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With a total of 1,739 new cases of covid-19 registered in the department and an ICU bed occupancy of 81.48%, the governor of Antioquia, Anibal Gaviria, decreed a new hospital red alert for the department.
“We had a two-hour meeting to make the decision (…), you can be sure that we will maintain all efforts to increase the number of Intensive Care Units in the department,” said the president in the middle of the announcement that was made. last night.
Although this is not the first time that Antioquia decreed the measure during the pandemic (see Parenthesis), Gaviria emphasized that at that time the system was not as prepared as it is today, but acknowledged that there are currently more levels of contagion.
Contrary to what would be believed, the hospital red alert does not in itself imply restrictions such as quarantines or closures, although they can be an incentive for the leaders to be motivated to decree new measures.
This is how he held it before THE COLOMBIAN, in previous days Leopoldo Giraldo, manager for the attention of the covid in Antioquia, who ruled out a quarantine for the next few days but asserted that, if necessary, “we will have to put people’s lives above and we will have to request the pertinent closures.”
However, as explained by the epidemiologist from CES University, Yessica Giraldo CastrillónThis alert means that there may be a collapse of the hospital system that would prevent the emergency from being attended.
“This measurement is like a traffic light: the color alert system indicates that according to the occupation you have, the risk of collapse begins.” Naranja, which is the state in which Antioquia has been sustained since last August 27, is a warning to try to maintain the system in optimal conditions and make intermediate decisions; Red, the new level that is entered, “is a reactive step with which we try by all means to lighten the system.”
Now, as explained by the internist and epidemiologist Juan Camilo DiazIn practical terms, the red alert goes in two directions: the first has to do with the restriction of all non-urgent procedures such as oral health services, cosmetic and outpatient surgeries, among others.
This allows beds and medical personnel to be freed up for use in covid care.
But at the same time, as it stands out Giraldo Castrillon, poses a risk for people with other diseases that must postpone their surgeries.
“At this time, what most worries us are cancer patients, in this disease the time in which the procedures are performed can be the difference between a good or a bad diagnosis,” he said.
And the second is related to the way clinics and hospitals are run. Normally these are directed internally and according to the directives of the IPS, however, with this measure what is done is that the Government takes the management of all its hospital capacity through its Regulatory Center for Emergencies, Emergencies and Disasters ( Crue), allowing control over ICU beds and who accesses them. “So what is tried is to guarantee that citizens who need to be interned can be cared for to overcome the crisis.”
Additionally, public and private IPS must activate their emergency plans and be clear about their expansion plan for human resources and services, this is key in case they are needed.
New positive cases of coronavirus and ICU occupation have grown simultaneously in recent weeks in Antioquia, even surpassing figures for Bogotá.
However, as recognized by the department’s health secretary, Lina bustamante, those increases were predictable because greater mobility of people meant more exposure to the virus and, therefore, more infections.
Due to these factors, the department has been on the verge of the hospital red alert since last October 13, when after five days in a row with the most abundant cases in the country (1,593), Bustamante He warned that the ICUs were about to reach 80% occupancy, and if they remained at that figure for three days, the measure should be decreed.
After that announcement, the occupancy in the department ranged between 75% and 83% without holding on to that last figure for more than a day. Regarding this, Gaviria said that the decision was made “because in the Metropolitan Area the occupation of ICU beds has been five consecutive days above 80%.”
Added to that, according to data from the Sectional Health Secretariat, in Antioquia there are 937 ICU beds enabled to receive covid patients, which are spread over 10 municipalities. Of those, half are over 80% (see: Infographic) and of the total beds, according to the latest report delivered by the Ministry of Health, 770 are occupied.
Regarding infections, there are three sub-regions that are of more concern because they present high levels of positives compared to the others: the metropolitan area of Valle de Aburrá, which concentrates 83.4%, Urabá in Antioquia with 5.5%; and the East, which comprises 4% of new cases.
The only clarity that Gaviria gave about new measures that help ease the ICU occupation, such as possible quarantines or partial closures, is that “each announcement will be made in due time.”
For now, the governor announced that good practices will be worked with the EPS to improve home care and that in the coming weeks it is expected to increase ICU beds.
What is known is that for this year the celebrations of October 31 are canceled. “We have 44 municipalities in our sights. I want to appeal to the responsibility of Antioqueños, who have the responsibility to take care of themselves, this is not the time for celebrations in houses or urbanizations with children, ”said Gaviria.
In that he agreed Yessica Giraldo, “What happens inside the ICU is only a reflection of what is happening outside,” said the expert while emphasizing that an increase in positive cases translates into more people who must access the health system.
“The responsibility lies with the leaders and the citizens, in not believing that this is okay and that we have a lot of time. It is necessary to take extreme measures to prevent the system from collapsing ”, he concluded.
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