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RIO – A technical note released by Monitor Covid-19, a Fiocruz study group, warns this Wednesday that the public health network in the city of Rio is already collapsing. On Wednesday 172 people were waiting for an ICU bed in the Metropolitan Region, which in addition to the capital includes Baixada Fluminense. In the private network, the situation is also worrying, since 98% of the intensive care beds in the city of Rio are occupied.
– We already see the collapse of the system. Inside the hospitals we have many problems, but also outside. And not everyone went through Covid-19, but indirectly they were left without assistance. Also, being hospitalized does not guarantee a place in the ICU. Many die from Covid-19 outside the ICU, even if they are confirmed as Covid-19 cases, ”says health worker Christovam Barcellos, member of MonitoraCovid-19 and researcher at Fiocruz.
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The survey ran through December 1, so the November data may still change. The researchers point out that it is not only hospitals that today suffer from overcrowding and care problems, but also basic care. One of the data analyzed that Fiocruz experts used to reach the conclusion of the number of deaths of this type in September and October: 1,100 more than expected for the period, indicates “that the health system has not returned to normal. that would be his “normality.” “, After the crisis of April and May”.
This picture points to a condition of collapse of the health system, not only of hospitals, but also of primary care, which, if prevention and timely treatment of cases of chronic diseases were maintained or extended, a Big number. deaths ”, says the technical note.
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Another technical note with data from the end of November indicated that Saúde do Rio was already “showing signs of collapse.” But since then, researchers have also pointed to the increase in deaths outside hospitals in October as one of the signs that Cariocas lack medical care. One of the main reasons would be the demobilization of beds after the months with the highest number of cases and deaths of Covid-19 in the city:
– The highest peak was in April and May, which was a major crisis, but October again increases the number of deaths outside hospitals. The peak is now lower, but the capacity of the health system has worsened. It is a collapse now generated by the system itself. It was warned that we could have a new increase in cases and the crisis is not only in hospitals, but in primary care. People who did not go to the health center could have been treated. It is no coincidence that they are deaths that are concentrated in cardiovascular problems and other chronic diseases – says Barcellos.
The proportion of deaths at home in the capital until December 1, 2020 compared to the same period in 2019 is also higher. Currently, the proportion of deaths at home is around 15%, while the average for that period is around 12%. November’s share is even higher than that recorded in the city at the peak of the pandemic.
In addition to the deaths that can be caused directly by the virus, experts point out that many were caused by chronic diseases, such as diabetes and hypertension, which would be indirectly caused by the pandemic, due to the restriction of access to health.
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“In previous years, there was an average of 12.7% of deaths that occurred in homes. This pattern was overcome from March to May 2020. From May to October there was a reduction in the indicator, but in October and November the values returned to increase, reaching 15% in November, which may demonstrate the impossibility of diagnosing and hospitalizing serious cases, both of chronic diseases and of Covid-19 ”, says an extract from the technical note.
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Another piece of data analyzed by the study group was the place of death in general, whether the person was hospitalized or not. Experts concluded that of the total deaths in Rio from the coronavirus, only 40% were in an ICU. “Probably more than half of the population that died from Covid-19 in the municipality did not even have the possibility of receiving intensive care,” they say.
Holiday alert
One of the concerns of the technical group is that the new increase in cases of the disease in Rio occurs around the holidays and end-of-year celebrations and warns that the situation of lack of assistance may soon worsen if there is no reinforcement in the structure of the hospital:
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“This lack of assistance may be aggravated by the increase in the number of cases and the exposure of the population to situations of risk of transmission of the SARS-CoV-2 virus, which causes Covid-19. In this sense, it is important to strengthen the structure hospitable “. of intensive care, the intensification of primary health care activities, linked to health surveillance, as well as the maintenance of measures of social isolation and alert of risk conditions in the coming weeks, especially given the worrying situation of the celebration of great end of the year parties, which already have regular advertising on social networks ”.
