The increasing hospital pressure in the third wave, especially in the intensive care units, has already forced postpone non-urgent surgical interventions in many hospitals in some communities, a situation that will occur, at least, until March.
“We have 2 or 3 weeks of upload, therefore, these numbers that we see today are going to continue to get worse these days. We have doubts as to whether the increase is going to be very vertical or is going to be flatter, but hospitals will have to adapt the activity, “Ricard Ferrer, president of the Spanish Society of Intensive, Critical and Critical Medicine, told EFE. Coronary Units (Semicyuc).
In fact, it is already happening: “Quite a few hospitals are delaying part of the activity not covid, especially the surgeries that require an ICU in the postoperative period “.
Reaching the peak will not in any case mean an immediate improvement because, remember, “the descents are very slow”Therefore, the increase in January will be followed by “a month of February with a lot of occupancy and a lot of non-covid activity committed. There remains a very great effort during these two months.”
As has happened in previous waves, the situation is very uneven by region, so that “now we see that in Valencia, the Balearic Islands or Extremadura” the situation is more complicated.
The Ministry of Health believes, with 10.47% of conventional beds and 16.38% occupied ICUs, “the situation does not require further action today”; the increase has not required the installation of field hospitals and health centers are activating different contingency plans with “small” measures.
The Virgen del Rocío de Sevilla suspended the scheduled surgery and only maintained emergency surgical activity for tumor and cardiac pathologies and transplants. Soon the old Military Hospital will reopen, which will have 175 conventional beds and 27 ICU beds.
The general director of Healthcare, José María Abad, has confirmed that the rebound has not generated complex situations and that health has sufficient resources, although specific reinforcements will be assessed.
The Miguel Servet Hospital in Zaragoza maintains the occupation of its ICU at 10 people, for which the surgical interventions are still scheduled. Here the toilets have been able to enjoy a Christmas break.
As it is the second community with the lowest incidence, it maintains the surgery program, although they are weighted according to the number of covid patients admitted to the ward and ucis of each center.
A hospital known as H-144, due to its number of beds, is still operating in the Gijón Fairgrounds, intended for mild patients; Today there were 43 patients admitted, slightly less than a third of their capacity.
The Health Service has already hired around 2,000 workers and plans to increase them according to needs.
The occupancy of the ucis is close to 60%. The Son Espases de Palma has occupied 50 of its 56 seats. Between now and tomorrow it will open two more beds and is preparing to be able to open a new area for critics with additional places starting at the weekend.
According to its manager, Josep Pomar, there is no “immediate” concern, but he admits that the situation “remains complex” to organize the response, but the hospital has “a sufficient reserve of critical beds”.
Can Misses, from Ibiza, has rescheduled 12 operations because four of its 15 anesthetists are under surveillance, but it has not been necessary to implement the contingency expansion plan.
The ICU occupancy with respirator is 209 out of 404 (51%); 61 of those 209 patients are due to covid.
Doctor Negrín, in Las Palmas de Gran Canaria, has 87% of the ICU places with respirators occupied, that is, 54 out of 62, of them 11 due to coronavirus, while in the Insular-Maternal-Infant University Hospital Complex it is reduced to 41% (32 of 78, and 11 with covid).
In Tenerife, the ucis of the Hospital Universitario de Canarias, in La Laguna are at 75% of their capacity (40 out of 53, covid: 20) and those of the Hospital Universitario Nuestra Señora de La Candelaria have these units with respirators occupied in 74% (47 of 63, covid: 12)
Hospital occupancy reached 10.8% and ICU occupancy 22%. Although the Valdecilla Hospital is still “fully” operational and there has been no need to reschedule or suspend actions, the increase in income may force it to “stop some treatments.”
From next week, it will have a new ICU with 18 beds that will be attended by the same existing health personnel.
Castilla la Mancha
The directions of the health centers are scaling up in their contingency plans, which means a decrease in the pace of surgical programming, sources from the Ministry of Health have informed Efe. This decrease does not affect in any case urgent and non-delayed interventions.
Castile and Leon
With 11.8% of its conventional beds and 28.6% of the ucis occupied by covid, it has not suspended any surgical activity, consultations or tests.
