I have been dealing with the coronavirus since the beginning of March, when we were unaware of its presence in our country, since according to the Ministry of Health there was only one isolated and imported case here.
I have been an ER doctor for several years and I have gone through everything from a pandemic to the door. In fact I was one of the first to diagnose endemic cases of SARS-CoV-2, I remember that the first patient I saw was on March 2, yes, before 8M there were already cases here in Spain, endemic, after the cases diagnosed in the islands of foreigners.
I remember that shortly afterwards the first protocol came out on the use of protective material such as masks, gloves, etc. At first you only put on the mask if you were caring for someone from Wuhan and northern Italy, if not, you only put on the surgical ones and in those days patients with respiratory distress were nebulized.
The prohibition of nebulization and inhaler use came later, and we did not use ffp2 / ffp3 masks (the latter, those recommended in patients with nebulizers). Then they gave us a mask, and I was with her all March. It was around April 4 when they brought us decent medical supplies, including PPE, that initially after using them we had to leave them on hangers so that the person who entered the next shift would use it without washing. Then a week later, they started washing them.
After that we started to have masks per week and, seven days later, a new one for each guard of 17-24 hours and later we have gone back to rationing, one mask per week.
I work in a hospital in the center of Barcelona, and this is a shame. I have seen many people die, some from the coronavirus, but also some from secondary Torsades de Pointes (ventricular tachycardia) undergoing treatment. I have lived all the protocols that have been invented during this time, I have lived the shortage of respirators and people who died because they could not use a certain device. The protocols of “death” came out, a NIT scale (levels of therapeutic intensity) was used, with limitations for age and comorbidity, because they imposed it on us, over 65 years, no 70 or 80 years, if you were 65 and comorbidity you were screwed.
In addition, a “Covid-19 sedation protocol” was published. And that the virus only kills elderly or comorbid people is a lie, I saw young people die, I remember in a special way, perhaps because of the shocking, a 20-year-old boy who had been diagnosed with Covid-19 a week ago and that after more than three hours of resuscitation he died. Or an 18-year-old girl who died in similar circumstances, and another man of 53, also previously healthy. Anyway, I can’t count all the cases of deceased.
Despite all this, I have not had a PCR or antibody determination in case I have passed the disease asymptomatically. Nothing at all, and I’m still here, doing 17 or 24 hour guards in the Emergency Service.
I do not share what is said about confinement. I have taken advantage of the little time I had to read and there are many publications where it is explained that the true prevention is the use of masks and hand washing.
The confinement was fine for the first 15 days, if the government had taken advantage of that time to collect protection material, which it should give and not make people buy it, among other reasons because we have already paid for it with our taxes. As an internist with a master’s degree in infectious diseases, I think that HIV patients are given antiretroviral medication for free because it is an infectious disease, to avoid contagion due to a public health issue, and I think that the mask is what same. I see it unfair. The Government acted negligently and continues to do so.
Now we face other problems, in addition to the coronavirus, since prolonged confinement is causing mental illnesses, such as anxiety and depression, to the point that the number of consultations to the Emergency Department and especially to the Psychiatry Service has increased. On the other hand, there is an increase in cardiovascular diseases and loss of muscle tone in our elderly and not so elderly.
The challenge is to convince the population that they should put on the mask and avoid crowds, if that is the case with the confinement to spare. What’s more, confinement is counterproductive, it lowers our defenses for what has already been said.
The doctors have been working from the beginning without keeping “confinement” and if we have been infected in such a high number it has been due to the lack of protection and information measures, which came to us in a very biased way initially and later dripped, still when the Government already had information provided by the WHO.
* Leticia Moreno is a doctor and lives in Barcelona.
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