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If during the months of May and June – the full peak of the pandemic in the capital – the emergency rooms were crowded with patients, in the last month these units have returned to their usual activity: aggravated chronic patients and trauma. Even, according to data from the Chilean Society of Emergency Medicine (Sochimu), in the last weeks consultations for respiratory diseases – all suspected of coronavirus, by protocol – have remained between 18% and 20% of the total.
But in the hospitals and clinics of Santiago, the medical teams of the Urgency and Intensive areas have already begun to meet to plan a probable increase in demand for assistance due to Covid-19, brought about by the celebrations of National Holidays.
This is how he details it the head of the critical patient unit of Clínica Las Condes, Tomás Regueira, who comments that among the measures of the enclosure it has been arranged to avoid the holidays of the teams at the end of September. The work of coordinating beds has also been reinforced, so that they can be quickly converted if required.. “We have our own indicators in the clinic to take the pulse of the pandemic: we keep a count of the positivity of the PCR and the amount that is carried out, the emergency consultations for suspicion of the virus and the beds that are being occupied”, said the also president of the Chilean Society of Intensive Medicine, who admits that it is a concern among his peers what may happen the two weeks after the national holiday.
From the Indisa Clinic, the head of Emergency, Leonardo Ristori, asserts that the facility has never stopped being in “pandemic mode” and that the clinic has a five-stage plan to make your units more complex in the face of virus outbreaks. If the number of cases and the demand for care rise, depending on the severity of the situation, the clinic could “restrict non-emergency operations, invasive procedures such as endoscopies that are not urgent,” warns Ristori.
Among other measures, a new conversion of exclusive units for respiratory patients and the spacing of medical hours in consultation to avoid crowds.
The president of Sochimu, the emergency physician Luis Enberg, says the specialists have talked about this issue in recent days and that there is special concern about the exhaustion of health personnel. However, it states that although “This reactivation of the virus is expected by the end of September, not with the severity of the previous peak.”
Of course, Enberg warns that, if the demand for respiratory cases starts a constant rise above 20% of total consultations, mitigation measures must be taken, such as physically dividing the emergency unit between respiratory patients and those of other pathologies.
The upward trend, regarding the lack of refinement of more than half of Santiago, has already been perceived in centers such as the UC Clinical Hospital. The head of the emergency, Pablo Aguilera, states that “urgency is the lantern that looks at what is happening, the thermometer. From an objective point of view, in numbers, we see an increase in respiratory consultations. From five or 10 a day we are reaching 20. It is not such a discreet increase ”.
The medical team also defined limiting staff vacations at the end of September and beginning of October, in addition to separating the spaces for respiratory patients and other pathologies.
Monitoring has also been activated in hospitals such as the Barros Luco. There they detail that there is a “Covid Committee” which assesses indicators such as emergency consultations, bed occupancy and test reports on a day-to-day basis. With everything, Luis Castillo, head of the Critical Patient Unit, assured that Income flows will be optimized, with a supply of highly complex beds, “which will remain operational and duplicated, considering a possible increase in patient demand.”
A similar plan details the director of the Carmen de Maipú hospital, Juan Kehr. “If we find an increase in the number of cases in the coming weeks we are prepared to move to an Orange state, which implies an increase in complex or critical beds, with greater availability of mechanical ventilation ”.
Meanwhile, in the southeastern sector of the capital, the Sótero del Río -which absorbs a large part of the demand in that area- its director, Gonzalo Menchaca, details that during the last four weeks, and with a greater slack from the pandemic, they have provided days of rest for health officials who have been on the “front lines” since March. This, in order to be prepared for the regrowth “without thinking about specific dates, at any moment the epidemiological curve can go up.”
From the Ministry of Health, the minister Enrique Paris He maintained that “the pandemic has not completely subsided and we have to be alert” during September 18. Likewise, he proposed a mechanism to facilitate the traceability plan, which consists of tracking the environment of positive cases of Covid-19. “We want to propose that people who have family parties, write down the number of people, name and telephone, in the event that there is an intra-family contact, we can contact them.”
Meanwhile, the Undersecretary of Public Health, Paula Daza, said that “we are making a call to hold this party with great responsibility” and that “quarantined communes should be kept in quarantine.”
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