[ad_1]
The number of hospitalizations due to Covid in the São Paulo municipal system increased 26% in the last week and reached the same level as in early October, worrying doctors about the São Paulo government’s decision to review the SP Plan of measures of social isolation only at the end of the year. month.
However, after the repercussions with the medical community, the government now admits the possibility of reviewing the plan earlier and notes that ICU occupancy is well below critical level.
In São Paulo, hospitalizations went from 644 on the 11th to 814 on Tuesday (17). ICU admissions increased 33%, from 339 to 451. The occupancy rate for intensive care beds increased from 32% to 44%.
The figures reflect an accelerating trend in hospitalizations. In the comparison of the average of the week ended this Tuesday (17) with the previous one, they represent an increase of 14%.
In the last week, the cities of Greater São Paulo, the interior and Baixada Santista were also discharged from hospitalizations due to Covid.
In Santo André, for example, 39% (255 to 355), São Caetano do Sul, 30.6% (111 to 145), Praia Grande, 37.5% (from 24 to 33) and Sorocaba, 24% (172 to 213).
The analysis is from the InfoTracker project, USP and Unesp, which has been monitoring the pandemic in the state since its inception. Unlike the number of cases and deaths, the hospitalization data was not affected by the failure in the Ministry of Health system this month.
For researchers tracking the epidemic in the state, this increase does not appear to be a mere oscillation, but the prelude to a second wave, or the resurgence of the first, as some epidemiologists describe it.
In the evaluation of these specialists, it would be unwise for the São Paulo government to wait until the 30th to update the SP Plan, which regulates the quarantine stages in the state.
On Tuesday (17), the government of São Paulo published in the Official Gazette the decree that extends the quarantine until December 16, after an 18% increase in Covid admissions. Today part of the state, including the capital, is in the green stage, the penultimate in the liberation scale, and part in the yellow stage, which allows the opening of establishments but limits hours.
However, he said that it is necessary to analyze the data together with the statistics of new cases and deaths, which are provided by the Ministry of Health, with an update problem in recent days.
“There are no natural oscillations of this magnitude [nas internações]. It goes up that way, fast, only at the beginning of the pandemic ”, says Wallace Casaca, professor at Unesp (Universidade Estadual Paulista) and coordinator of the Covid-19 InfoTracker project.
The contagion index (RT), which indicates how many people will be infected by an infected person and helps to estimate the speed of transmission of the disease, remained above 1 in the country on the 13th. In São Paulo it is 1, 38.
The number must always be below 1 for the downward trend of cases to continue. InfoTracker and Imperial College London monitor this indicator.
“The capital of São Paulo showed a downward trend in RT at the end of October, as of November 4 it began to increase significantly. Passed 1.04 and reached this room [18], 1.38 “.
For Casaca, this set of data, associated with the increase in confirmed cases of the disease, are sufficient signs for the circulation restrictions to be reviewed soon.
“It would take some kind of government intervention and, obviously, the support of the population to try to contain this increase. A joint working group ”, he says.
Eliseu Waldman, professor of epidemiology at USP’s School of Medicine, says that the increase in hospitalizations and cases should be reassessed daily because, if the discharge continues in the next few days, it cannot wait until day 30.
“This comes at a time when hospitals have reduced Covid-specific vacancies and started to meet seized demand for other diseases. Field hospitals have been dismantled. Mobilizing the beds quickly will be very difficult ”.
According to him, there is already a shortage of beds in public hospitals on the São Paulo coast, which registers high cases, and there are patients transferred to the capital, in addition to pressure from the mayors for the government to release resources for the expansion of beds for Covid . .
Cardiologist Ludhmila Abrahao Hajjar, who works at InCor (Heart Institute) and at Vila Nova Star Hospital, also considers it risky to wait until the end of the month to update the SP Plan.
“We already know that it is increasing, that the transmission rate in the country has doubled. More restrictive measures must be taken, we must campaign to alert the population. You can’t wait any longer. “
For her, the electoral period, with rallies and large crowds, was one of the factors that led to the increase in cases and hospitalizations.
“There was a rally in the northeast with 3,000 people. People completely relaxed. People think that if they have not contracted it by now, they will no longer infect it and that the vaccine is yet to come. It is a set of misinformation, an imbalance of messages between states, municipalities and the federal government ”.
According to the doctor, the increase in Covid income in private hospitals is already leading managers to study the delay of elective surgeries. “Where is the cancer, the cardiovascular disease?” He asks.
The Albert Einstein, Sírio-Libanês and Oswaldo Cruz hospitals deny that there is a plan to suspend elective surgery.
“We don’t suspend anything. Neither surgeries nor endoscopies. The other time, we saw a very large increase in the severity of other diseases, such as cancer, advanced heart disease, and neurological diseases. We will work twenty-four hours a day to prevent this from happening, ”says Paulo Chachap, general director of Sírio-Libanês.
The hospital maintains between 120 and 130 patients admitted to Covid (up from an average of 80 in October), but with the prospect of growing demand, installed capacity is increasing. Today there are 135 beds for Covid. Another 50 beds will be opened, totaling 550 beds.
“First we expand and then we separate for Covid and not for Covid, depending on the pressure at the door. If the curve continues as is, these new beds will likely be assigned to Covid. “
Chapchap says that one change seen in recent days has been that patients in São Paulo, who previously represented 50% of hospitalized patients, now number 80%.
“As happened the other time, first we feel in the hospitals that do not serve the SUS and then in the hospitals that serve the SUS. There is a one, two week mismatch between the two pressures, ”he says.
For him, in addition to the need for the São Paulo government to give a new direction to this current reality of increasing cases, it is important that people behave differently, since the risk has grown.
“The restaurant may be open, but as an individual, I can decide that I am not going to the restaurant.”
According to Chapchap, the moment calls for solidarity. “If you are not afraid for yourself, think of health professionals who are exhausted, think of people who have other diseases and who can no longer postpone treatment.”
The review can be advanced, says the secretary
The Secretary of State for Health, Jean Gorinchteyn, says that the São Paulo government can review the SP Plan at any time, if necessary, and there is no need to wait until the 30th day for changes.
“The plan has in its DNA the clarity that, if the indices change during this period, there may be a recalibration in one region or another,” he says.
According to the secretary, the plan assesses hospitalizations and the number of deaths on a daily basis and it is these two axes that will determine whether the regions will remain in the phases in which they are, with more or less circulation restrictions.
“We had the possibility to recalibrate the plan this Monday (16) and we would reach 90% of the state’s population in the green phase. But as the Ministry of Health platform was unstable for ten days, we thought it would be a good idea to wait for the data collection to normalize. “
Gorinchteyn says that despite the increase in hospitalizations for Covid-19 prompting an alert, the state’s ICU occupancy is hovering at 46%. Remember that, at the end of May, the rate reached 95%.
“We have this margin of being able to look and call the population to take health measures. This is what will prevent the indices from growing. “
For him, the plan, in addition to the prerogative of quarantine, provides rites and sanitary regulations, but there is a depletion of people in relation to the restrictions.
“People made their way flexible. They went against the guidelines of the SP Plan ”.
According to him, in regions where there is an overload of hospitalizations by Covid, hospitals will suspend elective surgeries.