In the Rondilla de Valladolid hospital, dedicated exclusively to treating covid patients from the entire Community, there are 30 admitted.
Health has referred 34 non-covid patients to six private hospitals. The Valencian centers register the highest load in Spain, with 26.41% of the plant and 49.35% of the ICU.
In addition, it has set up 280 beds in the three field hospitals to refer PCR-confirmed positives, with mild or moderate clinical conditions, previously admitted to an acute hospital.
It has suspended all scheduled surgical activities, except for urgent, non-delayed and non-derivable ones, and the dispatch of shock plan patients to reduce waiting lists, as well as non-preferred diagnostic tests and scheduled admissions, except those involved in rapid diagnosis of Cancer.
All personnel affected by the suspension of normal tasks will be reassigned functionally, and if necessary, geographically.
Its hospitals have 85% of ICU beds occupied, both by COVID -the majority- and not; Those admitted for coronavirus amount to 2,541, of which 497 are seriously ill in the ICU, which translates into an occupation of 53%.
The pressure has led small and medium-sized companies to postpone non-urgent and scheduled surgical operations, such as those in Igualada, Mataró or the Parc Taulí de Sabadell or those in the Girona health region.
The big ones (Vall d’Hebron, Clínic, Bellvitge, Can Ruti, Sant Pau and Hospital del Mar) have not yet begun to postpone operations, but they are prepared for it, with a contingent to expand ICU beds if necessary.
Covid beds represent 6.23% of the total and ucis 10.68%. There are no plans to open field hospitals and there are no hasty discharges.
Surgeries have generally not been suspended, although there are 3 health areas -Coruña, Ferrol and Santiago- that have had to do so.
Extremadura hospitals, whose occupation of acute beds is 14% and 24.6% in ICU beds, maintain “practically normal” activity, according to the counselor José María Vergeles.
Surgical activity is maintained “almost normally” in almost all health areas, except for those whose occupation level for both covid and non-covid patients is higher, but the modifications only concern non-urgent and low priority surgeries . The doctors of the hospital centers are being respected their breaks.
The Ministry of Health has reopened the Virgen de la Montaña Hospital in Cáceres and the Badajoz University Hospital with the opening of its Teaching Area for healthcare.
ICU beds with covid have risen to 455 (41.6%), and there are 2,733 conventional patients (15.4%).
Filomena has joined the pandemic and covid income is added to those caused by fractures: to unload hospitals, which are already canceling scheduled surgeries, transfers of covid patients to Isabel Zendal hospital have increased, which has 222 patients this Thursday, up from 161 last week.
What has not been affected is transplantation activity despite the difficulties generated for the transfer of patients, bodies and organs after the storm.
Since this week, non-urgent or priority surgeries in all public hospitals have been suspended. The health department’s device establishes that, in the event of a collapse, specific floors with 500 additional places will be opened, although it has the capacity to triple the ICU places.
Unions and medical and nursing organizations have warned that staff cannot enjoy their days off, which is causing physical and mental fatigue.
The hospital system is in scenario 3 of the 5 designed; there are 78 patients with covid in the ucis, 33.9% of the total.
There are currently 312 beds open in these units and 230 occupied (73.7%), so, according to the Basque Department of Health, there is “a lot of room for action”.
The 421 patients with covid who are admitted to the ward only represent 9.7% of the total.
Sources from the Department of Health have confirmed that all urgent interventions are being carried out and that scheduled surgeries are still being carried out although “at a slower speed”.
The Department of Health has indicated to Efe that the situation is “stable”, and places it as one of the communities with less occupation, which allows it to keep consultations and surgeries thanks also to the maintenance of the reinforcement of personnel carried out at the beginning, which “has made it possible to maintain, in general terms, readjusted vacations since November in some hospital services.”
He has also postponed some non-urgent scheduled surgeries, but urgent and oncological ones are performed. The health personnel were reinforced a few months ago, on the occasion of the second wave.
With today’s data, of the 54 operative covid beds in the ICU of the San Pedro de Logroño Hospital, 24 are occupied, 44.4%, 1.8 points more than yesterday.
The total occupation of the ICU, also including 13 patients with other pathologies, is 37 patients, 68.5%, 5.6 points more than yesterday.