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The report is from a doctor who works in Emergency Care Units (UPA) in Greater Recife, the gateway to assistance in the public health network. With the Covid-19 pandemic, units have reached their limit.
“I understood that we are collapsing when last weekend [25 e 26 de abril], on a night shift, we received a patient with acute respiratory failure, with an immediate indication for a tube, but we did not have a respirator available; the entire unit was being used, “said the professional, who preferred not to be identified.
The patient, he said, had a suggestive medical history of Covid-19 and had respiratory distress. Six hours after being admitted, the man died, according to the doctor. “I cried all night,” he recalled.
The UPAs are the starting point of the patients’ journey towards the 1,100 beds created to face the new coronavirus in Pernambuco. Health professionals working in this primary care service state that the units have not received reinforcements for the treatment of patients with suspected Covid-19 and speak of a system failure.
The doctor also said that a couple of elderly patients were admitted to a UPA during the pandemic and the man died.
“They did not leave the house, so the family thought it could not be Covid when they started to have a cough and fever. The husband died and the wife went home. Both were positive for Covid,” he said.
“We don’t know what else to say to the family member who is at the UPA reception, anxiously awaiting the news of his hospitalized relative, unable to go there and give him a hug, a handshake. Perhaps that is what hurts the most … To see so many vulnerable and fragile people, without knowing if they will live or die, with so much fear and without being able to receive a hug. Unable to see a familiar face. Without being able to see a smile, “said the doctor.
“I have not been able to deal with the anxiety and fear of coming to the service and not knowing how many deaths we will have, whether we will be able to treat those people with dignity, how many stories we will find, how many stories will end there.”
/i.s3.glbimg.com/v1/AUTH_59edd422c0c84a879bd37670ae4f538a/internal_photos/bs/2020/9/z/mmi6rAROCJkMtvROkTWw/unidade-de-pronto-atendimento.jpg "Emergency Care Units (UPA) in Greater Recife receive patients with suspected Covid-19 and other diseases - Photo: Marlon Costa / Pernambuco Press")
Emergency Care Units (UPA) in Greater Recife receive patients with suspected Covid-19 and other diseases – Photo: Marlon Costa / Pernambuco Press
Every week, doctors say the situation has worsened. “Before going into mitigation, we were in high demand for potentially positive Covid-19 cases, but there were no reporting criteria. That was a complicated factor, because we could report and diagnose,” he said.
When the state confirmed the first cases of community transmission in March, the report was one of despair. The situation has worsened over the weeks. “In April, we began to receive cases with greater severity. Very serious patients with poor results in a short period of time. Regardless of age, regardless of comorbidities. And with each passing week, it worsens,” said the professional.
Given the increase in demand, the inputs and the structure have not been sufficient. “We do not have the necessary medications to manage these patients, we do not have professionals to care for everyone with the minimum of dignity. In one of the UPAs that I work with, we have more than 110 certificates on the team, including technicians, nurses, doctors. There are many people away. ” They are many sick people. Many people are afraid, “said the health professional.
‘It is literally a tail for oxygen’
Doctor reports lack of structure at UPA in Gran Recife
The lack of adequacy of UPAs to face the pandemic is a unanimous complaint among health professionals in these units.
“This service, extremely essential for the population, has not received any type of structure for this pandemic. We continue with the same number of doctors, nurses, technicians and other employees. Patients still have a stroke, still have an accident, still get shot or stabbed and [têm sintomas] Covid-19, ”said a second on-call physician, who also works at UPA in Greater Recife.
The lack of equipment needed for shortness of breath, the most troubling symptom of Covid-19, is the most obvious bottleneck in the units.
“Every turn is despair. Every day more patients arrive with Severe Acute Respiratory Syndrome, who need oxygen or intubation and mechanical ventilation. We don’t have an oxygen source for everyone. We stayed with patients in the medication room waiting for transfer to another to qualify for the source. It is literally a queue to be entitled to oxygen, “said the professional.
“The open beds have several. The main problem is that the UPA has the structure to receive this large number of patients and stabilize them to send to these beds that the state is opening,” he said.
Those who also feel the skin problems are the patients and relatives who need medical assistance in the public network. When presenting fever, cough and shortness of breath, the uncle of the hairdresser Noeli Félix was on Monday (27), Tuesday (28) and Wednesday (29), in the Imbiribeira UPA, in the South Zone of Recife. In the three days, they told him to go home.
“We live in Candeias[in[em[en[emJaboatão dos Guararapes], but they sent us there because the UPA in Barra de Jangada has no more vacancies, “said Noeli.
 / i.s3.glbimg.com/v1/AUTH_59edd422c0c84a879bd37670ae4f538a/internal_photos/bs/2020/8/z/GRG1oWQCuNscwTlsDVjw/upa-covid.jpg "UPAs receive suspected cases of Covid-19 and patients with other diseases in Greater Recife - Photo: Reproduction / TV Globo")
UPAs receive suspected cases of Covid-19 and patients with other diseases in Greater Recife – Photo: Playback / Globo TV
In Recife, the situation is also crowded, according to the hairdresser. “If you saw how it was yesterday [29], you would not believe it. It is a lot of people. By the flow of ambulances arriving, you see that you are completely out of control. The weather is horrible. As much as we talk about it, people have no idea how things are going, “he reported.
After three days of seeking medical attention for her uncle, Noeli said her relative was sent home. “We tried to use the Atende em Casa application, but we couldn’t. Inside, my uncle said they only gave him serum and medicine to go home. We will have to carry money, I do not know where to look for a private hospital, “said the hairdresser.
Imbiribeira UPA, in Recife, with a line outside to deal with suspected cases of Covid-19 this Thursday (30) – Photo: Playback / TV Globo
On Thursday (30), the Imbiribeira UPA received the daily cleaner Cleonice Maria da Silva and her husband, Tiago Silva, both 34 years old. Cleonice’s husband had to stay out of the unit, waiting in line. The couple arrived at 9 a.m. And, around 12 p.m., Tiago had not yet been seen.
“He has a headache, diarrhea and fever. The service is very bad. It is very full, there is no doctor. We see the situation of so many people dying, burying them as destitute, and sometimes I cannot sleep,” she said.
PD has a 316% increase in the number of hospitalizations for severe acute respiratory syndrome
The service is free by calling 0800 081 4100. Calls can be made Monday through Saturday, 7 am to 7 pm.
Secretariat responds to complaints
By means of a note, the State Health Secretariat (SES) reported that the service in the UPA works through the Risk Reception Classification, a system created to “guarantee a faster and higher resolution service, prioritizing the more serious cases. UPAs are initially seen by a nursing professional. Highly complex situations, where there is a risk to the patient’s life, are immediately referred to the doctors, “says the text.
Also according to the secretariat, “it is normal for complaints to appear, especially for patients who have a green or blue classification (low-risk cases), who are referred to less complex health units, such as health centers and polyclinics.”
In view of the pandemic moment, SES reported that it has been in dialogue with the municipalities so that the municipal secretariats develop the potential of their primary care network. ”
The Secretariat did not respond to complaints from health professionals about the lack of equipment and structure to care for patients.
Coronavirus in Pernambuco
This Thursday (30), 682 new cases of Covid-19 were confirmed in Pernambuco, in addition to 27 new deaths. With these additions, the state accounts for 6,876 patients with the disease, in addition to 565 deaths caused by the new coronavirus. There were also 121 records of healing, bringing the total recovered to 1,074.
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Tips for coronavirus prevention – Photo: Arte / G1
