Madrid hospitals begin to tremble one more summer. Professionals expected it because the situation is repeated every summer season in public health: close beds in the centers of reference and the staff is left under minimum by the holidays in the absence of replacements. The MATS union has already warned in a statement of the “saturation of the emergency” by the advent of the fifth wave of infections, milder but numerous and arriving at the gates of the emergency before the collapse of primary care. Cases are treated with fewer staff and there are also fewer beds available for admission. To this must be added, agree professionals, the consequences, in the form of advanced and serious diseases, a pandemic that left for later operations, tests and appointments with specialists. Waiting lists for surgeries have grown up to 3500%.
Madrid is the only community that delays the second doses of the vaccine.
“In the waiting room we have to discern between a possible heart attack, a lumbago or an earache. The last two could be treated in Primary, but only give telephone appointments and have to wait weeks for a face so come to the emergency and this is collapsed, “explains a worker of the Gregorio Marañón. In the emergency room of this hospital also come young people to make a PCR to the disbelief of the health while on Tuesday morning there were 90 patients awaiting admission. Some, without space in the boxes, they have had to be placed in the corridors of the observation area, where they have installed plugs in anticipation that the situation is repeated, describes the health, who prefers not to give his name.
Given the commotion of the image, workers say, have been given orders to put three beds per room to counteract the closure of plants in summer. At least 50 admission positions are not operational in this center. It’s not the only one. In La Paz, the time to go up to plant is already delayed more than 24 hours, according to the MATS union, because “there is nowhere to put the patients”. The Ministry of Health does not provide data on how many beds have been closed this summer. UGT estimates that will be about 2,300 until October, 20% of the total.
Hospitalizations by COVID began to increase in the region on July 8 with a change in theThe trend is extensive to the whole of Spain. That day there were 394 people admitted because of the virus. The number reached 745 on Monday. The fifth wave, however, is not measured at the moment through this parameter because the cases are less severe by age.
The number of infections and the incidence rate takes better the pulse of what is happening: those diagnosed on average per week draw an upward curve since early July. On day 1 were counted 621 weekly average and the figure goes by 3,055 on the 19th of the same month.
The rate of infected per 100,000 inhabitants stands at 467 in the last 14 days, according to the latest data update. Three weeks ago, it was less than 100. However, Madrid is not the region with the highest proportion and the rate is far from the exorbitant figures of other times when vaccination was not so advanced. All the territories of Spain are on the rise and the most worrying situations are currently in Catalonia, Navarre and Castile and Leon.
Unions insist that the problem is not only the spike in infections, but the weak situation of the Madrid system each summer by the absence of reinforcements, which makes it much more vulnerable to saturation. Infections are milder because of the effects of vaccination and because they affect younger people, but numerous enough to put again in check the Primary Care, the basis of the health system in Madrid and the Achilles heel of the public service in the region governed by Isabel Diaz Ayuso.
Health centers are not being able to adequately care for patients not COVID and outpatient emergency, the so-called SUAP, remain closed since the beginning of the pandemic. “The more saturated primary care is, the more people go to hospitals, whether or not it involves admission. The tracking is already almost impossible,” says Julian Ordonez, secretary of Health UGT Madrid. MATS also denounces that the Ministry of Health has not incorporated just reinforcement staff this summer because they are using the 11,000 contracts COVID.
The Ministry of Health ensures that the situation is “stable” and under control. “The emergencies may have points or peaks of activity, which are being monitored.The increase in the number of Covid-19 patients requiring admission remains slight due to the vaccination campaign,” say sources from the department directed by Enrique Ruiz Escudero. The increase in patients Covid-19 requiring income remains mild due to the vaccination campaign,” say sources in the department led by Enrique Ruiz Escudero. On the reinforcements of staff, a spokesman responds that “the managements perform the necessary hiring in case of increased demand for care.
“If the base of the system does not work, it has a negative impact on the next step, which are the hospitals. In health centers we find people who go directly to the emergency room to avoid waiting or because they do not even pick up the phone in administration. They do not give enough,” sums up Mary Justice, head of Primary Care AMYTS. The health of outpatient clinics will assume, one more summer, agendas (appointments) of their colleagues who go on vacation and waiting times are shot “as never before in the history I had seen,” says Justice.
The situation, so far controlled, has not forced to take extreme measures such as suspending the holidays of health workers. Although in some places, such as the hospital of Móstoles, they still do not have it all with them. The center has reopened a plant for patients suspected of COVID and health workers suspect that beds can be reopened. With what staff would be attended? “The direction let fall that in some autonomous communities are already removing holidays”, say from Comisiones Obreras. For the Union, this “would be the final straw for the health, that they do not let them go on vacation”.
Professionals are exhausted because they do not end up seeing the light at the end of the tunnel after a year and a half at full capacity in conditions in many precarious situations. In the Gregorio Marañón, for example, are denying unpaid leave for care of minors or elderly. “They argue that there are no people to replace us,” says one of the people of staff to the day of these refusals.
This is also the first summer that apply new rules for taking paid leave to care illuminated by the need for staff to care for the sick of COVID. “Now they can only be taken once per child or per adult. If you took it last year, this systematically can not, even if only one month,” says Ordonez. UGT asked by letter to the Directorate General of Human Resources to reconsider this policy. Without success.
Data and graphics by Ana Ordaz.