RJ has increased the cases of Covid-19 and the occupancy rate of ICU beds in the SUS network reaches 92% | Rio de Janeiro

According to the Municipal Secretary of Health, the highest occupancy rate ICU beds, so far, occurred on May 4, with 98% occupancy. Nursery beds had the highest occupancy rate on May 9, at 95%.

Until November 22, 21,974 deaths and 338,203 confirmed cases of the disease were registered in the state. The moving average of deaths is 97, a variation of 153% compared to two weeks ago, and the moving average of cases has also increased, with a variation of 114%.

The current scenario, however, is different from that of May. Now there is Temporary closed health units, relaxation of the rules of isolation and relaxation of the use of masks. In public places. According to experts heard by the G1, these factors must be observed to adopt new guidelines in the treatment of patients.

For the Fiocruz public health researcher, Marcelo Gomes, the recent increase in the number of cases cannot yet be pointed out as a trend. He points out that the main difference between the current situation and the situation of the city in May, at the beginning of the Covid-19 pandemic, is the lack of an emergency plan, with field hospitals, social isolation and maximum alert from the health authorities.

“We have a very different scenario in May. We made a lot of effort there, with a much higher percentage of exclusive beds for Covid. Not today. Our reaction time is shorter. It is a more worrying situation in the matter of service offer ”, the researcher analyzes.

OR The number of hospitalizations of patients with Covid-19 has increased. in the hospitals of the SUS network, which includes beds of municipal, state and federal units located in the city. For the infectologist Fernando Chapermann, the increase in cases does not represent a second wave of the disease.

“I think it is difficult for a second wave to occur because for the second wave to occur, we need to have the first one controlled, zero. And this did not happen. people relax, but this increase has not yet been reflected in hospitalizations. And the mortality curve is not at an alarming level, ”explained Chapermann.

In the specialist’s opinion, it is not necessary to reopen field hospitals. However, Chapermann reinforces that it would be very important to reactivate the beds that are standing in hospitals.

“We lost the field hospitals, the Bonsucesso Hospital and other health units beyond what was planned. Then it would be good to reactivate beds and equipment that were ready, working in these places with high demand. they have guidelines to support this health need, ”said the infectologist.

On June 3, when the city recorded the highest number of deaths in 24 hours, the capital’s Health Secretariat reported that 1,696 patients were hospitalized in exclusive nursing beds for Covid-19. This figure represented an occupation of 55% of the nursing positions available in the network.

Last Sunday (22), the units of the municipal network of Rio had 533 hospitalized patients, 263 in the ICU. The SUS network in the capital had 1,044 people hospitalized in specialized beds, 499 of them in the ICU.

On the same day, June 3, the SUS network had 667 people with Covid admitted to the ICU. The number represented 87% of the total available. Last Sunday, although the number of admissions to the ICU was lower, with 499 patients, the occupancy rate was higher, with 92%.

One of the factors that explains this relationship between available beds and the number of patients is the closure of field hospitals, in addition to the recent closure of federal beds at the Federal Hospital of Bonsucesso, which caught fire on the 27th.

According to the Municipal Secretary of Health (SMS), the Municipal Campaign Hospital in Riocentro, in the West Zone, remains open and has the capacity to expand with the opening of new beds.

“The municipality’s health system, therefore, remains alert and prepared to handle Covid-19 cases,” the secretariat reported.

Given the growth in the number of cases, the State Health Secretariat reported, on Wednesday (18), that it opened 83 new exclusive beds for patients with the new coronavirus. Of this total, 41 beds are in the capital.

On Tuesday (17), SMS reinforced the recommendations for Family Clinics, considering the current phase of the pandemic. Recommendations include:

• Resume spaces dedicated to the attention of respiratory problems;
• Reinforce the number of supplies and personal protective equipment;
• Call center offer for patients who need to stay at home.

For the researcher Marcelo Gomes, the recent data on bed occupancy and new cases of the disease you must trigger an alert on public administrators.

