Coronavirus near the health collapse in AMBA, ambulances have become mobile hospitals

The Availability of intensive treatment rooms It is at the most dangerous moment since the Covid-19 pandemic began, but that is not the only symptom The health system on the verge of collapse in the Buenos Aires metropolitan area (AMBA). If the hospitalization level remains the same and does not reduce the number of cases and circulation of the virus, The ambulances will become mobile hospitals And they will not be able to help people who demand attention while they take care of the various ailments that patients suffer and walk the streets until they find an available bed.

The warning comes from the private sector, AMBA Clinics and Clinics, Who are within their energy limits with A. 95% average occupancyAnd with institutions that are no longer able to receive more patients, but are being amplified towards public hospitals where demand grows rapidly. In the city of Buenos Aires, according to the latest official report, the 84% of beds’ occupancy in ICUs (378 out of 450) When 20 days ago it was 45.5% (205 out of 450). Day after day, the demand exceeds the maximum values ​​since the first case of Coronavirus was discovered in the country.

However, this It’s not the only indication toward saturation in AMBA. In the province of Buenos Aires, respiratory care is critical with the presence of A. Increased oxygen consumption by 330% So the Ministry of Health started production in hospitals and acquired 3000 oxygen concentrators. In addition to suspending non-urgent surgeries and rescheduling shifts The bottleneck in the phone and home health care, A direct result of the infrastructure to the maximum, and the consequent shortage of health workers when more beds are added to the intensive care units.

“The system is more vulnerable than last week, Technically, it’s in saturation, With more income than daily discharges, “as they revealed from the private sector, taking into account hospitalization for Covid-19 and the rest of the diseases.”When the system collapses, ambulances become mobile hospitalsWhere doctors treat patients at the gates of hospitals. They warn that we are the maximum possible. ”To clarify the situation, for example: on a typical pre-pandemic day, an ambulance can transport six or seven patients in an eight-hour shift; currently one or two transfers in the same period.

The only answer to whether we are about to collapse will be given through everyday situations. On the basis of the mathematical calculation, private enterprises work with Projections to see how the system is responding according to revenues and expenses, Above all, in the most problematic months as occupancy can reach 93% due to seasonal illnesses related to cold. We are working with stressed infrastructure even though it is oxidized by daily discharges. If the epidemic is applied to that mathematical equation, the equation collapses, “as they assert.

What is happening in the metropolitan area is consistent with his mathematical projection Nation, Which was published last week, based on official information available. Analysis done with this in mind Maintains current frequency to occupy intensive care beds With the same number of places available, the result is that the saturation of the system in the city of Buenos Aires will be between April 26 and May 3, that is, this week. Whereas in 40 AMBA municipalities, the critical time will be between the first and second week of next month, or 4-11 May. The scenario may be different if the household supply is expanded in either jurisdiction, or if other variables are modified.

For the Association of Clinics, Sanatoriums and Private Hospitals of the Argentine Republic (Adecra), the system operates under tension and pressure, despite To reach a breakdown there must be a multi-causal effectThat is, unavailability of beds, lack of oxygen, medications used in the ICU, and shortage of respirators, among others. “There are high expectations for treating cases, albeit a large number, because It could free us from the bottleneck in UTIS“, I acknowledge Jorge ShiroEntity head. He added: “There are first-level clinics in the city of Buenos Aires and the First Ring, which is most sought after by patients who enjoy good medical coverage, and who have a large number of Covid patients, although they have not collapsed.”

“The situation is imminentIf not now, it will be in the next few days, in both Tigray and the surrounding municipalities. The ambulance will become the patient’s roomWe’re on our way to it, “he predicts Fernando AbramzonTigre Minister of Health. In four weeks weekly infection in the neighborhood Jumped 165% This led the municipality to tighten traffic control procedures and ban activities in parks and shopping centers. It is very difficult to get an average care bed. The official added that between 40% and 50% of the patients are from collapsed social work and people remain in public order. “

In front of the respiratory guard entrance Municipal Hospital of San Caetano, in San Fernando, Staff empty anesthetic vial boxes. Until weeks ago, hospital bed occupancy was 60%, but today that number has risen to 80%. Currently, the hospital can respond to positive COVID-19 cases, however Marcelo Campos, Municipal Health Minister“If the restrictions are not tightened, San Fernando alone will not collapse, but the whole country will collapse,” he warned.

We had to take two patients to the hospital [Petrona V. de] Lamb, because there is oxygen left, Campos says, and explains: “What happens is that Distribution companies do not have an oxygen capacity so they do not complete the loadParallel to this, the demand has tripled because 80% of the patients suffer from respiratory diseases. ”Between Cordero and San Cayetano, there are 210 beds.

Intensive care from Domingo Angio Hospital, in Jose C Paz95% occupied; In general hospitalization 90%. The problem started last week due to increased demand. The patients grew in number and disease and then overlapped with those who were recovering and did not reach the oxygen, “the Minister of Health points out with that intention, Celestino Saavedra He, like his San Fernando counterpart, notes the input supply problem. “supplier It leaves us 30% or 40% of the tank loaded and that is enough for three daysBut if the system collapses, we cannot get enough air, ”he says, giving an example of what happened on Monday when eight patients had to be referred to various health care centers in the district and ten other patients to Caborality, another Covid hospital in José C., Peace.

The Argentine Association of Intensive Therapy (SATI) He also issued a stern warning about the critical situation in AMBA. According to the latest survey conducted at 54 UTIS, Occupancy rate is up to 96%, Higher than the 76% officially published by the Buenos Aires government, and more than half of the hospitals and clinics surveyed had no free beds.

According to SATI, who also alerted High degree of health worker exhaustionOnly 4.44% of organizations in the private sector in AMBA have free beds. Availability is higher than in the public sector where it is barely 3.17%. He said, “Infrastructure restrictions in public hospitals and private clinics must be added to health workers, especially therapists, who need up to four years for training.” Queen rose, SATI President.

La Plata, Ensenada, Lanus, Jose C Paz, Tigre, Lomas de Zamora, Quilmes, La Matanza, Itozingo, Escobar, Pilar and Merlo are just some of the municipalities that have problems with the availability of beds or supplies, as in the case of oxygen which, at the time Current and according to sources from the public and private health sector, it is not a rare commodity in the city of Buenos Aires. However, in the province of Buenos Aires, operations are also at the limit, as in the case of Clinic hospitalFrom the University of Buenos Aires. “Occupancy in the hospital is 78% while in the ICU it is 100%.. Either way, more than 60% are compatible with patients with COVID-19 and other diseases. This is available due to the decision to postpone surgeries and other non-urgent medical issues, “they reported from the hospital.

Another problem that adds to the health crisis is the increase in the value of medicines used in intensive care rooms. The daily cost of patient care ranges between $ 90,000 and $ 120,000, due in large part to the excessive value of the drugs used for these patients (Atracurium, Midazolam, Pancuronium, Fentanyl, and Propofol) in addition to the disposable and personal drugs. Protective equipment, “they explain from Clinic hospital. Other hospitals and clinics noticed the same situation.

Report by Ines Piatto Fasolo