patients without COVID.
The situation of relative calm is repeated in most hospitals, agrees Rosario Amaya, head of the ICU and medical director of the Virgen del Rocío in Seville: “The situation is now favorable, we have 11 patients with covid. What we have had in the last wave, above all, are pregnant women and deniers who have not been vaccinated, ”says the doctor. Surgical activity at the center has resumed its pre-pandemic rhythm and, although there are contingency plans prepared to face an eventual regrowth, “work is being done to move towards normality,” says the specialist, and to recover all ordinary activity.
The declining epidemic curve and high vaccination rates – 76.6% of the Spanish population has completed the vaccination regimen – has led to this relaxation of the situation in hospitals, which on August 9, in the middle of the fifth wave, had more than 10,000 hospitalized with covid. At that time, in addition, 22% of the available ICU beds were occupied by patients infected with coronavirus – more than 2,000 people. Occupancy now in critical places is 9.2%.
Marta Sánchez Celaya, deputy medical director of the Gregorio Marañón Hospital in Madrid, points out that the hospital’s situation runs parallel to the path taken by the epidemic curve: “When incidence falls, income falls. We have 15 patients in the ICU with covid, they are fifth wave patients. Of the patients admitted, we had 80% who were not vaccinated due to various circumstances ”, he points out. Also in the emergency department, covid activity has fallen and the cases detected last week (68) have been reduced by half in the last seven days (27).
Professionals now look with concern to the next few weeks. With winter on the horizon, health workers predict the return of seasonal respiratory viruses, classics of the winter months, such as the flu, which mainly affects the elderly and people with high vulnerability, and the respiratory syncytial virus, which causes bronchiolitis in the smallest kids. It will be a “challenge”, Celaya points out, to manage the coexistence of the three microorganisms and correctly identify the reason for consultation. That is, knowing how to distinguish if the respiratory consultation is due to covid, which requires specific isolation, or due to one of the other viruses.
Amaya, for her part, admits that the hospital is “on alert for what may come”, although she trusts that the use of the mask will persist, the protection measure that helped to circumvent, to a large extent, the experts point out. flu virus last winter. “We are waiting for what may come, but we hope it is not like the other waves, that when it seemed that we were already breathing a little, another wave was coming,” laments the medical director of Virgen del Rocío.
Facing winter, Ferrer aspires to “have already achieved functional control of the pandemic”, a scenario that would facilitate the management of healthcare pressure, although he assumes that the intensity with which the respiratory viruses will arrive “is unknown” and also admits his concern about the panorama that opens in the coming weeks.