[ad_1]
“Although we have managed to reduce the wait for covid patients in line from 16 per day to seven on average to access ICU beds, the orange alert in the health system remains, given the high occupancy of the units, which it makes refer patients to neighboring regions of the Valley that have availability ”.
This was assured by María Cristina Lesmes, Valle’s Health Secretary, who indicated that so far they have found availability in Cauca, Risaralda, Caldas and Quindío through a humanitarian route established by the Ministry of Health, but that sometimes patients and their relatives refuse to access, given the remoteness and difficulties that displacement implies.
The official said that this week 17 patients appeared waiting for a bed, of which 11 achieved places in the ICU of neighboring departments, but that in the end only one decided to be referred.
“We have tried to open the beds, but that has lowered the standard; for example, this week we had to take three patients out of the Valley: one to Risaralda and two to Cauca. But we have also opened the capacity by receiving medicines that we need and many clinics gave us on loan ”, indicated the Secretary of Health.
Lesmes added despite the fact that at the beginning of the pandemic the Valley achieved a solidarity bag of ICU to expand the capacity to 1,143 beds, more than 100 have had to be closed due to the lack of supplies, which present cost overruns not only in the Valley but also in the country, given its severe shortage. This has meant that the department has to invest $ 4.4 billion to buy these drugs, mainly sedatives and anesthetics.
“Given the refusal of relatives or patients to be referred from outside, they lose their priority to give it to whoever is behind. This has implied that these people have to wait twelve hours or more to receive a place within the department, ”said the official.
Read also: Colombia prepares for the “most challenging year in the history of health,” according to Minsalud
In addition, he explained: “The institution where the patient is delivered some data to the Regulatory Center for Urgencies and Emergencies, CRUE, del Valle: such as age, what comorbidities they have, their general condition and risk indicators for health complications. Based on these data, we make a prioritization list, in whose first places are those who are most seriously ill. With regard to coronavirus, timely and rapid treatment is essential as a differentiating factor when responding to the health difficulties that the patient may present.
Midazolam, propofol and rocuronium are some of those sedatives and anesthetics that are urgent in ICUs not only in the department, so doctors have been forced to use other drugs that are not as effective for the seriously ill patient with covid, as he warned the internist Elías Vieda Sílva, representative in the Valley of the Colombian Association of Critical Medicine and Intensive Care, AMCI.
“The lack of these supplies does not prevent the intubation process as such, but it does make it impossible to couple the patient to the ventilator, keep him stable during the time that the infection process lasts during respiratory disturbance and have him completely relaxed. In addition, it would be impossible to pronation process (change of position of the patient in bed to improve oxygenation) ”, explained Sílva.
For the representative of AMCI in the Valley, the call of the regional authorities to refer covid patients to other departments due to the lack of beds is a “desperate measure but that in situations of public calamity it is necessary to implement.”
The internist added: “In two weeks we will be able to see how much the impact has been on the growth of the cases of covid patients, as a result of the wasteful situation in recent days. If the ICUs reach 100% occupancy, the situation would become completely unsustainable. And to speak of an expansion of the units leads to having more medicines, which are very scarce in themselves ”.
In turn, Fabián Andrés Rosas, national president of the Colombian Association of Emergency Medicine, ACEM, explained that unlike the first wave, in which the services only cared for covid patients, on this occasion those injured by accidents also coincide traffic, people with critical pathologies, etc., which ends up overwhelming the medical capacities, already exhausted in the face of the increasing epidemiological curve.
“Although some hospitals overflowed at the time, there were resources and supplies. Not now, since there is a lot of requirement for them by various types of patients. That is why, in addition to the fact that ICU beds are not infinite, it is impossible to close the doors to critical and non-critical patients in the emergency units, ”said the emergenciologist.
In fact, the Valley Health Secretariat recommended that citizens go to emergency services only when their situation puts their health and life at risk.
Even so, the Director of the ACEM affirmed: “Although the authorities tell us that they are in charge of administering the ICUs, when it comes to looking for places it is quite difficult, given that the response of some cities only allows to have a maximum of four beds available or much less, especially if they have closed the spaces that were initially enabled as a hospital, such as Bogotá with Corferias ”.
Finally, Rosas urged that the National Government and the localities rethink the impact that the economic opening may have at this time, given the imminent rise in contagion indicators.
Pay for availability
For two more months the payment for availability of intensive and intermediate care units for patients with Covid-19 was extended throughout the country, as ordered this week by the Ministry of Health through Resolution 2476 of 2020.
“With this, the recognition of the advance payment for availability to public and private IPS is extended, corresponding to the months of November and December 2020,” said the Deputy Minister of Social Protection, María Andrea Godoy Casadiego.
In this sense, seven months of the advances are already completed. It should be noted that between June and October $ 289 billion were paid to insurers, while for November and December it is expected to recognize an additional $ 183 billion.
For his part, Miyerlandi Torres, Cali Health Secretary, assured that the city continues with an ICU occupancy rate of 88% for covid patients and 90% in general.
“We continue with the de-escalation of the occupation, strengthen ground logistics when it is necessary to move patients to other cities and we hope that the Ministry will be distributing the medicines from tomorrow (today),” Torres added.
[ad_2]
