Coronavirus in Colombia: transfer of ICU patients in the country – Other Cities – Colombia

Faced with the increase in victims and seriously ill people of covid-19 in the country, the Government and local leaders are taking contingency measures such as the transfer of intensive care patients to other regions, with greater availability of beds, to avoid the collapse of the hospital network.

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Bogotá – which faces the second peak of the pandemic with an ICU bed occupancy of 92.8 percent – will send patients, for now, to three cities on the Atlantic coast: Barranquilla, Cartagena and Santa Marta, which in the last 48 hours announced that they will receive about 30 seriously ill patients from Covid-19 from the capital.

With these transfers, Bogotá maintains a daily availability of 120 ICU beds for new patients in critical condition due to coronavirus.

Barranquilla, which has 45 percent ICU availability, has already received four covid-19 patients; Cartagena, where the occupancy reaches 62 percent, approved the separation of 10 beds; and Santa Marta, which has 45.9 percent ICU availability, will add another 10 places.

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In addition, Cundinamarca will continue to receive patients from Bogotá, and vice versa, due to a support agreement between the District and the department. In fact, this weekend in the Cundinamarca ICU system there were 23 patients from the capital. Other cities, such as Bucaramanga, received requests from Bogotá to refer patients. However, this request did not materialize.

Mayor Claudia López recalled that the transfer of critically ill patients is a national strategy and that, in fact, Bogotá is the city that has received the most critical patients from the coronavirus. He assured that since the ICU regulation began in the Emergency and Emergency Regulatory Center (Crue), 1,161 requests have arrived from 23 departments, of which the transfer materialized in 629 cases. Of these, 145 were in December and 73 so far in January. The patients have come from Cundinamarca (502), Boyacá (33), Meta (26), Tolima (20), Amazonas (9), Vaupés (7) and other parts of the country.

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Also, other regions are already transferring patients or are considering the possibility. The governor (e) of Antioquia, Luis Fernando Suárez, warned that they are studying the possibility of transferring ICU and medical personnel from the subregions that have less occupation (as is the case of the lower Cauca) to Medellín, where the intensive care units already in short supply.

Given the risks posed by the transfers of critical patients, there are considering the possibility of moving entire ICUs, including medical personnel, to the capital of the department.

“For a patient from Medellín who needs a bed, if there is no place to locate him, one option is to take him to Caucasia (under Cauca). But it is not easy to transfer a covid-19 patient, who may need to be intubated, so we are analyzing with the Ministry of Health the possibility of bringing these beds together with that human resource to hospitals in the metropolitan area, “said the president regional. This is possible, says Suárez, as several of the hospitals in this subregion have zero occupancy in ICUs.

In Valle del Cauca, although the department’s borders are still closed for the entry and exit of coronavirus patients (a decision that was made last week, there is internal transfer of patients. The main concern is to support the operational capacity of Cali, where the Ministry of Health reports a total ICU occupancy of 96.6 percent.

At the national level, the high occupancy of ICUs in Nariño (92.3 percent), Tolima (87.6 percent), Risaralda (85.8 percent) and other regions could lead their authorities to also take this route . In any case, health experts explain, these transfers logistically depend on the EPS.

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César Burgos, president of the Colombian Association of Scientific Societies (ACSC), says that the transfer is a necessary and normal matter. “Suggesting the forced displacement of critical patients to places where the resources they require are available is a constant that has been part of the fundamental right to health and that is why it is not strange that this happens” holds.

However, several sectors warn that although the increase in transfers is explained, in principle, by the increasing number of infections, there is also the responsibility of EPS that have not complied with the tests on time and that, even with a positive test in hand, they do not they follow up on cases, as some patients have reported. They also question that there was no increase in ICU beds in Bogotá, as announced. Given this, the Secretary of Health, Alejandro Gómez, responded: “In the first exercise, purely theoretical, that we shared with the public in March, we thought about a growth of up to 4,000 ICU beds. Before a month we had corrected ourselves and said that there were 2,000, because no city can grow infinitely in ICU beds ”.

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The relocation process

The transfer of a patient to another city depends on many factors. Jhonatan Bautista, an emergency doctor at Hospital El Tunal, warns that the first step in the process is to assess whether the patient is able to move by land or air. Then the alarms are turned on to search for territorial entities that can receive it. If this quota is achieved, notice is given to the EPS, on which, in essence, the final decision depends

“The EPS gets the medicalized ambulance and makes the transfer, which is sometimes done by medicalized air ambulance. All airplanes must be pressurized and emergenciologists or specialists in aerospace medicine go there, who are prepared to treat the changes that pressure can generate on the patient, ”he explains.

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BOGOTA, NATION AND HEALTH