“These reports that we have seen and other data that may indicate a change in trend, yes, they do trigger an alert. With flexibility, we return to hospital care for other health reasons. The search for hospital service increased and there was also a decrease in the supply of beds. All this creates a worrisome scenario, ”warned Marcelo Gomes.

Number of positive test fires

Another important indicator to analyze the current moment of the pandemic in the city is the performance of tests to measure the presence of the virus in people. And, like the other indicators, the number of Covid-19 tests with positive results for the disease during the month of November deserves attention.

Only the Richet Laboratory, which serves the Rede D’or health hospitals, carried out a total of 186,000 exams since March. Is in Just 18 days in November, doctors found 5,598 positive results for the disease. With 12 days to the end of the month, the number of people with Covid-19 in the period is already very close to the results found throughout the month of October and September.

For comparison, in May, the laboratory recorded 6,164 positive cases. The difference is only 566 cases of the disease, compared to the results found in November.

For Helio Magarinos Torres Filho, medical director of the Richet Laboratory, the most surprising thing is the high rate of positivity of the tests carried out in November. According to him, 37% of people who go to the laboratory for tests are diagnosed with the disease..

“We had a growth of around 15% positivity in November, compared to October. We have not yet reached the maximum number of pandemics, because at the peak of the pandemic we only evaluate patients with symptoms and now we are testing all of them. Now we have 37% positives, and this is a very high number when everyone is tested, “explained Magarinos.

In some private health units it is already possible to see the lack of kits to test patients who want to know if they have already had contact with the new coronavirus. This is the case of the Casa de Saúde São José, a private hospital located in Humaitá, in the South Zone of Rio.

According to the patients, last Thursday (19), the unit could not schedule new tests due to lack of kits.

In a note, Casa de Saúde São José denied the lack of Covid-19 tests in the unit. According to them, the hospital has been conducting tests to verify the new coronavirus, through the medical evaluation of the symptoms and the health status of the patients treated in their emergency.

What stakeholders say

The State Department of Health published on Wednesday (18) a resolution on the classification of Covid-19 beds in the Metropolitan Region of the State of Rio de Janeiro. The document determines that the beds destined to the treatment of patients with Covid-19, clinics or ICU, that are free must, necessarily, be classified in blue status, that is, ready to be used.

In addition to this action and 83 beds for patients with Covid-19 in Rio and Duque de Caxias, the secretariat reported on the expansion of the tests.

“SES is unifying the information on the municipal units capable of conducting the exams, in order to have greater control over the offer of rapid tests to the population.”

However, questioned about the possibility of reopening state field hospitals, the secretariat said there is no such possibility. According to them, the state field hospitals have already been demobilized.

The Municipal Secretary of Health told the G1 who does not believe in a second wave of coronavirus infection. They reported that 20 new ICU beds were opened in the Ronaldo Gazolla Municipal Hospital, to supply the 30 closed beds of the Bonsucesso Federal Hospital.

“The strategy is part of the Municipality’s Contingency Plan to monitor the fight against the coronavirus in the city. It is important to remember that the closed field hospitals were not owned by the City Council. The City Field Hospital, in Riocentro, remains open and can be expanded with the opening of new beds. The municipality’s health system, therefore, remains alert and prepared to deal with cases of covid-19 ”.

The SMS reinforced the recommendations for the population to maintain individual care to prevent the spread of the virus, such as avoiding crowds, wearing a mask and following hygiene rules.

Faced with a scenario of uncertainty, with a growing number of cases and fewer available beds, experts continue to affirm that the most important thing at this time is to maintain the rules of social distance, whenever possible.

All the health authorities heard by the report reinforced the guidance for people to wear protective masks when leaving home, as well as to wash their hands well and avoid crowds and closed environments.

“The behavior of the case curve is much more dependent on our action. Our behavior is much more relevant at that time. We cannot neglect preventive measures. Individual care continues to be essential,” said Fiocruz researcher Marcelo Gomes.

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