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Doctors warn that Madrid is heading "in slow motion" for a repeat of its Covid "atomic bomb" crisis


Doctors have warned that Madrid is heading "in slow motion" for a repeat of its Covid "atomic bomb" crisis in March.

Spain has averaged more than 10,000 new cases per day for the past week, the worst numbers in Europe and the fifth highest infection rate in the world.

Almost a third of the sick are in Madrid, which scares the capital's medical professionals after taking the brunt of the European spring outbreak – Spain has the highest per capita death rate on the continent.

On September 4th, Madrid recorded 4,852 cases, the highest number of infections in a single day, and the city today has an R-rate of 1.08 – any number greater than one means the contagion is multiplying.

A graph of daily coronavirus cases in Madrid shows a sharp increase since the beginning of August with larger peaks than in March – although tests have since increased

The R rate in Madrid is 1.08 - any number above 1 is considered harmful to public health as it means that contagion increases as it spreads

The R rate in Madrid is 1.08 – any number above 1 is considered harmful to public health as it means that contagion increases as it spreads

Although the numbers need to be offset by Spain's increased testing capacity compared to the first outbreak, the surge affects medical professionals.

"It's like March in a way, but in slow motion," said Dr. Carlos Velayos, who works as an intensive care doctor in the public hospital in the suburbs of Fuenlabrada.

The hospital is expanding its intensive care capacity from 12 to 24 beds by the end of September as all of them are currently filling up with coronavirus patients.

EUROPE'S DAILY CHIRURAVIRUS CASES

SPAIN: 10.140

FRANCE: 8,684

RUSSIA: 5,559

UNITED KINGDOM: 3,286

UKRAINE: 2,953

* All figures are based on the last reported seven-day average

With 1,281 patients in intensive care units on Wednesday, Spain has roughly the same number of beds for treating serious COVID-19 patients as France, the United Kingdom, Germany and Italy combined.

And 359 of them are in the Madrid region, which accounted for around a third of the national average of 8,200 new infections per day last week.

Spain's virus caseload of over 600,000 is one of the highest in the world and more than 30,000 have died in the country from the new virus.

Velayos said predictive models were telling Madrid hospital administrators that some intensive care units could reach maximum capacity in the second half of September. Little or nothing has been done, however, to avoid returning to extended shifts for many health professionals still recovering from the stress of the first wave of the pandemic.

"In March it was like an atomic bomb that brought down the entire health system in a matter of weeks," said Velayos. “We may not be there yet, but that's nothing not to worry about. We have allowed the outbreaks to become uncontrollable. & # 39;

The health workers are better prepared this time around as they learn how to treat incoming patients more effectively and they have the means to better protect themselves from contagion. However, operating theaters in the Madrid area of ​​6.6 million people are already being converted into intensive care units and operations have been postponed as hospitals compete to recruit professionals for the expanded capacity.

Regional authorities say the health system still has room to manage the flow of incoming patients, but following warnings from medical staff like Velayos, officials are now responding with tougher measures that could include selective lockdowns in parts of the city as early as next week.

The five countries with the highest average number of daily cases in the past week in Europe

The five countries with the highest average number of daily cases in the past week in Europe

Current infection rates in Europe, according to the European Center for Disease Control (ECDC), with Spain and France among the hardest hit countries in the recent recovery

Current infection rates in Europe, according to the European Center for Disease Control (ECDC), with Spain and France among the hardest hit countries in the recent recovery

The restrictions, if finally passed, will focus on urban areas where the coronavirus is spreading faster, officials said on Wednesday. These are suburbs like Fuenlabrada, but also working-class neighborhoods in the south of Madrid, where the infection rates have risen steadily since August.

They are also areas where less affluent residents, and mostly migrant families, crowd into small apartments and use public transport to travel to other areas of the Spanish capital for manual labor.

COUNTRIES THAT REPORT THE LATEST CASES / DEATH REPORTS EVERY DAY

CASES

India: 93,199

US: 38,897

BRAZIL: 31,599

ARGENTINA: 10,960

SPAIN: 10.140

DEATHS

INDIA: 1,162

US: 854

BRAZIL: 808

Mexico: 456

ARGENTINA: 207

* All figures are based on the last reported seven-day average

Ángela Cantos lives in the Vallecas neighborhood, one of the hot spots of the recent wave of eruptions. She said if her neighborhood is locked, "Madrid will be paralyzed".

"Who will cook and clean in other districts when they close here?" She said.

The region's deputy head of health, Dr. Antonio Zapatero said on Wednesday: "Madrid want to flatten the curve ahead of the arrival of autumn and the complications that the cold weather could bring." The "drastic measures" will be decided by the weekend.

Zapatero also said that people have relaxed their protections by holding large gatherings, often forgetting about social distancing or masks. He also announced that police will monitor compliance with mandatory self-isolation, as it has been found that at least 90 people are skipping quarantines after testing positive for the new virus.

The country brought the contagion under control earlier this year with a three-month lockdown, one of the strictest anywhere. Since the restrictions were eased in mid-June, the outbreaks have spread across the country.

The Spanish government says the country is now doing more testing and that more than half of those newly infected have no symptoms. However, health centers have increasing problems dealing with the number of virus tests required and responding to patients. Currently, 8.5% of beds in the country treat COVID-19 patients in hospitals, but only one in five beds in Madrid.

Regarding intensive care units, official data shows that 38% of beds in the area have coronavirus patients, although some hospitals are already 90% busy before they put in place emergency plans for new beds like they did in the spring.

& # 39; Madrid maintains a constant level of infection but we need to consider the impact of the pandemic in primary care in hospitals, which is currently completely sustainable. But we have to ensure that this line of infection decreases, ”said Zapatero, who was commissioned in March with the Madrid makeshift hospital with 1,500 makeshift beds in an exhibition center.

This time the officials hope they don't have to get to that point. The regional government is spending 50 million euros to build a massive new epidemic hospital with more than 1,000 beds by the end of October.

It also promises more primary care resources as health centers have now become the new bottleneck for affected citizens who may have contracted the virus.

In addition to most tests, front line doctors in Spanish health centers have now taken on the burden of contact tracing.

"The primary care problems didn't come from the last six months," said Dr. Olaya Muñoz who works in a health center in the heart of Madrid. "COVID was more stressful for a system that hadn't worked for at least a decade."

Muñoz finds time to talk while catching breath as she walks uphill to visit two elderly patients at home. After that, they expect more than 40 appointments at their community health center. Although she does most of them over the phone these days, she can't spend more than an average of six minutes per patient.

"The workload is just unbearable," she said.

Dr. María Cruz Martín Delgado, spokeswoman for the Spanish Association of Intensive Care Specialists Semicyuc, says a breakdown in primary care could not only result in more asymptomatic cases going undetected, but could also lead to more patients downstream, in and in hospitals Intensive care units.

What Martín wants is a clear protocol from the authorities at national and regional level on how to proceed.

"We need to know why we must turn down other patients because we doctors cannot take all responsibility again when we have to respond to an emergency when we don't have the resources," she said.

Velayos, the intensive care specialist from Fuenlabrada, said that the work overload in March and April was widely recognized by his colleagues as part of an exceptional situation that had to be dealt with with all the generosity of the world.

"But right now we're talking about a chronic situation where stress will be the norm and routine," he said.

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